Special Circumstances

Upper airway stimulation (UAS) has emerged as a viable alternative to treat obstructive sleep apnea in select patients who cannot tolerate continuous positive airway pressure. This chapter discusses special populations and circumstances that may impact care of patients using UAS. Topics addressed include women receiving implants, patients with Down syndrome, left-sided implants, replacement of an internal pulse generator, revision surgery, use of UAS with other implanted medical devices, and implants outside of indications approved by the U.S. Food and Drug Administration. Evidence is provided where applicable, but for many of the situations detailed, limited published data are available; the information provided represents consensus and expert opinion.