(A1212) Impact of Hypoglossal Nerve Stimulation on Diabetes Control in Patients with Obstructive Sleep Apnea

Introduction: Hypoglossal nerve stimulation (HNS) has demonstrated efficacy in treating obstructive sleep apnea (OSA), but its impact on comorbidities such as diabetes remains underexplored. This retrospective study aims to assess the effects of HNS therapy on diabetic health outcomes in patients with OSA.

Methods: A retrospective review was conducted on patients who underwent HNS therapy between June 2020 and October 2024 at a single institution. The study included adult patients with moderate to severe OSA who were intolerant to CPAP. Patient demographics, baseline apnea-hypopnea index (AHI), and polysomnography (PSG) data were collected. In the subgroup of diabetic patients, changes in A1C, insulin dependency, and diabetes medication usage were assessed. Statistical analyses, including paired t-tests, were performed to compare pre- and post-intervention outcomes, with statistical significance set at P < 0.05.

Results: The study population consisted of 80 patients who were 66.3% male with a mean age of 57.28 ± 11.81 years, body mass index of 30.13 ± 4.17 kg/m2, and baseline apnea-hypopnea index (AHI) of 37.04 ± 17.19 events/h. A significant decrease in AHI was noted following HNS implantation at an average of 9-months post-op (mean change -20.65; P< 0.001). Of the 25% of patients diagnosed with diabetes, the mean A1C decreased from 6.60 ± 1.6 to 6.27 ± 1.2 (P = 0.27). Among the patients with insulin dependence prior to implantation, 50% were able to discontinue insulin use post-implantation. No trend toward a reduction in diabetic medication use was observed pre- and post- implantation. Additionally, BMI showed a mean reduction of 0.64 from a pre-op mean BMI of 30.65 (P=0.59).

Conclusions: Our findings illustrate the efficacy of HNS in significantly improving AHI while also suggesting a mild decrease in A1C. Furthermore, there was a trend toward improved diabetic control among patients who were insulin-dependent prior to HNS implantation. These results underscore the need for larger studies with longer follow-up to better understand the role of HNS in improving diabetic control and other OSA-related comorbidities.