Therapeutic electrical stimulation of the hypoglossal nerve in obstructive sleep apnea

Alan R. Schwartz, Marc L. Bennett, Philip L. Smith, Wilfried De Backer, Jan Hedner, An Boudewyns, Paul Van De Heyning, Hasse Ejnell, Walter Hochban, Lennart Knaack, Thomas Podszus, Thomas Penzel, J. Hermann Peter, George S. Goding, Donald J. Erickson, Roy Testerman, Frans Ottenhoff, David W. Eisele

Research output: Contribution to journalArticlepeer-review

248 Scopus citations


Background: Hypoglossal nerve stimulation has been demonstrated to relieve upper airway obstruction acutely, but its effect on obstructive sleep apnea is not known. Objective: To determine the response in obstructive sleep apnea to electrical stimulation of the hypoglossal nerve. Methods: Eight patients with obstructive sleep apnea were implanted with a device that stimulated the hypoglossal nerve unilaterally during inspiration. Sleep and breathing patterns were examined at baseline before implantation and after implantation at 1, 3, and 6 months and last follow-up. Results: Unilateral hypoglossal nerve stimulation decreased the severity of obstructive sleep apnea throughout the entire study period. Specifically, stimulation significantly reduced the mean apnea-hypopnea indices in non-rapid eye movement (mean ± SD episodes per hour, 52.0 ± 20.4 for baseline nights and 22.6 ± 12.1 for stimulation nights; P<.001) and rapid eye movement (48.2±30.5 and 16.6±17.1, respectively; P<.001) sleep and reduced the severity of oxyhemoglobin desaturations. With improvement in sleep apnea, a trend toward deeper stages of non-rapid eye movement sleep was observed. Moreover, all patients tolerated long-term stimulation at night and did not experience any adverse effects from stimulation. Even after completing the study protocol, the 3 patients who remained free from stimulator malfunction continued to use this device as primary treatment. Conclusion: The findings demonstrate the feasibility and therapeutic potential for hypoglossal nerve stimulation in obstructive sleep apnea.

Original languageEnglish (US)
Pages (from-to)1216-1223
Number of pages8
JournalArchives of Otolaryngology - Head and Neck Surgery
Issue number10
StatePublished - 2001
Externally publishedYes


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