Impact of Chronic Pain and Peripheral Neuropathy on Adherence to Hypoglossal Nerve Stimulation Therapy

Sunday, October 12, 2025

2:54 PM - 3:00 PM EDT

Location: 136

Disclosure(s):

Alison Y. Choi, BS:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Ryan J. Soose, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Rachel L. Whelan, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Thomas M. Kaffenberger, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: Hypoglossal nerve stimulation (HGNS) has emerged as a promising treatment for patients with obstructive sleep apnea (OSA). However, factors impacting adherence to HGNS therapy have not been thoroughly studied. This study seeks to explore how chronic pain and peripheral neuropathy may affect the willingness and ability of patients to maintain consistent use of HGNS therapy.

Methods: A single-center retrospective review of 229 patients with OSA who underwent HGNS implantation in 2011-2021 was performed. Patients with chronic pain and/or peripheral neuropathy diagnoses were identified and included. Demographics, sleep study data, and adherence data from device downloads and Sleep Sync were collected. Preliminary analyses was performed with nonparametric t-tests and chi-square tests using Prism 10.

Results: Of 229 patients, 53% (n=127) were found to have chronic pain or peripheral neuropathy at time of HGNS implantation. 36% had chronic pain (n=46), 13% had neuropathy (n=17), 47% had both (n=60). Mean age of control group was 71±11.2 years, 81% male, 96% white, and mean BMI was 28.3±3.4 kg/m2. Mean age of pain/neuropathy group was 67±10.1 years, 67% male, 97% white, and mean BMI was 30.3±3.6 kg/m2. Apnea-hypopnea index and Epworth Sleepiness Scale scores significantly decreased for both groups after implantation (p < 0.0001). Adherence to therapy after 3-6 months of implantation was significantly lower for the pain/neuropathy group at 6.2 hours/night compared to the control group at 7.4 hours/night (p=0.0007). Loss to follow up rate was 38.6% for control and 45.6% for pain/neuropathy group (p=0.28). There was a significantly greater proportion of females in the pain/neuropathy group than control (p=0.02).

Conclusions: Our preliminary results suggest that while HGNS is an effective treatment method in reducing OSA severity, having chronic pain and peripheral neuropathy may negatively impact adherence to therapy and lead to increased loss to follow-up. Additionally, female patients may be at higher risk for chronic pain and neuropathy, which should be taken into consideration when optimizing OSA treatment.

Presenting Author(s)

Alison Y. Choi, BS

Medical Student
University of Pittsburgh School of Medicine
Ann Arbor, MI, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Co-Author(s)

Ryan J. Soose, MD

Associate Professor
Univ of Pittsburgh
Pittsburgh, PA, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.
Rachel L. Whelan, MD

Assistant Professor of Otolaryngology
Childrens Hospital of Pittsburgh
PGH, Pennsylvania, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Senior Author(s)

Thomas M. Kaffenberger, MD

Assistant Professor of Otolaryngology
University of Pittsburgh Medical Center
Pittsburgh, PA, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.