Treatment

Hypoglossal Nerve Stimulation

Key Points About Hypoglossal Nerve Stimulation

This is surgery to implant a battery-powered device in your child’s body to treat obstructive sleep apnea (OSA).
It stimulates the tongue muscle to help keep your child’s airway open as they sleep.
It is currently approved for children with Down syndrome age 13 and older with severe OSA.

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Frequently Asked Questions

What is hypoglossal nerve stimulation?

Hypoglossal nerve stimulation can address obstructive sleep apnea (OSA) when other treatments do not work or are not a good choice. OSA is common in children with Down syndrome, and the treatment is approved for eligible children.

Hypoglossal nerve stimulation works by preventing your child’s tongue from blocking their airway while they sleep. Doctors insert an implant under the skin of the chest with a wire electrode. The electrode gently stimulates a nerve under the tongue with each breath your child takes. As your child sleeps, the device stimulates the tongue nerve to gently move the tongue forward. This clears your child’s airway.

What are the benefits of hypoglossal nerve stimulation?

What are the risks of hypoglossal nerve stimulation?

Hypoglossal nerve stimulation complications are very rare. Risks are mostly temporary and may include:

Infection or bleeding from the surgery to implant the device
Allergy to the implant
Temporary discomfort from the nerve stimulation
Dry mouth
Sore or irritated tongue

Note: If your child needs an MRI in the future, it is important to let the radiologist know your child has an implanted device in place.

What happens before a hypoglossal nerve stimulation?

The first step is making sure hypoglossal nerve stimulation is a good choice for your child, since the device is not right for everyone. The doctor will ask you questions about your child’s sleep patterns and medications and want to know if your child has had a tonsillectomy or other procedure.

The doctor will examine your child and may schedule a procedure called drug-induced sleep endoscopy to see exactly what is happening in your child’s airway as they sleep.

If you and the doctor agree that the treatment is the best option for your child, you will work with the team to schedule surgery to have the device implanted in your child’s body.

What happens during a hypoglossal nerve stimulation?

Inserting the hypoglossal nerve stimulation device takes two or three hours. The surgery happens in a hospital operating room and involves several steps:

Your child is asleep under general anesthesia.
The doctor makes a small opening in the skin under your child’s jaw and gently moves muscles aside to reach a branch of the nerve under the tongue.
The doctor places a tiny electrode that surrounds the nerve branch like a cuff.
The electrode connects to the second piece of the device, the pulse generator disk, which lives under the skin of the chest and sends a gentle electric signal to the tongue nerve branch.
The doctor closes all the surgical openings, and your child is moved to recovery.

What happens after a hypoglossal nerve stimulation?

Once your child’s surgery areas have healed, you will return to the doctor to adjust the settings and learn how to operate the device.
You turn on the device at night or any time your child sleeps.
You and your child will return to get a sleep study to see how well it is working to control the OSA.
The device can stay safely in your child’s body. The battery is designed to last for many years and can be replaced with minor outpatient surgery.

How do I know if hypoglossal nerve stimulation is right for my child?

Departments That Perform Hypoglossal Nerve Stimulation

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Ear, Nose and Throat (Otolaryngology)

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