Aryan Shiari, MD; Hussam Z. Al-Sharif, MD; Ali A. Zaied, MD; Adel S. Zurob, MD; Christopher D. Williams, MD
WMJ. 2026;125(4):457-461. Published November 1, 2026.
ABSTRACT
Introduction: The objective of this study was to assess the safety, efficacy, and patient satisfaction of hypoglossal nerve stimulation (HNS) therapy as an alternative to continuous positive airway pressure therapy for obstructive sleep apnea in adults with intellectual and developmental disabilities (IDDs), including trisomy 21 and cerebral palsy.
Methods: We conducted an observational study of 4 adults with IDDs and moderate to severe obstructive sleep apnea who underwent implantation of an HNS device. Patient demographic characteristics, device usage, obstructive sleep apnea and daytime sleepiness outcomes, and patient satisfaction scores were retrospectively reviewed and analyzed.
Results: The mean adherence rate was 92.3%. The mean [SD] pretreatment apnea-hypopnea index was 39.0 [16.7] events per hour, which decreased to 8.5 [4.7] event per hour after treatment, representing a mean [SD] reduction of 77.5% [12.9%]. Epworth Sleepiness Scale scores decreased in 2 patients, were unchanged in 1 patient, and increased in 1 patient. Patient-reported satisfaction was high, with mean [SD] scores of 5.0 [0.0] for comfort, ease of deactivation, and effectiveness and 4.5 [0.6] for ease of activation.
Conclusions: Treatment of obstructive sleep apnea with HNS was associated with decreased apnea-hypopnea index values and was well tolerated among adults with IDDs, suggesting that it may be a viable alternative to continuous positive airway pressure therapy for patients who cannot tolerate conventional treatment. However, the variable Epworth Sleepiness Scale findings and small sample highlight the need for larger studies with long-term follow-up to further evaluate the safety and effectiveness of HNS in this population.