Getting Started with Hypoglossal Nerve Stimulation: In-Depth Q&A for Better Sleep Quality

For those experiencing sleep problems and looking for alternatives to conventional treatment approaches, in this Q&A article, we will introduce you to the Hypoglossal Nerve Stimulation procedure, providing answers to all the major questions you may have. With a better understanding of the treatment, you can then decide on the most appropriate alternative for quality sleep.
 

Q.1 What is Hypoglossal Nerve Simulation?

Hypoglossal nerve stimulation is a treatment for obstructive sleep apnea where a small device is implanted under the skin in the chest area to stimulate a nerve under the tongue to prevent the tongue from blocking the airway during sleep.

 

Q.2 Who are good candidates for Hypoglossal Nerve Stimulation?

Good candidates for Hypoglossal Nerve Stimulation are those:

• with moderate to severe obstructive sleep apnea
• unable to tolerate continuous use of CPAP
• without neurological diseases
• with a body mass index (BMI) within the eligibility range
• passing a thorough evaluation by a specialist

Q.3 How does Hypoglossal Nerve Stimulation work?

A small device is implanted under the skin in the chest area and connected to the hypoglossal nerve, which controls the tongue muscles. Going to sleep, the patients can turn on the device with a remote control. The device then sends electrical pulses to the nerve controlling  the tongue movements, keeping the airway open throughout the night. When they wake up, they can turn off the remote control to deactivate the device.

 

Q.4 How long does hypoglossal nerve stimulation surgery take, and how long is the hospital stay required?

Typically a minor surgery, it takes no more than four hours under general anesthesia. After surgery, the patients need only an overnight stay in the hospital, after which they can return home and resume their normal daily activities.

 

Q.5 How long is the recovery period after hypoglossal nerve stimulation surgery? When is the device turned on?

It takes about 2–4 weeks for the surgical wound to heal and the implant-surrounding tissues to settle. Then a follow-up appointment is scheduled about one month after surgery for the device to be activated and programmed.

 

Q.6 How is hypoglossal nerve stimulation different from CPAP?

• Hypoglossal nerve stimulation is mask-free. With no need to deliver pressurized air into the mask to keep the airways open, it provides more comfort and allows more natural breathing pattern.
• Unlike CPAP, HGNS works silently.
• Implanted, HGNS is thus not obtrusive or cumbersome.
• It is ideal for those who cannot use CPAP or find CPAP inconvenient.

Q.7 Is hypoglossal nerve stimulation safe?

Approved by the US Food and Drug Administration as well as the Thai FDA, the device is safe and has been in use by a large number of patients worldwide.

 

Q.8 How long does the battery last?

The battery life of the device is approximately 10 years on average. When the battery runs out, the patient will need a minor surgery to replace the battery.

 

Q.9 Does hypoglossal nerve stimulation have any implications regarding MRIs?

There may be some limitations, depending on the device model. Some models may allow MRIs of certain areas. So, always let your doctor know before each MRI is performed.

 

Q.10 Can hypoglossal nerve stimulation be used in combination with CPAP?

Generally, with hypoglossal nerve stimulation in place, CPAP is not needed. However, in some cases, your doctor may consider using them together temporarily.

 

Q.11 Does hypoglossal nerve stimulation affect daily life?

You can continue with normal daily life as HGNS requires no dietary or physical activity restrictions.

 

Q.12 Is there a mobile application for hypoglossal nerve stimulation?

There is no mobile application for hypoglossal nerve stimulation for general users, but doctors can access usage data from the device.

 

Q.13 Can hypoglossal nerve stimulation completely cure sleep apnea?

Hypoglossal nerve stimulation devices do not offer a cure, but do provide better control of symptoms while in use by the patients.

 

Q.14 How much does hypoglossal nerve stimulation cost?

The cost of hypoglossal nerve stimulation is approximately 1.4-1.7 million baht, depending on the country and the hospital where implantation is performed.

 

Q.15 Is hypoglossal nerve stimulation available in Thailand?

Currently, it is available at some specialized hospitals, such as Bumrungrad International Hospital. If interested, please contact the Ear, Nose, and Throat Center at 02-011-3285 for a detailed consultation with Bumrungrad specialists.

 

Q.16 Can patients with other medical conditions undergo hypoglossal nerve stimulation implantation?

Those patients with certain neurological diseases like ALS or Parkinson's disease may not be good candidates for hypoglossal nerve stimulation.

 

Q.17 What happens if the battery in the hypoglossal nerve stimulation device runs out?

If the battery runs out, the device will stop working and sleep apnea symptoms may return. Patients will need to undergo surgery to replace the battery.

 

Q.18 Can the hypoglossal nerve stimulation device be removed?

It can be removed surgically, but always consult a doctor before making a decision.
 
If you have sleep problems, whether it's snoring, sleep apnea, or chronic insomnia, Bumrungrad International Hospital's team of sleep specialists is ready to provide consultation and address all sleep issues with their expertise and cutting-edge medical technology to help patients regain nightly quality sleep.
 
 
By Prof. Prof.Dr. Chairat Neruntarat