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Objectives: This study aims to evaluate the efficacy of Apnex, Inspire, and ImThera hypoglossal nerve stimulation (HGNS) devices in changing the severity of obstructive sleep apnea (OSA)., Method: ology: A systematic search was conducted across the databases to collect baseline and postoperative outcome measures. Articles were then filtered and data from post-filtration was extracted. The efficacy of each device was assessed individually, and the reported outcomes were analyzed at short-term (≤1 year) and long-term (>1 year) intervals., Results: A total of 30 papers were included; 26 were single-arm studies encompassing 549 middle-aged overweight patients. Four RCTs included 273 participants. Results show that HGNS is an effective and safe treatment option. The Inspire device significantly improved, reducing the apnea-hypopnea index (AHI) by -20.14 events/h in the short term and -15.91 events/h in the long term. It also decreased the oxygen desaturation index (ODI) by -14.16 events/h (short term) and -12.95 events/h (long term). Patient-reported outcomes showed decreased Epworth Sleepiness Scale (ESS) scores by -5.02 (short term) and -4.90 (long term) and improved Functional Outcomes of Sleep Questionnaire (FOSQ) scores by 3.58 (short term) and 3.28 (long term). The Apnex and the ImThera devices featured similar improvements but to a lesser extent., Conclusion: Hypoglossal nerve stimulation is a safe and effective treatment for patients with OSA, exhibiting high adherence and satisfaction rates. However, it is important to note the potential for refining selection criteria to include a wider spectrum of patients with OSA., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)