New Study Shows Inspire Therapy Helps Reduce Hypoxic Burden

Inspire Medical Systems, Inc. participated in SLEEP 2026, the 40th annual meeting of the Associated Professional Sleep Societies (APSS) on June 14–17 in Baltimore, Maryland.

SLEEP is the premier global forum for sleep medicine and research, jointly hosted by the American Academy of Sleep Medicine (AASM) and the Sleep Research Society (SRS).

Advancing Innovation and Clinical Evidence

“We are pleased to return to SLEEP and showcase the continued evolution of the Inspire platform, including the Inspire V system, alongside compelling new clinical data demonstrating real-world effectiveness,” said Tim Herbert, Chairman and Chief Executive Officer. “Our long-standing partnership with SLEEP reflects our commitment to advancing physician education and improving outcomes for patients with OSA worldwide.”

At Booth #525, attendees explored:

• The Inspire V system and recent technology advancements
• Clinical evidence supporting closed-loop therapy detailing respiratory sensing and inspiratory overlap
• The Inspire SleepSync™ remote patient management platform
• Resources for establishing and scaling Inspire programs

Multiple presentations at SLEEP 2026 highlighted the growing body of evidence supporting Inspire therapy, particularly in improving cardiovascular risk markers. Separately, Inspire highlighted additional research at its exhibit booth, including recent peer-reviewed articles on hypoxic burden and cardiovascular outcomes, which complement these presentations and are not being presented as part of the SLEEP 2026 program.

The first article from Dr. Xu¹ is a secondary analysis from the STAR trial that demonstrated:

• Significant reductions in hypoxic burden, a key physiologic measure of oxygen desaturation linked to OSA risk
• Improvements in daytime sleepiness that correlate with hypoxic burden reduction, independent of AHI or arousal index changes
• Meaningful hypoxic burden improvements in at least 50% of AHI non-responders, supporting its role as a complementary biomarker
• Hypoxic burden is a measure of the total impact of oxygen desaturation events during sleep, integrating the depth, duration, and frequency of these events to quantify sleep apnea severity

These findings reinforce hypoxic burden as an emerging and clinically relevant endpoint and align with a growing number of studies evaluating cardiovascular outcomes in patients treated with Inspire therapy versus Continuous Positive Airway Pressure (CPAP) and untreated populations.

Mark Aloia, Ph.D., Head of Research at Inspire Medical Systems, Inc., and one of the authors of this independent study said, “The study demonstrates that STAR trial patients had a greater reduction in hypoxic burden than in AHI, which may result in less heart disease risk down the road. Many patients classified as HGNS non-responders according to AHI, showed a decrease from a high to a low percentage of hypoxic burden, potentially decreasing their risk for heart disease (based on previous hypoxic burden studies). This offers patients who were otherwise untreated or undertreated an opportunity to effectively treat their OSA and challenges the field to reconsider how we define treatment response in these patients.” ²

The second article from Dr. Nayak³ compared clinical outcomes between HNS and CPAP in OSA patients using data from the TriNetX database and compared a matched group of 3,525 patients in each group (CPAP and Inspire therapy).

• OSA is linked to cardiovascular, metabolic, and neuropsychiatric morbidity
• The hypoglossal nerve stimulation cohort had significantly lower odds of stroke, myocardial infarction, atrial fibrillation/flutter, hypertensive crisis, pulmonary embolism, ventricular tachycardia, COPD exacerbation, acute kidney injury, hospitalization, acute heart failure, and others
• Hypoglossal nerve stimulation may offer systemic benefits and reduce healthcare burden compared to CPAP

PREDICTOR Study Publication

Inspire also announced the publication of the PREDICTOR study⁴, which identified body mass index and neck circumference as predictors of complete concentric collapse. These findings suggest that many patients may be screened for Inspire therapy eligibility without requiring drug-induced sleep endoscopy (DISE), potentially reducing diagnostic burden, time to treatment, and healthcare costs.

1. Xu et al, Hypoglossal Nerve Stimulation and Hypoxic Burden in Patients with Obstructive Sleep Apnea – A Secondary Analysis of the STAR Trial; JAMA Otolaryngology Head Neck Surg. doi:10.1001/jamaoto.2026.1049 Published online May 21, 2026
2.  Xu J., Hajipour Z., Aloia M., Op de Beeck S., Vanderveken O.M., Huyett, P., Soose R., Dedhia R., Strollo Jr P., Azarbarzin A. (2026) Hypoglossal Nerve Stimulation and Hypoxic Burden in Patients With Obstructive Sleep Apnea: A Secondary Analysis of the STAR Trial. JAMA Otolaryngol Head Neck Surg.
3.  Nayak et al, Clinical Outcomes of Hypoglossal Nerve Stimulation Versus Continuous Positive Airway Pressure in Obstructive Sleep Apnea; OTO Open 2026, Vol. 10(2):e70240 April-June 2026
4.  Weiner et al, Anthropometric Measurements Inform Complete Concentric Collapse Status in Patients with Obstructive Sleep Apnea; OTO Open 2026, Vol. 10(2):e70245 April-June 2026

Mark Aloia, who is also an independent Health Psychology Consultant, has been employed by Inspire Medical Systems, Inc., as the Head of Research since September 2024.