Technical Considerations Following Implantation

The hypoglossal nerve stimulation system provides sleep apnea control and nightly usage when the stimulation is adjusted to meet the patient’s needs. During activation, respiratory sensing is checked and thresholds are set at standard electrode configurations. Follow-up contacts over the next few weeks are very important to ensure therapy adherence and to identify any treatment issues. Polysomnographic titration concentrates on therapeutic voltages, even in the supine position. In-lab polysomnography can be skipped as long as sufficient sleep apnea control is achieved and checked with a home sleep test in the setting of a good clinical response in terms of reduced daytime sleepiness and regular usage. If the latter is not achieved, even with the polysomnographic titration, advanced sleep lab adjustments are indicated in which the effects of modified electrode configuration and correct respiratory sensing are monitored.