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[Hypoglossal nerve stimulation for obstructive sleep apnoea; technique, indication and future prospects]
Patty E Vonk1,2, Linda B L Benoist3, Kristel M Kasius4
1OLVG, afd. Keel-, Neus- en Oorheelkunde/Hoofd-Halschirurgie, Amsterdam.
Nederlands Tijdschrift Voor Geneeskunde
|May 24, 2019
Summary
Upper airway stimulation (UAS) offers an alternative for obstructive sleep apnea (OSA) patients intolerant to CPAP. Hypoglossal nerve stimulation activates tongue muscles, opening the airway and increasing demand for this innovative OSA treatment.
Area of Science:
- Neurology
- Otolaryngology
- Sleep Medicine
Background:
- Continuous positive airway pressure (CPAP) is the primary treatment for moderate to severe obstructive sleep apnea (OSA).
- A significant portion of patients (1 in 3) experience CPAP intolerance or treatment failure.
- Upper airway stimulation (UAS) presents a viable alternative for these patients.
Purpose of the Study:
- To describe the technique, indications, and future prospects of hypoglossal nerve stimulation for obstructive sleep apnea.
- To highlight UAS as an alternative for patients with CPAP intolerance or failure.
Main Methods:
- Unilateral stimulation of the hypoglossal nerve.
- Activation of the genioglossus muscle to protrude the tongue.
- Pharyngeal airway opening via muscle activation.
Main Results:
- Hypoglossal nerve stimulation effectively opens the pharyngeal airway.
- UAS is a feasible alternative for CPAP-intolerant OSA patients.
- Reimbursement in the Netherlands since April 2017 has increased demand for UAS.
Conclusions:
- Hypoglossal nerve stimulation is a promising treatment for obstructive sleep apnea.
- UAS offers a valuable alternative for patients who cannot tolerate or fail CPAP therapy.
- The increasing demand suggests a growing role for UAS in OSA management.
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