{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T16:32:13Z","timestamp":1787761933373,"version":"build-2784847793"},"reference-count":52,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T00:00:00Z","timestamp":1776643200000},"content-version":"vor","delay-in-days":19,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["OTO Open"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Obstructive sleep apnea (OSA) is linked to cardiovascular, metabolic, and neuropsychiatric morbidity. Continuous positive airway pressure (CPAP) remains first\u2010line therapy, but poor adherence limits effectiveness. Hypoglossal nerve stimulation (HNS) is an emerging alternative for CPAP\u2010intolerant patients. This study compared clinical outcomes between HNS and CPAP in OSA patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design<\/jats:title>\n                    <jats:p>Retrospective Cohort Study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>TriNetX Research Network.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We identified adults with OSA who underwent HNS implantation or initiated CPAP therapy, with 2 years of follow\u2010up. Propensity score matching (n\u2009=\u20093525 per group) balanced baseline demographics and comorbidities. Acute cardiovascular, respiratory, and metabolic outcomes were assessed from 30 days posttreatment to 2 years. A similar analysis was performed to compare health outcomes of HNS and uvulopalatopharyngoplasty (UPPP) surgery without future CPAP use.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The HNS cohort had significantly lower odds of stroke (odds ratio [OR] 0.626,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u2009.0085), myocardial infarction (OR 0.612,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u2009.0108), atrial fibrillation\/flutter (OR 0.594,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u2009.0001), hypertensive crisis (OR 0.456,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u2009.0274), pulmonary embolism (OR 0.209,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u2009.0001), ventricular tachycardia (OR 0.349,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u2009.0001), COPD exacerbation (OR 0.270,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u2009.0001), acute kidney injury (OR 0.283,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u2009.0001), ED visit (OR 0.457,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u2009.0001), hospitalization (OR 0.419,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u2009.0001), acute heart failure (OR 0.198,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u2009.0001), heart failure exacerbation (OR 0.221,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u2009.0001), acute respiratory failure (OR 0.172,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u2009.0001), and pneumonia (OR 0.255,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u2009.0001). Daytime sleepiness was more common in the HNS group (OR 2.019,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u2009.0001). HNS and UPPP cohorts displayed largely similar health outcomes.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>HNS may offer systemic benefits and reduce healthcare burden compared to CPAP. Future studies should incorporate adherence data and cost\u2010effective analyses to guide treatment.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/oto2.70240","type":"journal-article","created":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T10:16:41Z","timestamp":1776680201000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Clinical Outcomes of Hypoglossal Nerve Stimulation Versus Continuous Positive Airway Pressure in Obstructive Sleep Apnea"],"prefix":"10.1002","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-8881-8921","authenticated-orcid":false,"given":"Amala","family":"Nayak","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Virginia Commonwealth University School of Medicine Richmond PO BOX Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-6746-4824","authenticated-orcid":false,"given":"Iman","family":"Adibi","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Virginia Commonwealth University School of Medicine Richmond PO BOX Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8863-0573","authenticated-orcid":false,"given":"Alyssa","family":"Calder","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Virginia Commonwealth University School of Medicine Richmond PO BOX Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3396-0115","authenticated-orcid":false,"given":"Arman","family":"Saeedi","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Virginia Commonwealth University School of Medicine Richmond PO BOX Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-6243-276X","authenticated-orcid":false,"given":"Aaron","family":"Tucker","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Virginia Commonwealth University School of Medicine Richmond PO BOX Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6415-8948","authenticated-orcid":false,"given":"Ryan","family":"Nord","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Virginia Commonwealth University School of Medicine Richmond PO BOX Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,4,20]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrdp.2015.15"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1152\/physrev.00043.2008"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201307-1282ST"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/AIA.0000000000000354"},{"key":"e_1_2_8_6_1","unstructured":"CPAP for Prevention of Cardiovascular Events in Obstructive Sleep Apnea | New England Journal of Medicine. 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