Sleep apnea treatment
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A sleep apnea implant is an FDA-approved, surgically placed device for treating moderate to severe Obstructive Sleep Apnea (OSA) with upper airway stimulation. It targets the hypoglossal nerve, a nerve that controls tongue movement.

The newest type of sleep apnea implant uses proximal hypoglossal nerve stimulation (pHGNS) therapy. pHGNS is designed to improve upper airway function for a wide range of adult OSA patients, including those who can't or won't use positive airway pressure therapy, commonly called CPAP.

Sleep apnea implants use upper airway stimulation to treat Obstructive Sleep Apnea (OSA). A device implanted in the chest sends mild pulses to the tongue muscles during sleep. These pulses stimulate muscle movement and increase muscle tone, helping to keep your upper airway open while you sleep and allowing you to breathe better.

LivaNova's sleep apnea system has two main implantable components:

1. Generator: A battery-powered device implanted in the chest that sends mild pulses to the hypoglossal nerve (which runs under the tongue) to keep the airway open.
2. Stimulation lead: A thin, flexible connector links the generator to a soft band placed around the nerve that controls the tongue’s position, shape, and tone. The band has tiny electrodes that send signals to help move and tone the tongue.

Stimulation can be turned on and off through a hand-held controller, which also tracks sleep data and system usage data.

All sleep apnea implants use a type of upper airway stimulation called hypoglossal nerve stimulation (HGNS). There are two versions: pHGNS and dHGNS.

The p in pHGNS stands for proximal, which means closer to where the nerve starts. In this approach, the small contacts that send mild pulses are placed on the main part of the nerve before it branches out under the tongue.

The d in dHGNS stands for distal, meaning farther down the nerve. In this case, the contacts are placed on one of the smaller branches of the nerve, after nerve branching.

The proximal nerve trunk is easier to reach, which can mean a shorter, less invasive surgery. Stimulating the nerve trunk before it branches allows the therapy to influence all of the muscles controlled by the proximal hypoglossal nerve.

In addition, LivaNova’s pHGNS implant includes six electrodes, allowing for more precise targeting of the nerve trunk than systems with fewer electrodes.

About half of OSA patients can’t use or don't tolerate Continuous Positive Airway Pressure (CPAP). Proximal hypoglossal nerve stimulation (pHGNS) is a proven safe and effective treatment that can be an alternative for patients who cannot tolerate or are otherwise unable to continue CPAP.

More than half of people with OSA have worse symptoms when sleeping on their back.¹ Gravity pulls the tongue backwards into the upper airway, restricting airflow. 

Proximal hypoglossal nerve stimulation (pHGNS) can be used in any sleep position, including back sleeping. 

1. Positional therapy in the management of positional obstructive sleep apnea—a review of the current literature | Sleep and Breathing | Springer Nature Link

You might feel tingling or other sensations from pHGNS sleep apnea therapy. This varies between individuals and may decrease over time. The most commonly reported side effects for pHGNS patients are headache, implant site pain, ear pain, discomfort in the back of the mouth and throat, and difficulty swallowing. 

Insurance coverage for the pHGNS device can vary. Many insurance plans do cover hypoglossal nerve stimulation, but it depends on your specific plan and whether certain criteria are met.