Hypoglossal Nerve Stimulator

Hypoglossal Nerve Stimulator

Hypoglossal nerve stimulator is a treatment to help with obstructive sleep apnea when continuous positive airway pressure (CPAP) has not worked. You, along with your ENT or sleep doctor, decide if this is the right treatment for you.

How the Implant Works

The ENT doctor places the hypoglossal nerve stimulator in surgery.

  • The device is placed under the skin during surgery (this is most often on the right side of your chest).
  • There are also two wires from the device. One is attached to the nerve that moves the tongue and the other is in the lower chest to detect breathing.

After surgery, the stimulator will help keep your airway open as you sleep. Here’s how it works:

  • You turn the hypoglossal nerve stimulator device on at bedtime with the remote control.
  • There is a delay time frame before the implant starts working so you can fall asleep. This delay is based on the amount of time you need to fall asleep.
  • Once the delay time frame is over, the device starts working. It triggers the nerve to make your tongue and other muscles move. This helps keep your airway open as you sleep.
  • The device has a set time to turn off in the morning, or you can turn it off with the remote.
  • View instructional videos by Inspire Medical Systems Inc.
  • For patient questions call 844-OSA-Help, option 3.

Risks

All surgeries have risks. The risks linked to having a hypoglossal nerve stimulator placed include:

  • Your obstructive sleep apnea does not improve.
  • Injury to the nerve in the tongue or lower lip.
  • Pneumothorax (air builds up in the chest, outside of the lung).
  • Infection at the incision site.

When to Call Your Doctor

  • A new fever higher than a 102° F
  • Incision site changes such as:
    • A large amount of swelling
    • Increased redness
    • Pus (yellow or green drainage)
  • Pain that does not go away with pain medicine

After Surgery Care

Diet:

  • Restart your normal diet as tolerated.

Activity:

  • Return to school, daycare or work when you can eat and drink your normal diet and no longer need pain medicine. This is most often five to seven days after surgery.
  • For two weeks after surgery:
    • Wear an arm sling on the arm near the implant (for example: if implant is under right chest, wear sling on right arm, or if the implant is under left chest, wear sling on left arm).
  • For four weeks after surgery:
    • Keep your right arm below your shoulder. Avoid activities that require arm or shoulder movement greater than 90 degrees.
    • Do not pick up anything weighing 5 pounds or more with your right hand.
    • No activities with your right hand such as running, jogging, lifting weights, sports, gardening, etc., or until cleared by the surgeon. 

MRI precautions:

There are two models of hypoglossal nerve stimulator made by Inspire:

  • Model 3028 (look on the back of your patient ID card) is safe for some MRI scanners:
  • MRI of the head, legs and arms
  • Look at the Inspire manual. 
  • It is safe to have CT scans, ultrasounds and X-rays.
  • Model 3024 is not safe for MRIs.
  • It is safe to have CT scans, ultrasounds and X-rays.

Medicines:

You may have some mild discomfort after surgery. To help with pain, discuss the following medicines with your doctor:

  • Acetaminophen (Tylenol), every four to six hours as needed
  • Ibuprofen (Motrin), every eight hours as needed
  • Roxicodone (Oxycodone), every six hours as needed, if the above medicines are not helping

Note: Do not take any aspirin or medicines with aspirin in them for seven days since they may cause bleeding.

Wound care:  

  • Keep the pressure dressing in place for 24 hours.
  • If needed for comfort, cover the incision with a small bandage until it is healed.
  • Keep the incision dry for 48 hours. You may shower after 48 hours.
  • Two times a day for 10 days:
    • Clean incision with warm soapy water.
    • Pat dry with soft cloth.
    • Put a small amount of antibiotic ointment.
  • You can use a cool compress for comfort.
    • Place a small towel or cloth over the incision.
    • Use ice or cool pack for 10 to 20 minutes every two hours as needed.
  • Do not use a hot compress or heating pads.
  • Use sunscreen over the healed incision for one year. 

Follow-up:

  • Clinic follow-up appointments are needed:
    • One month
    • Two months
    • Four months
    • Then your doctor will tell you when to return to clinic (this is most often one time a year).
  • Repeat sleep studies are needed to see what settings are best for you. These are scheduled:
    • One to two months after surgery
    • Then your doctor will tell you when to return for the next sleep study. This is most often at six months and again at one year.

Last Updated 10/2018

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