Upper Airway Stimulation for Treatment of Obstructive Sleep Apnea

We proposed to describe hypoglossal nerve stimulation therapy of obstructive sleep apnea emphasizing the evidence for benefit and identifying patient selection factors foretelling of favorable outcomes. Hypoglossal nerve stimulation has proven to have lasting efficacy in the treatment of multiple aspects of obstructive sleep apnea including event frequency, nocturnal hypoxemia, sleepiness, patient quality of life, sleep architecture, and treatment adherence. Obstructive sleep apnea severity, pattern of pharyngeal collapse, weight, age, and previous surgery are cited predictors of hypoglossal nerve stimulation outcomes. Advances in science have honed the clinical and historical factors predictive of hypoglossal nerve stimulation therapy efficacy. Positive airway pressure therapy is the primary therapeutic modality for sleep apnea. However, some subjects given positive airway pressure fail to accept or reliably adhere to treatment. Hypoglossal nerve stimulation therapy can be offered as alternative in such cases. Science has identified clinical features predictive of efficacy.