Updated German Sleep Society Guidelines

Includes Recommendation for Hypoglossal Nerve Stimulation Therapy for Subset of Sleep Apnea Patients

The German Society for Sleep Medicine (DGSM) has issued a written update to its sleep apnea treatment guidelines that now includes a recommendation for the use of hypoglossal nerve stimulation therapy in select sleep apnea patients who are unable to get consistent benefit from CPAP.  In the annually published DGSM guideline, hypoglossal nerve stimulation therapy received an “S3” classification which signifies the highest quality level of development methodology awarded by the Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften (AWMF).

The updated guidelines states: “Neural stimulation of the hypoglossal nerve can be used in patients who do not have any anatomical abnormalities and who have moderate to severe OSA if positive pressure therapy cannot be used under the above-mentioned conditions. It should only be used in patients with CPAP intolerance or ineffectiveness with an AHI of 15–50/h and an obesity severity level of ≤ I if no concentric obstruction has been documented.”

The guideline is based on a large body of clinical evidence which includes a multi-center study that demonstrated the efficacy of the treatment by a randomized therapy withdrawal and a multi-center German post-market study.  These studies have all shown consistent reductions in sleep apnea burden, clinically meaningful improvements in quality of life measures and high therapy adherence levels.

Click to view the updated guidelines


Click below to view peer-reviewed publications on Upper Airway Stimulation.

Feb 2017

Upper Airway Stimulation for Obstructive Sleep Apnea: Patient- Reported Outcomes after 48 Months of Follow-up

M. Boyd Gillespie, MD, MSc, Ryan J. Soose, MD, B. Tucker Woodson, MD, Kingman P. Strohl, MD, Joachim T. Maurer, MD, Nico de Vries, MD, David L. Steward, MD, Jonathan Z. Baskin, MD, M. Safwan Badr, MD, Ho-sheng Lin, MD, Tapan A. Padhya, MD, Sam Mickelson, MD, W. McDowell Anderson, MD, Olivier M. Vanderveken, MD, and Patrick J. Strollo Jr, MD; on Behalf of the STAR Trial Investigators

Link to Publication

Jan 2017

Outcomes of Upper Airway Stimulation for Obstructive Sleep Apnea in a Multicenter German Postmarket Study

Clemens Heiser, MD, Joachim T. Maurer, MD, Benedikt Hofauer, MD, J. Ulrich Sommer, MD, Annemarie Seitz, MD, Armin Steffen, MD

Link to Publication

Sep 2016

Single-Institution Experience and Learning Curve with Upper Airway Stimulation

Thaler ER, Schwab RJ

Link to Publication

Sep 2016

Selective Upper Airway Stimulation for Obstructive Sleep Apnea: A Single Center Clinical Experience

Clemens Heiser, Andreas Knopf, Murat Bas, Constanze Gahleitner, Benedikt Hofauer

Link to Publication

Sep 2016

The Role of Upper Airway Stimulation Therapy in the Multidisciplinary Management Approach of Obstructive Sleep Apnea in the Adult Patient

Karl Doghramji, MD: Maurits Boon, MD

Link to Publication