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Patient selection criteria for hypoglossal nerve stimulation therapy

Patient selection criteria for hypoglossal nerve stimulation therapy
Parameter Criteria
Age 18 years or older
AHI 15 to 100 events/hour
BMI 40 kg/m2*
Central and mixed apneas <25% of total events
Drug-induced sleep endoscopy findings No complete concentric collapse of the velopharynx or soft palate
Failed or declined PAP therapy Yes

HNS: hypoglossal nerve stimulation; AHI: apnea hypopnea index; BMI: body mass index; PAP: positive airway pressure.

* Since most trials were conducted in patients with a BMI <32 kg/m2, most United States commercial insurances require a BMI <32 kg/m2, although Medicare coverage and coverage in Europe extends to patients with BMI <35 kg/m2.
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