Ann Intern Med
Implanted nerve therapy improves sleep apnea in patients who can’t use CPAP
Clinical takeaway: For adults with moderate to severe obstructive sleep apnea (OSA) who cannot tolerate positive airway pressure therapy, proximal hypoglossal nerve stimulation may offer a safe and effective alternative.
Many patients with obstructive sleep apnea struggle to adhere to positive airway pressure therapy, prompting interest in device‑based alternatives. The multicenter randomized controlled OSPREY trial evaluated proximal hypoglossal nerve stimulation, an implantable therapy designed to improve upper‑airway patency during sleep.
The study enrolled 104 adults (mean age ~56 years) with moderate to severe OSA (baseline apnea–hypopnea index [AHI] ~35 events/hour) across 23 U.S. centers. Participants were randomized to immediate stimulation or delayed activation at seven months. The primary endpoint was achieving an AHI <20 events/hour at month seven.
At seven months, 58.2% of patients in the treatment group reached the primary endpoint, compared with no clinically meaningful improvement in the control group. Median AHI fell by ~18 events/hour among treated patients, with concomitant reductions in oxygen desaturation events. Improvements were also seen in patient‑reported outcomes, including a ~4‑point improvement on the Epworth Sleepiness Scale and better functional sleep scores. Benefits were maintained or further improved through 12 months of follow‑up.
Safety outcomes were favorable. No serious device‑ or procedure‑related adverse events were reported, and most treatment‑related events were mild, supporting the feasibility of this minimally invasive approach.
Investigators concluded that proximal hypoglossal nerve stimulation provides clinically meaningful and durable improvements in apnea severity, oxygenation, and symptoms, filling an important treatment gap for patients unable to use standard therapies.
Source: Malhotra A, et al. (2026, April 21). Ann Intern Med. Proximal Hypoglossal Nerve Stimulation for Obstructive Sleep Apnea in the OSPREY Study: A Randomized Controlled Trial