There’s no one-size-fits-all approach for managing sleep apnea. Continuous positive airway pressure (CPAP) has been the go-to treatment for almost 40 years, but doctors have realized that some patients are not able to tolerate a CPAP mask or keep up with CPAP treatment over time.
If you have a moderate or severe case of obstructive sleep apnea (OSA), treatment isn’t an option—it’s critical for your long-term health and well-being. That’s why doctors recognize the need for alternatives when treatments like CPAP are no longer an option.
Hypoglossal nerve stimulation (HGNS) is a newer approach to treating OSA that offers another way to keep your airway open during sleep. This handout explains some of the basics so you can talk with your doctor about whether it might be right for you.
Who Can Benefit from HGNS
HGNS is used for people with moderate to severe OSA who are unable to use CPAP or have been unsuccessful with CPAP. Indications, contraindications, and warnings differ by product. To determine if you’re a good candidate for one or both options, you’ll have a thorough evaluation that includes a sleep study and sometimes a special exam to look at the airway.
HGNS involves implanting a small medical device through a minimally invasive procedure. As more specialists become trained in HGNS, access to this newer treatment is expanding at hospitals and surgery centers across the country.
Since the first device received FDA approval in 2014, tens of thousands of patients have used HGNS to manage their OSA. In 2025, a second HGNS device gained FDA approval, providing more options for patients in the United States.
How HGNS Works
HGNS helps you breathe better at night by gently moving your tongue, so your airway stays open. When necessary, it sends a gentle signal to a special nerve in your tongue called the hypoglossal nerve. This keeps your tongue from blocking your airway so you can breathe normally during sleep.
The initial surgery to implant the device lasts about two to three hours under general anesthesia, and most people are discharged the same day or after an overnight stay. On average, recovery takes about one to two weeks.
To give your body time to heal, the device is not turned on right away. Typically, you’ll follow up with your surgeon within a week and a sleep doctor within one to two months. Once they’ve given the green light, you’ll be ready to start using the device. Your therapy will be optimized through follow-up visits as needed.
Everyday Life With HGNS
When you’re going to sleep, you will turn the device on—either with a smartphone app, or a remote or a wearable, depending on which model you’re using. At first, you may feel a slight pulling or tingling on your tongue. Most people get used to this feeling quickly.
Most patients see a difference in how they’re feeling and sleeping soon after activation. Over time, HGNS often becomes a natural part of the bedtime routine.
With regular follow-up care and support from your doctor, HGNS can be a powerful tool to help you sleep better and wake up ready for the day.
This patient primer is sponsored by Nyxoah, Inc., a medical technology company focused on development and distribution of innovative solutions to treat obstructive sleep apnea (OSA).
Source: SleepWorld Magazine Sept/Oct 2025
