Hypoglossal nerve stimulation is an important treatment option for obstructive sleep apnea, and its use is growing worldwide. Treatment success occurs in 60-70% of implanted patients, but this still leaves many patients classified as non-responders. While sleep medicine providers often assume a primary role in the initial care of patients treated with hypoglossal nerve stimulation, surgeons can play a key role in evaluation and additional treatment for non-responders. This interactive session will utilize cases and the audience response system, discussing the underlying anatomic and non-anatomic mechanisms for nonresponse as the basis for guiding treatment. The session will combine existing research with expert opinion and experience to provide attendees with a framework for making treatment decisions. The session will specifically address the therapeutic role of changes in hypoglossal nerve stimulation system system settings, revision surgery related to the system, additional pharyngeal surgery, and other conservative options (including medications, positional therapy, weight loss, positive airway pressure therapy).