{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T03:37:02Z","timestamp":1790307422051,"version":"4.1.0"},"reference-count":32,"publisher":"Springer Science and Business Media LLC","issue":"4","license":[{"start":{"date-parts":[[2025,7,18]],"date-time":"2025-07-18T00:00:00Z","timestamp":1752796800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,7,18]],"date-time":"2025-07-18T00:00:00Z","timestamp":1752796800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"National Institute of Health","award":["DC020262"],"award-info":[{"award-number":["DC020262"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sleep Breath"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Purpose<\/jats:title>\n            <jats:p>Evaluate patient phenotypes and longitudinal patterns of hypoglossal nerve stimulator (HGNS) use and identify predictors of long-term HGNS adherence.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>Patients who underwent HGNS implantation for obstructive sleep apnea (OSA) from 2017 to 2023 and had available data through 9 months post-device activation were included. Adherence rate was defined as percentage of patients using the device for at least 4\u00a0h for 70% of nights. Repeated measures ANOVA and Cochran\u2019s Q tests were used to analyze changes in HGNS use over time. A k-means clustering analysis was used to identify HGNS user subgroups with shared characteristics and associations with HGNS use.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>A total of 59 patients were included, with a mean (SD) age of 62.7 (11.2) years, mean (SD) body mass index of 28.5\u00a0kg\/m2 (3.2), and an average pre-operative apnea-hypopnea index (AHI) of 38.7 events\/hour; the majority were male (78%) and White (98.3%). Patients used their HGNS devices on average for 81.1% of nights (SD 23.5%) and 362\u00a0min\/night (SD 115), with 0.96 (SD 1.4) pauses\/night at 9 months post-activation. The mean percentage of nights and the time\/night used decreased significantly over the first 9 months (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001 for both), while pauses\/night increased (<jats:italic>p<\/jats:italic>\u2009=\u20090.008). The estimated adherence rate was 52.5% at 9 months. The cluster analysis revealed subgroups with shared characteristics; however, clusters were not associated with HGNS use.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>HGNS use appears to decrease over the first nine months after activation. Additional research is warranted to investigate drivers of HGNS use decrement. Given lack of a standardized definition for adherence, future studies should report more granular HGNS use metrics to facilitate comparison across studies.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1007\/s11325-025-03415-y","type":"journal-article","created":{"date-parts":[[2025,7,18]],"date-time":"2025-07-18T10:23:29Z","timestamp":1752834209000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Evaluating changes in hypoglossal nerve stimulator use over time and long-term adherence"],"prefix":"10.1007","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2126-6663","authenticated-orcid":false,"given":"Nicholas R.","family":"Lenze","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dania","family":"Alazawi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meghan","family":"Dailey","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Brown","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul T.","family":"Hoff","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cathy A.","family":"Goldstein","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,7,18]]},"reference":[{"issue":"14","key":"3415_CR1","doi-asserted-by":"publisher","first-page":"1389","DOI":"10.1001\/jama.2020.3514","volume":"323","author":"DJ Gottlieb","year":"2020","unstructured":"Gottlieb DJ, Punjabi NM (2020) Diagnosis and management of obstructive sleep apnea: A review. 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This study was approved by the University of Michigan Institutional Review Board (IRB #HUM00155002).","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval"}},{"value":"The data used for this study was de-identified and unable to be tracked to individual human subjects. The University of Michigan Institutional Review Board granted a Waiver of HIPAA Authorization for this project based on its retrospective, de-identified nature.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent"}},{"value":"No conflicts of interest. D. Alazawi: No financial disclosures or conflicts of interest. M. Dailey: No financial disclosures or conflicts of interest. C. Brown: No financial disclosures or conflicts of interest. P. Hoff: Dr. Hoff reports involvement on the Inspire Advisory Council, Cryosa safety monitor, and Nyxoah safety monitor. C. Goldstein: Dr Goldstein is a member of the medical advisory boards for Huxley Medical and Apnimed.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"249"}}