Hypoglossal nerve stimulation, or HGNS, is a non-invasive obstructive sleep apnea (OSA) treatment. This therapy, which involves implanting an electrode in the hypoglossal nerve, is intended to treat OSA in patients who cannot adhere to positive airway pressure. The results of this procedure have been promising, with several studies reporting a decrease in the incidence of OSA and subjective sleep complaints.
In addition to improving patient compliance, hypoglossal nerve stimulation has also been shown to have significant effects on respiratory parameters, reducing the incidence of sleep apnea. Furthermore, it can be tailored to the individual needs of a patient, allowing them to sleep more comfortably while keeping the airway open.
Hypoglossal nerve stimulation has been used successfully to treat a variety of patient populations, including those who have failed other therapies for obstructive sleep apnea. One recent case series reports the use of HGNS in adolescents with Down syndrome and obstructive sleep apnea. However, it is important to note that this is a preliminary study and additional studies are needed to confirm the results.
In one of the earliest studies, a 14-year-old boy with severe OSA received a HGNS device. After a short duration of stimulation, the boy was able to reduce his apnea-related arousals during sleep. At the same time, he was able to reduce his OSA-18 score. His tracheostomy was removed at the same time that he was able to use HGNS alone for OSA.
Another study in young children with DS used a selective stimulation technique to improve upper airway stability. They placed the stimulator near the genioglossus muscle and co-activated the retractors and protrudor muscles. The results of this study were not as promising as in adults. Nevertheless, this method has been a promising advance in treating obstructive sleep apnea in pediatric patients.
Surgical options for obstructive sleep apnea can be painful and have variable success rates. Surgical treatment for obstructive sleep apnea has undergone many changes over the years. The most commonly used surgical approach is the UPPP, or upper airway pharyngeal retractors. These devices are more effective in treating mild to moderate OSA.
However, adherence to continuous positive airway pressure is a major challenge in treating OSA. According to a study, it is estimated that about 40-60 percent of patients are not able to maintain adherence to the therapy. For this reason, hypoglossal nerve stimulation has been introduced. A handheld remote is used to activate the device before bed, and then it is switched off when the patient awakens. While this approach is comparatively simple, it is not always easy to adhere to, and it requires frequent adjustments.
Another option is a transcutaneous nerve stimulation. Patients are given a patch that is applied to the genioglossus muscles, which is the muscle that innervates the hypoglossal nerve.
Other options for obstructive sleep apnea treatment include the use of mandibular advancement devices. These devices can be effective in treating moderate and mild OSA. When compared to a CPAP treatment with CPAP machines, these devices are reportedly less invasive but still require anesthesia.
For more information about CPAP machines, CPAP devices, obstructive sleep apnea treatment and sleep study test, contact The Air Station Singapore:
The Air Station Pte Ltd
Address: 11 Lorong 3 Toa Payoh, Jackson Square, Block B #01-13, Singapore 319579, Singapore
