How Does an Implant for Sleep Apnea Work? (2025)

A hypoglossal nerve stimulation implant is a new treatment for sleep apnea. It replaces the traditional continuous positive airway pressure (CPAP) machine therapy in people who have not had success with CPAP.

How It Works

A hypoglossal nerve stimulator implant is a device surgically placed inside the body to treat obstructive sleep apnea. Inspire is currently the only brand approved by the Food and Drug Administration (FDA).

Obstructive sleep apnea is a condition that occurs in people with narrow throats. When sleeping, the muscles in the mouth and throat relax, causing the airways to become blocked. This leads to poor sleep quality and can increase the risk of several health conditions.

A hypoglossal nerve stimulator device sends a signal to the nerve under the tongue (hypoglossal nerve), which causes the tongue to move forward. This opens the airway, allowing the user to breathe more easily while sleeping.

The device is controlled by a remote and is only used when the person is sleeping. It is turned on when going to bed and has a delay feature that allows the user to fall asleep before the stimulator turns on.

Who Qualifies for Implant Surgery?

Several specific qualifications must be met for someone to qualify for hypoglossal nerve stimulator implant surgery.

These qualifications include:

• A body mass index (BMI) of less than 35
• Having no success or tolerance for CPAP devices
• A recent (within two years) sleep study
• Having 15 to 65 apnea-hypopnea index(AHI) events per hour
• Apnea episodes are predominantly obstructive (not central apnea)
• Endoscopy results that do not show soft palate collapse
• No other significant findings that would prevent adequate performance of the device

Risks and Side Effects

As with all surgeries, there are risks and potential side effects to hypoglossal nerve stimulator implants. Besides infection, which is the most common risk, the risks are:

• Bleeding
• Allergy to the implanted device
• Nerve damage
• Pain at the surgical sites
• Numbness at the surgical sites
• Pneumothorax (air that enters the chest and causes a collapsed lung)
• Pleural effusion (fluid that develops in the chest)
• Scar tissue around the implant
• The implant moving from the spot it was placed

Side effects of the nerve stimulator implant include:

• Dry mouth
• Awareness of the nerve stimulation
• Difficulty speaking or swallowing
• Tongue scraping the teeth

Estimated Implant Cost

The cost of the implant will vary from person to person based on their insurance coverage, co-pay, and deductible. Most insurance companies will cover part or all of the cost of the implant and follow-up visits if the patient meets the surgical requirements.

Estimated costs of the implant, surgery, and follow-up visits run about $30,000 to $40,000 before insurance coverage.

Day of Outpatient Surgery

Hypoglossal nerve stimulator implant surgery is an outpatient procedure performed under general anesthesia. It lasts about two to three hours.

The surgery requires three separate incisions.

To place the electrode, an incision of about 4 centimeters (cm) is made under the jaw. The electrode surrounds the hypoglossal nerve branches that control the tongue.

Then an incision below the collarbone to insert the generator.

How to Use the Implant's Remote

The implant will be ready to use approximately one month after insertion. At a follow-up appointment, the healthcare provider will activate it, adjust the settings, and show you how to use it.

Use the remote to turn on the device when going to sleep (including naps). When it is turned on, it will give a quick pulse to the tongue to confirm with the user it is on. After that, there will be a 30-minute delay (which can be made shorter or longer by a provider) to allow the user to fall asleep without stimulation.

Aftercare

After the procedure, the incision sites may be sore and painful. Rest for a few daysand follow postoperative instructions on when you can return to work and activities.

Contact a healthcare provider if any of the following occurs:

• Shortness of breath
• Fever
• Pain that is not controlled by prescription or over-the-counter medication
• Swelling, redness, or discharge from the incision sites
• Bleeding
  

Implant Expiration and Duration of Use

The implant's battery life is approximately seven to 10 years. In addition to battery use, the device can remain in the body for many years, and there is no known maximum time limit.

Summary

The only brand of hypoglossal nerve stimulation implant currently approved by the FDA in the United States is Inspire. This implant sends a signal to the nerve that controls the tongue to move it out of the way to allow adequate breathing while sleeping. The outpatient surgery to place the implant is approximately two hours and is often covered by insurance.