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Hypoglossal Nerve Stimulation in Patients With Obstructive Sleep Apnea



Hypoglossal nerve stimulation, or HGNS, emerges as an alternative therapy for patients with obstructive sleep apnea (OSA). It is a relatively new treatment option that can be used in patients who cannot tolerate continuous positive airway pressure (CPAP), or who have concentric collapse of the palate.



What Is HGNS?




HGNS is a sleep apnea treatment involving an implanted medical device developed by Inspire Medical Systems. As approved by the Food and Drug Administration (FDA) in 2014, HGNS stimulates the hypoglossal nerve in a rhythm synchronized with the breathing of patients with OSA.


HGNS electrical device implanted in the upper right chest that delivers pulses to the hypoglossal nerve. These pulses provide electrical stimulation to key muscles that assist with swallowing and breathing while sleeping.



Sleep Therapy Alternative




HGNS is recommended for sleepers who have failed or cannot tolerate treatment with positive airway pressure therapies, according to the FDA.


HGNS is considered a promising alternative for OSA. It can be used as a sleep therapy in both adults and children with sleep apnea. In most cases, it provides a significant improvement in upper airway stability and quality of life.



High Success Rate


Compared to conventional surgical options, HGNS has a low incidence of complications. Additionally, it has a high success rate, resulting in a decrease in apnea-hypopnea index (AHI) which measures the frequency at which people stop or reduce their breathing during sleep. This means that HGNS reduces the number of episodes per hour of sleep in those with OSA.



HGNS Effectiveness



HGNS is effective in patients with Down syndrome. HGNS works by activating the hypoglossal nerve, enhancing the tongue's protrusion and relieving nasopharyngeal collapse. HGNS can be an alternative to a tracheostomy, which can be quite invasive.


In addition to improving patient compliance, HGNS has also been shown to have significant effects on respiratory parameters, reducing the incidence of sleep apnea. Furthermore, it can be tailored to the individual needs of a patient, allowing them to sleep more comfortably while keeping the airway open.


Therefore, HGNS is a very promising therapy with very good long-term effectiveness and is very promising in patients with OSA. While the results of HGNS are promising, further studies are needed to determine if a threshold exists.




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