Bilateral Hypoglossal Nerve Stimulation (BHGNS) therapy for sleep apnea

How BHGNS therapy works

BHGNS received FDA approval in August 2025, making it one of the most recently cleared treatments for obstructive sleep apnea. Adena is proud to be among the first providers in the region offering access to this technology.

Obstructive sleep apnea happens when the tongue and throat muscles relax during sleep and block the airway. BHGNS therapy addresses this directly by stimulating the hypoglossal nerve — the nerve that controls tongue movement.

A small nerve-stimulation device is placed under the chin through a single tiny incision. During sleep, the device delivers gentle, precise stimulation to both branches of the hypoglossal nerve, nudging the tongue forward slightly to keep your airway open at night. The stimulation it works on both sides of the tongue at once, which is a key difference from other nerve stimulation devices.

To power the implant, you wear a small patch on your chin at bedtime and clip a lightweight activation chip to it. The activation chip provides the power supply externally, which is what allows the implant itself to be completely battery-free. When you wake up, you remove the chip and patch.

If you have been told your sleep study shows central apneas or if your CPAP therapy is not fully resolving your symptoms, ask your Adena provider whether central sleep apnea may be a factor.

BHGNS vs. HGNS

Both BHGNS and HGNS are FDA-approved implants that treat obstructive sleep apnea by stimulating the tongue nerve. They work on the same principle but differ in design, placement, and clinical profile. Your doctor will help determine which is the better fit for you.

	Central sleep apnea (CSA)	Obstructive sleep apnea (OSA)
Battery inside the body	No	Yes
Incision location	Under the chin (single)	Near the collarbone
Nerve stimulation	Bilateral (both sides)	Unilateral (one side)
Full-body MRI compatible	Yes	Requires physician discussion
External component during sleep	Small patch on the chin	Remote control to turn on/off
Works with complete concentric collapse	Yes	No
AHI range	15 to 65	15 to 100
BMI threshold	35 or less	Under 40
FDA approved	August 2025	2014

One notable difference: BHGNS is designed to work in patients with complete concentric collapse at the soft palate, a condition that disqualifies patients from HGNS therapy. If you were previously told you did not qualify for HGNS, BHGNS may still be an option.

Who is BHGNS therapy for?

BHGNS is FDA-approved for adults with moderate to severe obstructive sleep apnea who have tried CPAP and found it did not work or they could not tolerate it. Your doctor will review your sleep study results, anatomy, and health history to confirm you are a good candidate.

Only doctor can determine whether BHGNS therapy is right for you. Contact Adena Sleep Medicine to schedule a consultation.

How it works

1

Before your procedure

Your sleep medicine team will review your sleep study, health history, and anatomy to confirm you are a good candidate for BHGNS. A drug-induced sleep endoscopy may be recommended to evaluate how your airway behaves during sleep before proceeding.

2

During your procedure

The BHGNS device is placed under the chin through a single small incision during a short outpatient procedure. The surgery is minimally invasive and performed by a surgeon trained in the technique.

3

After your procedure

Most patients go home the same day. The device is activated after a healing period of about two months. Your care team will work with you to fine-tune the stimulation settings to find what works best for your anatomy and sleep patterns.

Frequently asked questions

What is BHGNS therapy?

Is CPAP the only treatment for sleep apnea?

Are there other treatments for sleep apnea besides CPAP?

What is the newest treatment for sleep apnea?

How does BHGNS differ from HGNS?

Both are implants that stimulate the tongue nerve to treat obstructive sleep apnea, but they differ in design. BHGNS has no battery inside the body, uses a single incision under the chin, and stimulates both sides of the tongue nerve simultaneously. HGNS is placed near the collarbone and stimulates one side. BHGNS also works in patients with complete concentric collapse at the soft palate, while HGNS does not. Your doctor can help determine which is best for you.

How much does BHGNS therapy cost?

Is BHGNS therapy MRI compatible?

Yes. BHGNS is compatible with full-body MRI scans, including scans performed on both 1.5-tesla and 3-tesla machines, when specific safety conditions are followed. These numbers refer to the strength of the MRI scanner. This is a notable advantage over some other implant options. You should still let your MRI technician know that you have a BHGNS implant and bring your implant identification card to every MRI appointment.

What happens after the BHGNS implant is placed?

Can I qualify for BHGNS if I was told I do not qualify for HGNS?

Ready to explore a new option?

We are at the forefront of sleep apnea care in the region, and BHGNS therapy is one of the ways we are bringing the latest innovations directly to our patients. If CPAP has not been the right fit or you have questions about BHGNS therapy, our sleep medicine team is here to help. Call us to schedule a consultation and find out if you are a candidate.

Call Adena Sleep Medicine: 740-779-8700