Hypoglossal Nerve Stimulation (HGNS) is an advanced treatment for Obstructive Sleep Apnea (OSA), which comprises a surgically implanted device that sends signals to the nerve of the tongue (hypoglossal nerve), to prevent the tongue and palate from blocking the upper airway during sleep. OSA is a condition where the muscles at the back of your throat relax too much during sleep, causing your airway to collapse. This leads to pauses in breathing, snoring, and poor sleep quality. Unlike traditional therapies like Continuous Positive Airway Pressure (CPAP) that require wearing a mask, HGNS is a small, implantable device that works from inside your body to keep your airway open.
This therapy can be considered for patients with moderate to severe OSA - in particular, patients who have struggled with other treatments such as CPAP therapy, dental appliances, or others. This therapy comprises a surgically implanted device that monitors breathing patterns and provides electrical stimulation/signals to the tongue nerve. This tongue nerve stimulation moves the tongue forward and keeps the airway open.
To learn more about HGNS therapy, watch: Hypoglossal Nerve Stimulation (HGNS) for Sleep Apnea - Things to know
How does HGNS Therapy work?
The device stimulates the hypoglossal nerve, which controls the muscles of your tongue, moving your tongue and palate forward to prevent it from blocking your airway. Patients undergoing HGNS Therapy turn on a remote before they go to sleep, with the device being programmed to start stimulation later (about 30 - 45 mins later) to allow time for patients to fall asleep before starting the stimulation. The device can also be paused and restarted if the patient needs to wake up in the middle of the night. HGNS works automatically, adjusting to the patient’s breathing patterns, allowing for uninterrupted, restful sleep without external equipment like masks or hoses.
Example of remote control for HGNS Therapy: Allows patients to turn on the device when going to bed, or pause and start therapy when they go to the toilet
Real-World Success Data
HGNS has been shown to be a highly effective treatment for moderate to severe OSA. Clinical trials and ongoing studies¹ reveal significant benefits, including:
In patient satisfaction surveys², over 85% of users are happy with the results and would recommend the treatment to others. This therapy has been particularly beneficial for individuals who cannot tolerate CPAP therapy.
Undergoing the Surgery
How is the HGNS Device Implemented?
The HGNS device is implanted during a minimally invasive outpatient surgery, typically lasting 2 to 3 hours. The surgery is performed under general anaesthesia to ensure patients are comfortable throughout the procedure. Here are the key steps of the procedure:
After surgery, patients are typically discharged the same day or after a short hospital stay, depending on your doctor’s recommendation.
Pulse Generator Placement
Possible Side Effects of Surgery and the Device
While HGNS is considered safe with overall risks less than 1% based on published data, there are some potential risks and side effects associated with the surgery and the device itself.
Your healthcare team will go through the side effects and complications of this surgery in more detail and guide you through it. Making appropriate adjustments can often improve your comfort and functionality.
Who is a Candidate for HGNS?
HGNS Implant therapy is generally recommended for adults with moderate to severe OSA who:
HGNS is not suitable for patients with severe neuromuscular disorders, allergies to device materials, or those with untreated, severe cardiac conditions. A thorough evaluation with your sleep specialist will determine if you are a good candidate.
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By understanding HGNS and its benefits, risks, and the procedure, you can make an informed decision. Speak with your doctor if you think HGNS could be the right solution to help you regain restful sleep and improve your quality of life.
The Department of Otorhinolaryngology – Head & Neck Surgery at Sengkang General Hospital provides a wide range of specialist services focusing on a wide range of ear, nose, throat, sleep apnoea, and head and neck cancer conditions.
The Sleep Medicine Unit at Sengkang General Hospital is a multidisciplinary sleep team helmed by Ear, Nose and Throat (ENT) surgeons, respiratory physicians, orthodontists, psychiatrists, psychologists and sleep technologists specialising in the diagnosis and management of a wide range of sleep disorders like obstructive sleep apnoea, snoring, insomnia, obesity hypoventilation syndrome, circadian rhythm sleep disorders, narcolepsy, parasomnias, and other sleep related movement disorders.
For appointments, contact us at 6930 6000 or email us at appointments@skh.com.sg.
¹ Strollo, P. J., Soose, R. J., Maurer, J. T., de Vries, N., Cornelius, J., Froymovich, O., Hanson, R. D., Padhya, T. A., Steward, D. L., Gillespie, M. B., Woodson, B. T., Van de Heyning, P. H., Goetting, M. G., Vanderveken, O. M., Feldman, N., Knaack, L., Strohl, K. P., & STAR Trial Group. (2014). Upper-airway stimulation for obstructive sleep apnea. The New England Journal of Medicine, 370(2), 139–149. https://doi.org/10.1056/NEJMoa1308659
² Thaler, E., Schwab, R., Maurer, J., Soose, R., Larsen, C., Stevens, S., Stevens, D., Boon, M., Huntley, C., Doghramji, K., Waters, T., Kominsky, A., Steffen, A., Kezirian, E., Benedikt Hofauer, Sommer, U., Withrow, K., Strohl, K., & Heiser, C. (2019). Results of the ADHERE upper airway stimulation registry and predictors of therapy efficacy. The Laryngoscope, 130(5), 1333–1338. https://doi.org/10.1002/lary.28286
The information provided is not intended as medical advice. Terms of use. Information provided by SingHealth.
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