Genio hypoglossal nerve stimulator
Genio criteria:
- >18yo
- BMI<35
- AHI 15-65/hr
- CPAP unsuccessful
- No severe neuromuscular disease
- No other sleep disorders, eg narcolepsy
- DISE can show AP or concentric collapse

Patient is a 38year old male who works in a shop and holds a driver's licence. He is longstanding OSA manifesting as frequent nocturnal wakening, morning headaches, and significant daytime somnolence. His partner has noted loud snoring. Positional change has not been of benefit. He was unable to tolerate CPAP despite trialling multiple mask types due to air leakage and claustrophobia. Mandibular advancement device did not prove beneficial. ENT review did not reveal any structural surgical targets.

His past medical history includes only hyperlipidemia for which he takes a statin and a past appendicectomy. He is an exsmoker of 12.5 pack years. He quit smoking earlier this year. He drinks 7.2 units of alcohol on average per week.

Polysomnography revealed severe OSA with AHI of 42.9/hr, ODI of 44.4/hr. He has BMI of 33.3 and ESS of 11/24. He was discussed in the sleep MDT and underwent drug induced sleep endoscopy, which showed multilevel collapse that improved with jaw thrust. He was deemed appropriate for Genio hypoglossal nerve implantation.