Hypoglossal Nerve Stimulator Implantation for Obstructive Sleep Apnea

Patient Selection Criteria

The Veterans Administration and Department of Defense Clinical Practice Guidelines recommend hypoglossal nerve stimulation therapy for patients with OSA with an AHI of 15-65/h and a body mass index <32 kg/m² who cannot adhere to PAP, with a weak recommendation 1
The American Academy of Sleep Medicine guidelines support surgical intervention, including hypoglossal nerve stimulation, as a secondary treatment for OSA when the outcome of PAP therapy is inadequate, such as when the patient is intolerant of PAP, or PAP therapy is unable to eliminate OSA, based on consensus 2

Drug-induced sleep endoscopy is important for determining appropriate candidates for hypoglossal nerve stimulation, as it can identify anatomical obstructions such as epiglottic obstruction 1

Untreated OSA can worsen cardiovascular disease, cerebrovascular disease, and diabetes management, making effective treatment urgent in patients with multiple comorbidities 2

Hypoglossal nerve stimulator implantation can potentially reduce OSA severity and associated symptoms, improve quality of life, and reduce cardiovascular risk associated with untreated OSA, although specific outcomes are not cited in the provided references 1