Related Experiment Video
Updated: Jul 2, 2025
In Vivo Evaluation of the Mechanical and Viscoelastic Properties of the Rat Tongue
Published on: July 6, 2017
Hypoglossal nerve stimulation over-titration
Melisa Chang1,2, Virginia Moore1, Kevin Eng1,2
1Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, California.
Abstract:
This case report reviews worsening obstructive sleep apnea (OSA) events in a patient over-titrated with a hypoglossal nerve stimulator. A healthy 57-year-old man underwent hypoglossal nerve stimulator implantation for moderate OSA. During an in-laboratory hypoglossal nerve stimulator titration the patient had improvement of his OSA at 2.1 V. However, a further increase of voltage resulted in worsening of obstructive events. The pathophysiology behind this finding is unknown but may result from unfavorable changes in the upper anatomy due to higher energy delivered to the hypoglossal nerve and surrounding structures. This high energy may also lead to genioglossus muscle fatigue. This finding highlights the importance of hypoglossal nerve stimulation titration with a dedicated sleep study.
Citation:
Chang M, Moore V, Eng K, Ryden A, Zeidler M. Hypoglossal nerve stimulation over-titration. J Clin Sleep Med. 2024;20(6):999-1001.
