SFRMS, SPLF and SFORL sleep medicine work-group
Hypoglossal nerve stimulation in the treatment of obstructive sleep apnea: Update on French practices and position paper of the SFRMS, SPLF and SFORL sleep medicine work-group
Abstract
To update practices for setting up, follow-up and indications in hypoglossal nerve stimulation in France.
Analysis of Medline, Cochrane and Embase databases (1970-2024), with assessment of techniques, follow-up modalities, results and side effects. Six physicians (3 ENT specialists, 3 pulmonologists, all involved in hypoglossal stimulation) took part in a work-group between January 2024 and January 2025.
Only one implant, Inspire IV, is available in France, indicated for non-obese (BMI<32kg/m2) patients with moderate-to-severe obstructive sleep apnea-hypopnea syndrome (OSAHS) (apnea/hypopnea index [AHI] 15-50/h), and failure of or contraindications for continuous positive airway pressure (CPAP) or mandibular advancement device (MAD). Prior drug-induced sleep endoscopy (DISE) is mandatory. Studies show a 68% decrease in AHI, 70% decrease in oxygen desaturation index (ODI) at 12months, and improvements in somnolence and quality of life, which seem stable at 36months. About 25% of patients experience side effects, which are mostly transient. Final set-up requires polysomnography; follow-up requires clinical examination and/or poly(somno)graphy.
This new alternative treatment in France should be proposed for symptomatic patients with failure of CPAP or MAD, rigorously screened in multidisciplinary centers.
Source and rights
Published by European annals of otorhinolaryngology, head and neck diseases, 2026. The guideline itself is at the source linked here.
Prognia summarises this guideline for reference and education. It is not medical advice. Always check the official guideline and current local protocols before acting on it.
