• Fauziya Hassan and Neeraj Kaplish.
• Division of Pediatric Pulmonology, Department of Pediatrics, University of Michigan, Ann Arbor, MI; Michael S. Aldrich Sleep Disorders Center, Division of Sleep Medicine, University of Michigan, Ann Arbor, MI. Electronic address: fhas@med.umich.edu.
• Chest. 2021 Oct 1; 160 (4): 1406-1412.

AbstractUnilateral stimulation of the hypoglossal nerve may result in clinically valuable patency of the upper airway in well-selected patients for treatment of OSA. The Food and Drug Administration has established stringent criteria for the placement of this medical device. The treatment is a consideration among patients who have been nonadherent or intolerant of positive airway pressure therapy, with moderate to severe OSA, and a BMI of ≤ 32 kg/m2. Some of the insurance providers have lowered BMI guidelines to allow implantation in patients with a BMI of < 35 kg/m2. Further, a clinical assessment with sleep endoscopy is available to define proper anatomic features and to determine, based on the results, if the patients are appropriate surgical candidates. Current Procedural Terminology codes that are specific to the placement as well as removal or replacement of the device, or both, are discussed, as well as sleep medicine-related evaluation and management.Copyright © 2021 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

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