Tips to Live By

Hypoglossal Nerve Stimulation for Sleep Apnea: How It Works & Who Should Consider It

May 28, 2024 - Katie McCallum

If you've been diagnosed with obstructive sleep apnea, it's important that you take steps to effectively treat the condition.

"Sleep apnea doesn't just reduce sleep quality, it can have an impact on your relationships, productivity and even your overall health," says Dr. Mas Takashima, an ENT doctor specializing in sleep surgery at Houston Methodist. "Left untreated, sleep apnea can increase the risk of high blood pressure, type 2 diabetes, heart disease and more. It's one of the so-called 'silent killers' that should not be ignored."

The most well-known sleep apnea treatment is the CPAP machine, a device worn at night that uses continuous positive air pressure (CPAP) to help keep your airway open as you sleep. But some people find these devices bothersome to wear and cumbersome to travel with, to name just a few of the common complaints.

The good news: Other sleep apnea treatment options exist. There are many different surgical techniques that can help, and many people who have sleep apnea surgery may never need to use a CPAP machine again.

Still, the decision to undergo surgery can be intimidating. Fortunately, there's more good news here.

"Advancements in sleep apnea treatment have made new, less invasive surgical procedures an option for treating moderate to severe sleep apnea," explains Dr. Takashima. "As an alternative to traditional sleep surgery, certain individuals are candidates for a hypoglossal nerve stimulator."

How does hypoglossal nerve stimulation work to treat sleep apnea?

Obstructive sleep apnea occurs when muscles at the back of your throat relax so much when you sleep that they fail to keep your airway open, interrupting your breathing. This can happen throughout the course of the night or even while napping.

"Hypoglossal nerve stimulation helps correct this issue by stimulating your hypoglossal nerve, which is the motor nerve responsible for controlling several of the muscles in your tongue," explains Dr. Takashima.

This device, which is implanted in the upper chest via two small incisions, is only turned on while you're asleep. It works by detecting respiration and, each time you breathe, stimulating your hypoglossal nerve to push your tongue forward, opening up your airway.

"Hypoglossal nerve stimulation is proven to work remarkably well," Dr. Takashima says.

Clinical studies have demonstrated that people using hypoglossal nerve stimulation benefit from meaningful reductions in sleep apnea severity. More than half of participants experience at least a 50% reduction in apnea-hypopnea index (AHI), a measure of the average number of breathing difficulty events per hour of sleep. Studies also show resulting improvement in quality of life.

"In addition, it often eliminates the need to use a CPAP machine," adds Dr. Takashima.

Who's eligible for hypoglossal nerve stimulator?

Hypoglossal nerve stimulator is an FDA-approved device for people with sleep apnea who meet the following criteria:

  • Have moderate to severe sleep apnea (not mild)
  • Obstruction that occurs at the palate and/or base of the tongue
  • BMI less than 40


"About 30% of patients with moderate-to-severe sleep apnea aren't candidates because their collapse is on the side of throat," says Dr. Takashima. "Hypoglossal nerve stimulator increases the airway's front-to-back diameter, which isn't helpful if the obstruction is side-to-side or concentric."

How do you know if hypoglossal nerve stimulator is right for you?

If you're struggling to adhere to using your CPAP machine and are interested in hypoglossal nerve stimulation, talk to your ENT specialist.

He or she can assess the severity of your sleep apnea, examine your palate and tongue anatomy and advise on the other factors that affect eligibility for this procedure.

"We're here to help you understand if this procedure is right for you, specifically, and the benefits it may be able to provide you," says Dr. Takashima.

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Categories: Tips to Live By