Insomnia and Hypoglossal Nerve Stimulation

Purpose of Review Hypoglossal nerve stimulation (HGNS) use is rapidly increasing, yet factors remain that limit its overall adherence and treatment outcomes. This review explores the prevalence of insomnia in patients with HGNS, the effects of insomnia on HGNS treatment outcomes, and possible management options. Recent Findings Insomnia is present in approximately 26–57% of patients using HGNS with the highest prevalence in veterans. Insomnia may be a barrier to HGNS use and optimal treatment benefit. In those with insomnia, subjective benefit in daytime sleepiness, perceived sleep quality, and overall satisfaction with HGNS is less than in those without insomnia. The current data on optimal treatment of insomnia in those with HGNS is limited; however, CBT-I and pharmacologic therapy may have benefit. Additionally, the use of HGNS may improve insomnia in some patients. Summary Insomnia is highly prevalent in patients using HGNS and may negatively affect HGNS use and improvement in daytime symptoms. Screening for and treatment of insomnia in all patients prior to HGNS implantation and activation are recommended.