№ lp_1_2_16463
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Evidence-based assessment summarizing clinical outcomes, safety findings, and procedural classifications for hypoglossal nerve stimulation in the treatment of moderate to severe obstructive sleep apnea, drawing on published studies and health authority reviews.
Year:
2017–2021
Medical field:
Sleep medicine
Condition:
Moderate to severe obstructive sleep apnea
Intervention:
Hypoglossal nerve stimulation
Procedure codes:
64582, 64583, 64584
Type of document:
Evidence review and policy summary
Reviewing bodies:
NICE; VbBS; HERC
Last review date:
November 2021
Study types included:
Systematic review; randomized controlled trial; prospective and retrospective case series
Number of studies:
7
Total patients:
326
Geographic context:
United Kingdom; United States
Regulatory context:
Clinical governance and payer policy assessment
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The product description is provided for reference. Actual content and formatting may differ slightly.
Year:
Not specified
Region / City:
Not specified
Topic:
Obstructive sleep apnea treatment
Document Type:
Medical information sheet
Organization / Institution:
Richard L. Roudebush VA Medical Center Sleep Medicine Program
Author:
Richard L. Roudebush VA Medical Center Sleep Medicine Program
Target Audience:
Patients with obstructive sleep apnea
Period of Effectiveness:
Not specified
Approval Date:
Not specified
Modification Date:
Not specified
Year:
2017
Region / City:
United States
Topic:
Obstructive Sleep Apnea, Commercial Motor Vehicle Drivers, Medical Certification
Document Type:
Medical Examination Recommendation
Organization:
Federal Motor Carrier Safety Administration (FMCSA)
Author:
FMCSA
Target Audience:
Medical professionals, commercial motor vehicle drivers
Effective Period:
2017 and ongoing
Approval Date:
2017
Revision Date:
None
Year:
[Year]
Region / City:
[City]
Theme:
Medical Opinion
Document Type:
Independent Medical Opinion
Organization / Institution:
[Medical Facility Name]
Author:
Dr. Grant Thomas
Target Audience:
Healthcare providers, VA personnel
Period of validity:
N/A
Approval Date:
N/A
Date of Changes:
N/A
Note:
Date
Topic:
Medical Opinion
Document Type:
Independent Medical Opinion
Author:
[Physician’s Name]
Target Audience:
Veterans Affairs (VA) Review Boards, Healthcare Providers
Note:
Year
Theme:
Obstructive sleep apnea, Pediatric otolaryngology
Document Type:
Research study
Context:
A research study on physical examination techniques for evaluating tonsil, adenoid, and pharyngeal grading in children with obstructive sleep apnea.
Authors:
David J. Stevens; Sarah L. Appleton; Andrew D. Vincent; Yohannes A. Melaku; Sean A. Martin; Tiffany K. Gill; Catherine L. Hill; Andrew Vakulin; Gary A. Wittert; Robert J. Adams
Document Type:
Supplementary material to a research article
Subject:
Obstructive sleep apnea, nocturnal hypoxemia, grip strength, muscle mass, fat mass
Population:
Community-dwelling middle-aged and older men
Study Design:
Observational study with linear regression analyses
Data Collection Methods:
In-home polysomnography; questionnaires; blood analysis; dual-energy X-ray absorptiometry
Variables Examined:
Age; income; alcohol consumption; smoking; dietary patterns; physical activity; diabetes; hypertension; arthritis; cancer history; cardiovascular disease; depression; muscle mass; fat mass; testosterone; inflammation
Statistical Methods:
Univariate and adjusted linear regression models
Sleep Assessment Device:
Embletta X100 (Embla Systems, Colorado)
Outcome Measures:
Dominant and non-dominant hand grip strength; lean mass; fat mass
Supplement Sections:
Supplementary S1 (regression adjustments and univariate associations); Supplementary S2 (non-respiratory sleep metrics and body composition associations)
Year:
2008–2014
Region / Institution:
HERC, Regence BCBS, SIGN
Subject:
Obstructive Sleep Apnea, Tongue Base Surgery
Document Type:
Clinical Guidelines and Evidence Review
Procedure Codes:
CPT 41512, Excluded Services Guidelines E1–E2
Techniques:
Tongue Base Suspension, Submucosal Ablation
Evidence Sources:
Kezirian 06, Farrar 08, TEC Review 07, Regence BCBS 08
Patient Indications:
Adults with OSA intolerant to CPAP or oral appliances
Outcome Measures:
AHI improvement, Epworth Sleepiness Scale, Functional Outcomes of Sleep Questionnaire
Policy Status:
Experimental, Non-Coverage Recommendations, Medically Necessary under certain criteria
Related Guidelines:
Guideline Notes 172–173, Excluded Services Guidelines 1–2
Surgical Risks:
Not specified in document
Year:
2026
Region / City:
Not specified
Subject:
Obstructive Sleep Apnea Treatment
Document Type:
Clinical Correspondence
Institution:
Dental Sleep Medicine Clinic
Author:
Treating Dentist / Sleep Medicine Specialist
Intended Audience:
Referring Physician
Patient Age / DOB:
As indicated in document
Therapy Initiated:
Oral Appliance Therapy (OAT)
Additional Recommendations:
Weight management, positional therapy, nasal patency improvement
Standards Followed:
American Academy of Dental Sleep Medicine guidelines
Year:
2026
Region / city:
Global
Theme:
Sleep apnea, Dry eye disease, Meta-analysis
Document type:
Systematic review, Meta-analysis
Organization:
Not specified
Author:
Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al.
Target audience:
Researchers, Medical professionals
Period of validity:
Not specified
Approval date:
Not specified
Date of amendments:
Not specified
Year:
2026
Location:
Hotel Nikko, San Francisco, CA, USA
Topic:
Sleep Apnea, Snoring, Sleep Disorders
Document Type:
Educational Conference Program
Organizing Institutions:
University of California, San Francisco Department of Otolaryngology-Head and Neck Surgery; Penn Center for Sleep Disorders, University of Pennsylvania
Authors / Faculty:
Andrew N Goldberg, MD; Eric J Kezirian, MD; Richard J Schwab, MD; Jolie L Chang, MD; David M Claman, MD; plus additional UCSF and external faculty
Intended Audience:
Healthcare professionals including physicians, nurses, and physician assistants
Accreditation:
AMA PRA Category 1 Credits™, ANCC Contact Hours, AAPA Category 1 CME Credits, Interprofessional Continuing Education (IPCE)
Educational Objectives:
Review new developments in diagnosis, management, and treatment of sleep apnea and snoring; evaluate medical and surgical interventions; assess patient outcomes and technology impact
Commercial Support:
Eli Lilly, Neurocare, Inc, Reflux Gourmet, Sleep Res Inc
Exhibitors:
Aerin Medical, Apnimed, Avadel, Axsome Therapeutics, Cadwell, Clevemed, Cryosa, DayBreak, Eli Lilly, Ensodata, Fisher & Paykel, Harmony Bioscience, Inspire, Jazz Pharma, Livanova, Moona Health, Neilmed, Nox Medical, Nyxoah, Onera, Philips, Ron Andrews Medical Company, Serene Sleep, Sleep Res, Vertex Pharmaceuticals, Zoll Itamar
Course Chairs:
Andrew N. Goldberg, MD; Jolie L. Chang, MD; David M. Claman, MD; Eric J. Kezirian, MD; Richard J. Schwab, MD
Year:
2017
Region / City:
United States
Topic:
Obstructive Sleep Apnea, Commercial Motor Vehicle Drivers, Medical Certification
Document Type:
Medical Examination Recommendation
Organization:
Federal Motor Carrier Safety Administration (FMCSA)
Author:
FMCSA
Target Audience:
Medical professionals, commercial motor vehicle drivers
Effective Period:
2017 and ongoing
Approval Date:
2017
Revision Date:
None
Year:
2023
Region / City:
England
Topic:
Healthcare, Quality Standards
Document Type:
Policy document
Organization / Institution:
NHS England
Author:
General Practice Specification and Extraction Service (GPSES), NHS England
Target Audience:
Healthcare providers, Medical professionals
Period of Validity:
2023-2024
Approval Date:
01/04/2023
Date of Amendments:
01/08/2023
Contextual Description:
Policy document outlining business rules for COPD management under the Quality and Outcomes Framework for NHS England.
Note:
Year
Theme:
Obstructive sleep apnea, Pediatric otolaryngology
Document Type:
Research study
Context:
A research study on physical examination techniques for evaluating tonsil, adenoid, and pharyngeal grading in children with obstructive sleep apnea.
Authors:
David J. Stevens; Sarah L. Appleton; Andrew D. Vincent; Yohannes A. Melaku; Sean A. Martin; Tiffany K. Gill; Catherine L. Hill; Andrew Vakulin; Gary A. Wittert; Robert J. Adams
Document Type:
Supplementary material to a research article
Subject:
Obstructive sleep apnea, nocturnal hypoxemia, grip strength, muscle mass, fat mass
Population:
Community-dwelling middle-aged and older men
Study Design:
Observational study with linear regression analyses
Data Collection Methods:
In-home polysomnography; questionnaires; blood analysis; dual-energy X-ray absorptiometry
Variables Examined:
Age; income; alcohol consumption; smoking; dietary patterns; physical activity; diabetes; hypertension; arthritis; cancer history; cardiovascular disease; depression; muscle mass; fat mass; testosterone; inflammation
Statistical Methods:
Univariate and adjusted linear regression models
Sleep Assessment Device:
Embletta X100 (Embla Systems, Colorado)
Outcome Measures:
Dominant and non-dominant hand grip strength; lean mass; fat mass
Supplement Sections:
Supplementary S1 (regression adjustments and univariate associations); Supplementary S2 (non-respiratory sleep metrics and body composition associations)
Year:
2008–2014
Region / Institution:
HERC, Regence BCBS, SIGN
Subject:
Obstructive Sleep Apnea, Tongue Base Surgery
Document Type:
Clinical Guidelines and Evidence Review
Procedure Codes:
CPT 41512, Excluded Services Guidelines E1–E2
Techniques:
Tongue Base Suspension, Submucosal Ablation
Evidence Sources:
Kezirian 06, Farrar 08, TEC Review 07, Regence BCBS 08
Patient Indications:
Adults with OSA intolerant to CPAP or oral appliances
Outcome Measures:
AHI improvement, Epworth Sleepiness Scale, Functional Outcomes of Sleep Questionnaire
Policy Status:
Experimental, Non-Coverage Recommendations, Medically Necessary under certain criteria
Related Guidelines:
Guideline Notes 172–173, Excluded Services Guidelines 1–2
Surgical Risks:
Not specified in document
Year:
2026
Region / City:
Not specified
Subject:
Obstructive Sleep Apnea Treatment
Document Type:
Clinical Correspondence
Institution:
Dental Sleep Medicine Clinic
Author:
Treating Dentist / Sleep Medicine Specialist
Intended Audience:
Referring Physician
Patient Age / DOB:
As indicated in document
Therapy Initiated:
Oral Appliance Therapy (OAT)
Additional Recommendations:
Weight management, positional therapy, nasal patency improvement
Standards Followed:
American Academy of Dental Sleep Medicine guidelines
Subject:
Cardiovascular diagnostics and coronary artery disease
Topic:
Diagnostic modalities for obstructive epicardial coronary artery disease and coronary microvascular dysfunction
Document type:
Scientific reference tables
Medical field:
Cardiology
Diagnostic categories:
Invasive assessments; Non-invasive assessments
Key conditions addressed:
Obstructive epicardial coronary artery disease; Coronary microvascular dysfunction; Vasospastic angina; Myocardial bridging
Clinical metrics included:
FFR; CFR; IMR; MPR; MBF; CFVR; WMSI; ST-segment depression
Imaging modalities:
CT; Echocardiography; Nuclear SPECT; PET; Perfusion CMR
Physiological testing:
ECG exercise testing; Cardiopulmonary exercise testing; Intracoronary Doppler; Thermodilution methods
Stress agents mentioned:
Adenosine; Dipyridamole; Regadenoson; Dobutamine; Exercise
Clinical availability categories:
Routine; Widely available; Selected centres; Research or academic centre
Reproducibility scale:
low (+); acceptable (++); good (+++)
Reference format:
Supplementary references S1–S63
Associated abbreviations defined:
CAD; FFR; CFR; CMR; PET; SPECT; MBF; MPR; IMR and others
Year:
2026
Region / city:
England, UK
Topic:
Obstructive sleep apnoea, occupational health
Document type:
Research supplementary materials
Institution:
Imperial College London, Royal Brompton Hospital, Guys and St Thomas NHS Foundation Trust
Authors:
Ryohei Kinoshita, Jennifer K Quint, Constantinos Kallis, Michael I Polkey
Target audience:
Epidemiologists, public health researchers, clinicians
Study period:
Data from multiple datasets including SHHS, HSE2019, WSC
Corresponding author contact:
[email protected]
Methodology:
Descriptive study, multiple imputation model, risk factor analysis
Data sources:
SHHS, HSE2019, WSC, literature review from 2010 onwards
Variables analyzed:
Age, sex, ethnicity, obesity, smoking, alcohol, hypertension, diabetes, hyperlipaemia
Content type:
Supplementary tables, study design diagrams, prevalence estimates
Year:
2023
Region / city:
International
Topic:
Cardiovascular research
Document type:
Scientific appendix
Organization:
REDWOOD-HCM, SEQUOIA-HCM, FOREST-HCM Investigators
Author:
Ahmad Masri, MD, MS; Martin S. Maron; Theodore P. Abraham, MD; Michael E. Nassif, MD; Roberto Barriales-Villa, MD; Ozlem Bilen, MD; Caroline J. Coats, MD, PhD; Perry Elliott, MBBS, MD; Pablo Garcia-Pavia, MD PhD; Daniele Massera, MD; Iacopo Olivotto, MD; Artur Oreziak, MD, PhD; Anjali Tiku Owens, MD; Sara Saberi, MD, MS; Scott D. Solomon, MD; Albree Tower-Rader, MD; Stephen B. Heitner, MD; Daniel L. Jacoby, MD; Chiara Melloni, MD, MS; Jenny Wei, PhD; MD; Mark V. Sherrid, MD
Target audience:
Cardiologists, researchers in cardiovascular medicine
Period of validity:
Not specified
Approval date:
Not specified
Date of changes:
Not specified
Year:
2026
Region / city:
Global
Theme:
Sleep apnea, Dry eye disease, Meta-analysis
Document type:
Systematic review, Meta-analysis
Organization:
Not specified
Author:
Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al.
Target audience:
Researchers, Medical professionals
Period of validity:
Not specified
Approval date:
Not specified
Date of amendments:
Not specified