What is upper airway stimulation?

The Ohio State Wexner Medical Center is proud to be one of the few facilities in Ohio to offer upper airway stimulation—an innovative surgical treatment option for patients with obstructive sleep apnea who cannot tolerate other treatments, such as a CPAP machine. 

Upper airway stimulation uses an FDA-approved implantable device (similar to a pacemaker) to monitor a your distinct breathing patterns and provide the exact stimulation needed to contract your throat muscles and keep your airway open. Long-term studies show upper airway stimulation patients experienced:

  • A 78% reduction in sleep apnea events
  • Reduced snoring, with 85% of bed partners reporting no snoring or only soft snoring
  • Improved quality of life and daytime functioning

Upper airway stimulation is an option that works inside your body with your natural breathing process. It goes where you go, is easy to use and operates silently.

How does upper airway stimulation work?

With obstructive sleep apnea, the tongue or other soft tissue may block the airway, creating dangerous breathing problems during sleep. Upper airway stimulation uses an FDA-approved implantable device to deliver mild stimulation to the hypoglossal nerve to prevent the tongue from blocking the airway.
  • The upper airway device is implanted during an outpatient surgical procedure that typically lasts 60 – 90 minutes.
  • Two small incisions are made during surgery:
    – One under the chin to connect a wire (called a lead) to the nerve that controls the tongue
    – One below the collarbone to place the battery and the respiratory sensor
  • The device is not activated for a month after surgery to allow for full recovery. Patients may experience mild discomfort the first few days and some scarring, but most report minimal pain.
  • After one month, the patient returns to their sleep medicine physician at Ohio State to have the device activated and to set initial stimulation parameters.
  • The patient is then able to turn the device on and off using a handheld remote. The device can be set to start at an interval after the patient goes to bed (typically 30 minutes), allowing adequate time for the patient to fall asleep naturally.
  • Throughout the night, the device continually monitors the patient’s unique breathing patterns, issuing stimulation to the muscles of the tongue only when the patient inhales, thus reducing obstructive events.
  • Upon awakening, the patient simply turns off the device using the remote.

Some patients report mild twitching of the tongue during use, but this can be minimized by adjusting the stimulation settings. A follow-up sleep study helps each patient maximize the device’s effectiveness and appropriate stimulation levels. The device battery lasts about 10 to 12 years and can be replaced when necessary.

Click here to learn more about Dr. Eugene Chio and Inspire therapy.

Who is a potential candidate for this surgery?

  • Patients must be over age 18 with a confirmed diagnosis of moderate to severe obstructive sleep apnea.
  • Symptoms of obstructive sleep apnea include snoring, daytime sleepiness, irritability and difficulty concentrating. Left untreated, it can also lead to other health conditions such as high blood pressure, heart disease or stroke.
  • If you suspect but do not have a confirmed sleep apnea diagnosis, we will help you schedule the required sleep studies when you make your initial appointment.
  • The upper airway stimulation device might also be appropriate for those who have both obstructive and central sleep apnea, as long as the central sleep apnea episodes account for less than 25 percent of all disrupted breathing episodes.
  • Individuals should have a BMI of 32 or less, although we will work with patients on an individual case basis.

How do I get started? 

  • Schedule an appointment for a consultation with Dr. Eugene Chio by calling 614-366-ENTS (3687). 
  • All potential candidates for upper airway stimulation will need to have a physical examination and a sleep endoscopy.
  • An overnight sleep study is also required, although results from prior sleep studies may be used.
  • We will coordinate and help you schedule the test prior to your appointment with Dr. Chio if needed.

Before, during and after surgery

Before surgery: Are you a good candidate?

If you suffer from obstructive sleep apnea, you may be a candidate for upper airway stimulation, a surgical alternative that eliminates the need for a CPAP machine. Eugene Chio, MD, explains candidate criteria, how the procedure is performed and how the implantable device works.

During surgery: How upper airway simulation works

Eugene Chio, MD, explains upper airway stimulation and how the implant device works. 

After surgery: What to expect months after surgery

Individuals with obstructive sleep apnea can now come to The Ohio State University Wexner Medical Center for upper airway stimulation, a surgical treatment option that eliminates the need for a CPAP machine. Eugene Chio, MD, explains what to expect after the treatment.

More about our upper airway stimulation services

Two-incision approach to sleep surgery implant

Ohio State University Wexner Medical Center otolaryngologist Eugene Chio, MD, has implanted more upper airway stimulation devices than anyone in the world. Today, he does it with a two-incision approach he developed to shorten the procedure and healing time.

Freda's story: Upper airway stimulation for sleep apnea

Freda suffered from obstructive sleep apnea for 22 years before receiving upper airway stimulation therapy at The Ohio State University Wexner Medical Center. Freda explains how the procedure has improved her quality of life.

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