A medical system for obstructive sleep apnea (OSA) treatment includes therapy delivery circuitry configured to output one or more electrical stimulation signals to a tongue of a patient; sensing circuitry configured to sense one or more compound muscle action potential (CMAP) signals, wherein the one or more CMAP signals are generated in response to the delivery of the one or more electrical stimulation signals; and processing circuitry configured to: cause the therapy delivery circuitry to output the one or more electrical stimulation signals to the tongue; receive information indicative of the one or more CMAP signals from the sensing circuitry; determine, based on the one or more CMAP signals, one or more therapeutic stimulation parameters for the OSA treatment; and cause the therapy delivery circuitry to deliver therapeutic electrical stimulation signals according to at least the determined one or more therapeutic stimulation parameters.