0368 Prevalence of Insomnia in Patients with Hypoglossal Nerve Stimulation (HNS) at a Tertiary Care Sleep Center

Abstract Introduction Insomnia is a sleep disorder that may be under diagnosed and under treated. We reviewed insomnia type in patients who underwent implantation of Hypoglossal Nerve Stimulation (HNS). Hypoglossal nerve stimulation (HNS) is an efficacious option for treating obstructive sleep apnea although there is evolving literature regarding coincidental prevalence of insomnia in this select group of patients. Methods A retrospective, single-center, cohort study used medical records from Sept 2017- March 2023 of 144 participants (28% Female, n=40) with HNS. Analysis included insomnia diagnosis date, comorbidities, and the insomnia type. Effective OSA mitigation was defined by 15 AHI or 50% reduction from baseline AHI and AHI is 20 with HNS device. HNS adherence and device usage was reviewed at 90 days and 180 days. HNS compliance was assessed using SleepSync™ software. Results Of the 144 participants, 30 adults had insomnia (21%). Of the type of insomnia, Psychophysiological (33%, n=10), Sleep onset (27%, n=8), and Sleep maintenance (17%, n=5) were the most frequently diagnosed. Psychophysiological insomnia was unmasked in 33% of the patient after HNS implantation while sleep onset insomnia was reported prior to HNS implantation in 24% of the patients. In the psychophysiological group, 3 patients tolerated HNS after treatment of insomnia although five patients were lost to follow up and two patients had their HNS explanted. The group with psychophysiological insomnia had an increase of pauses on their HNS device at 180 days compared to at 90 days. Conclusion Of the 144 participants, 30 adults had insomnia (21%). Of the type of insomnia, Psychophysiological (33%, n=10), Sleep onset (27%, n=8), and Sleep maintenance (17%, n=5) were the most frequently diagnosed. Psychophysiological insomnia was unmasked in 33% of the patient after HNS implantation while sleep onset insomnia was reported prior to HNS implantation in 24% of the patients. In the psychophysiological group, 3 patients tolerated HNS after treatment of insomnia although five patients were lost to follow up and two patients had their HNS explanted. The group with psychophysiological insomnia had an increase of pauses on their HNS device at 180 days compared to at 90 days. Support (if any) None