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Hypoglossal Nerve Stimulation

Obstructive sleep apnea treatment

For decades, the most popular treatments for sleep apnea were CPAP and BiPAP machines. Surgery has always been an option as well, but the attention hasn’t been as intense as it is now with the newest surgical procedure. If you have obstructive sleep apnea and haven’t found a solution that works best for you, you might want to consider hypoglossal nerve stimulation.

Hypoglossal nerve stimulation is a new obstructive sleep apnea treatment that involves surgery to place a device inside the body.

What Is the Hypoglossal Nerve?

The throat is somewhat similar to a tube (for breathing, speaking, and swallowing) that is surrounded by muscles.  During sleep, muscles in the body relax, creating a situation where there can be blockage of breathing in the throat.  The hypoglossal nerve is the main nerve that controls tongue movement. Stimulation of this nerve can move the tongue forward, opening the space for breathing in the throat.

What Is Upper Airway Stimulation?

The only hypoglossal nerve stimulation system that is approved for sale in the United States by the Food and Drug Administration is Upper Airway Stimulation from Inspire Medical Systems. There are four parts to this new sleep apnea treatment:

Implanted Pulse Generator: This is the main unit, somewhat similar to a pacemaker, that delivers the stimulation signal to the hypoglossal nerve.

Stimulation Lead: The stimulation signal is delivered to the hypoglossal nerve through the stimulation lead.

Sensing Lead: This measures breathing patterns that prompt the system to send the signal to move the tongue forward when a patient is breathing in, which is when they need to open the space for breathing.

Remote Control: The control allows a patient to adjust the system slightly and turn the system on and off, as well as pause it. This gives them the freedom to have the system work only when they’re sleeping.

Research on Hypoglossal Nerve Stimulation

Studies have shown that patients with sleep apnea who respond best to Upper Airway Stimulation share similar characteristics. One,their body mass index is no greater than 32 kg/m2. Two, they all share certain findings on a short evaluation procedure called drug-induced sleep endoscopy. 

Body mass index is a measure reflecting body weight and height, and a value of 32 is approximately 235 pounds for someone who is 6 feet tall. Drug-induced sleep endoscopy is performed in the operating room, with the goal of learning more about what is causing blockage of breathing in the throat in someone with obstructive sleep apnea.

Conclusion

While more research needs to be done on hypoglossal nerve stimulation, the newest obstructive sleep apnea treatment, this first system (Upper Airway Stimulation) seems to be worth considering. If you are looking for a new sleep apnea treatment, consult your doctor to find out whether hypoglossal nerve stimulation could be the right option for you.

Dr. Eric Kezirian

Inspire and Upper Airway Stimulation are trademarks of Inspire Medical Systems, which is not affiliated with this website.

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