Live Recordings (Sleep Medicine Trends 2026)-07 Comparing and Contrasting Implantable Devices for OSA

Video Transcription

Video Summary

Jason Yu, an ENT surgeon and sleep-medicine specialist at Emory, reviews implantable neurostimulation for obstructive sleep apnea (OSA), focusing on Inspire and the newly FDA-approved Nyxoah Genio. Both target the hypoglossal nerve, a surgically accessible pure motor nerve that activates tongue muscles, especially the genioglossus, to dilate the upper airway.<br /><br />Inspire, with over 100,000 implants, has evolved from a three-incision system with a rib sensor to newer versions with fewer components and improved sensing. Patients use a handheld remote; programming includes voltage, timing features, and (newer models) ramping. Clinical trials (STAR and follow-up data) show meaningful AHI reductions, though ~20% may not respond, requiring optimization or adjuncts (e.g., positional therapy, nasal treatment, oral appliance, weight loss/GLP-1s).<br /><br />Genio uses a single submental implant that stimulates both hypoglossal nerves, but its power source is external and taped under the chin nightly, controlled by a phone app. Its DREAM trial showed AHI and oxygen-desaturation improvements similar to Inspire, though with higher dropout.<br /><br />Key differences include unilateral vs bilateral stimulation, internal vs external battery, incision number, respiratory sensing approach, and MRI compatibility. Future devices (e.g., LivaNova) and alternative nerve targets are under study.

Keywords

obstructive sleep apnea

hypoglossal nerve stimulation

Inspire implant

Nyxoah Genio

implantable neurostimulation

apnea-hypopnea index reduction

genioglossus activation

respiratory sensing

MRI compatibility