Hypoglossal Nerve Therapy

What is Hypoglossal Nerve Therapy?

Hypoglossal Nerve Therapy, also known as upper airway stimulation, is a surgical treatment for adults with moderate to severe obstructive sleep apnoea (OSA) who are unable to use or do not benefit consistently from continuous positive airway pressure (CPAP) therapy.

It uses a small implantable device to provide mild electrical stimulation to the hypoglossal nerve, the nerve that controls tongue movements. This stimulation helps maintain an open airway while you sleep.

How It Works

The therapy involves placing a small device under the skin of the chest and connecting it to the hypoglossal nerve that controls tongue movement. A separate breathing sensor is placed between the ribs to monitor your natural breathing pattern. The device delivers gentle electrical pulses to the hypoglossal nerve in rhythm with your breathing. This causes the tongue and other airway muscles to move forward, preventing the soft tissues of the throat from collapsing and blocking airflow.

You control the device with a handheld remote that is turned on before sleep and turned off when you wake up. The stimulation occurs automatically throughout the night based on your breathing pattern, providing support only when it is needed.

Who is Hypoglossal Nerve Therapy Suitable For?

Hypoglossal Nerve Therapy may be considered when:

You have been diagnosed with moderate to severe obstructive sleep apnoea (typically assessed by a sleep study).
You have difficulty using or obtaining consistent benefit from CPAP therapy.
Your body mass index is within a range considered suitable by the specialist.
You are aged 18 years or older and meet other specific anatomical and clinical criteria determined by your ENT specialist.

A thorough evaluation including airway assessment and sleep study results helps determine eligibility for this therapy.

What to Expect

Hypoglossal Nerve Therapy is performed as a surgical implantation under general anaesthesia:

The procedure typically takes two to three hours and is performed on an outpatient basis, allowing most patients to go home on the same day.

After healing, which usually takes several weeks, the device is activated and tailored to your specific breathing needs by your specialist.

1

A small generator is implanted beneath the skin in the upper chest.
2

A breathing sensor lead is placed between the ribs to detect your breathing pattern.
3

A stimulation lead is positioned around the hypoglossal nerve near the tongue.

Is Hypoglossal Nerve Therapy Right For You?

Hypoglossal Nerve Therapy offers a promising alternative for patients who cannot tolerate CPAP or for whom CPAP has not provided adequate relief. A detailed assessment at My ENT Specialist can help determine whether this therapy is suitable for your sleep apnoea profile.

Benefits of Hypoglossal Nerve Therapy

Hypoglossal Nerve Therapy aims to:

Reduce sleep apnoea events, including breathing pauses and shallow breaths during sleep.
Improve sleep quality by maintaining an open airway without the need for a mask or tube.
Lower snoring intensity in many patients.
Provide a discreet solution without external CPAP equipment.

Many patients report improvements in daytime alertness, sleep quality and overall quality of life after the treatment.

Recovery and Follow Up

After surgery, mild discomfort or swelling at the incision sites is common and resolves over days to weeks.
Your specialist will schedule follow-up visits to activate the device, fine-tune its settings, and review your progress.
Regular monitoring helps ensure optimal therapy and addresses any questions or adjustments needed.

Considerations and Potential Risks

Like any surgical procedure, Hypoglossal Nerve Therapy involves potential risks and considerations:

Temporary discomfort around the implant or stimulation site.
Mild tongue weakness or changes in tongue sensation that usually improve with time.
Device-related effects such as mouth dryness or tongue abrasion in some patients.
As with any implantable device, battery life is finite and may require replacement in future.

Your specialist will discuss potential benefits and risks based on your individual condition before any treatment decision is made.

Frequently Asked Questions

1. Will I still need CPAP after Hypoglossal Nerve Therapy?

In most cases, the implant is intended to reduce or eliminate the need for CPAP, particularly for patients who struggle with its use.

2. How long does the procedure take?

The implantation usually takes two to three hours and is done under a general anaesthetic.

3. When can I start using the device after surgery?

The device is typically activated several weeks after the surgery once the implant site has healed, and settings are adjusted for comfort and effectiveness.

4. How long does the battery last?

The device battery is designed for long term use, often lasting many years. When the battery runs low, a minor procedure can replace it.

5. Is the device noticeable?

Once healed, the implanted components are not visible externally. You control the device with a handheld remote that is simple to operate.

Next Steps

If you are living with moderate to severe obstructive sleep apnoea and find CPAP difficult to tolerate or not effective, Hypoglossal Nerve Therapy may be an option. Contact My ENT Specialist for a full assessment and personalised discussion about this therapy.