{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T20:07:22Z","timestamp":1778011642629,"version":"3.51.4"},"reference-count":37,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2019,12,14]],"date-time":"2019-12-14T00:00:00Z","timestamp":1576281600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2020,9]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>The hypoglossal nerve stimulator (HNS) is an effective treatment for obstructive sleep apnea (OSA) in a relatively healthy subset of the population. Our aim was to determine the efficacy of HNS in a veteran population with a high incidence of chronic disease and mental health disorders. Our secondary aim was to compare subjective outcomes and adherence between veterans with and without mental health disorders.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We included all patients who underwent HNS at our institution to date. Veterans were divided into two groups based on whether or not they carried a diagnosis of anxiety, depression, and\/or post\u2010traumatic stress disorder. Demographics, comorbidities, previous OSA treatments, adverse events, and adherence to therapy were recorded. Baseline and treatment outcome data were collected and analyzed including polysomnographic parameters, Epworth sleepiness scale score (ESS), and body mass index.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Thirty\u2010one patients were identified: 93.5% male, median age = 63.0\u2009years. Median apnea hypopnea index (AHI) decreased from 30.0 to 3.0 events\/hour (<jats:italic>P\u2009&lt;<\/jats:italic> .001) and median ESS dropped from 11.0 to 6.5 (<jats:italic>P\u2009&lt;<\/jats:italic> .001). There was no difference between groups with regard to change in AHI or ESS (<jats:italic>P\u2009=<\/jats:italic> .31 and .61). Twenty\u2010six (89.7%) patients achieved surgical success (decrease in AHI\u2009&gt;\u200950% and AHI\u2009&lt;\u200920 events\/hour) and 21 (72.4%) had AHI\u2009&lt;\u20095 events\/hour. The mean device usage was 5.4 hours\/night which was not significantly different between groups (<jats:italic>P\u2009=<\/jats:italic> .55).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Our cohort exhibited similar declines in AHI and ESS compared to published studies with adequate adherence to HNS. There were no significant differences in ESS or adherence to therapy between veterans with and without mental health disorders.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>4 <jats:italic>Laryngoscope<\/jats:italic>, 130:2275\u20132280, 2020<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.28422","type":"journal-article","created":{"date-parts":[[2019,12,14]],"date-time":"2019-12-14T11:59:23Z","timestamp":1576324763000},"page":"2275-2280","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Hypoglossal Nerve Stimulation in Veterans with Obstructive Sleep Apnea"],"prefix":"10.1002","volume":"130","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0536-8886","authenticated-orcid":false,"given":"Kathleen M.","family":"Sarber","sequence":"first","affiliation":[{"name":"Division of Pulmonary Medicine Cincinnati Children's Hospital Medical Center  Cincinnati Ohio U.S.A."},{"name":"Division of Pediatric Otolaryngology Cincinnati Children's Hospital Medical Center  Cincinnati Ohio U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katherine W.","family":"Chang","sequence":"additional","affiliation":[{"name":"College of Medicine University of Cincinnati  Cincinnati Ohio U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Madison V.","family":"Epperson","sequence":"additional","affiliation":[{"name":"College of Medicine University of Cincinnati  Cincinnati Ohio U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4300-5146","authenticated-orcid":false,"given":"Meredith E.","family":"Tabangin","sequence":"additional","affiliation":[{"name":"Division of Biostatistics and Epidemiology Cincinnati Children's Hospital Medical Center  Cincinnati Ohio U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mekibib","family":"Altaye","sequence":"additional","affiliation":[{"name":"Division of Biostatistics and Epidemiology Cincinnati Children's Hospital Medical Center  Cincinnati Ohio U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0997-9692","authenticated-orcid":false,"given":"Stacey L.","family":"Ishman","sequence":"additional","affiliation":[{"name":"Division of Pulmonary Medicine Cincinnati Children's Hospital Medical Center  Cincinnati Ohio U.S.A."},{"name":"Division of Pediatric Otolaryngology Cincinnati Children's Hospital Medical Center  Cincinnati Ohio U.S.A."},{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University of Cincinnati  Cincinnati Ohio U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Reena","family":"Dhanda Patil","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University of Cincinnati  Cincinnati Ohio U.S.A."},{"name":"Department of Otolaryngology Cincinnati Veterans Affairs Medical Center  Cincinnati Ohio U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2019,12,14]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.5665\/sleep.5972"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1525-1497.2006.00526.x"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12890-017-0393-7"},{"key":"e_1_2_6_5_1","unstructured":"HenryM MahatheyA MorrillT RobinsonA ShivjiA WattR. 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