Compare Your Implant Options
Two FDA-approved hypoglossal nerve stimulators. One goal: helping you sleep and breathe better — without CPAP.
Understanding Hypoglossal Nerve Stimulation
Both Inspire and Genio treat obstructive sleep apnea by gently stimulating the hypoglossal nerve — the nerve that controls your tongue. During sleep, mild electrical impulses keep your airway open so you can breathe naturally, without a mask or machine. Dr. Nord is one of the few surgeons who implants both devices and can help determine which option is the best fit for you.
How Each Device Works
Inspire Upper Airway Stimulation
Breath-synchronized, unilateral stimulation
Inspire is a fully implanted two-part system placed in the chest and neck. A small generator (similar to a pacemaker) delivers stimulation to one side of the hypoglossal nerve in sync with your natural breathing pattern throughout the night. You control the device with a small handheld remote — simply turn it on at bedtime and off when you wake up.
Genio Bilateral Nerve Stimulation
Battery-free implant, bilateral stimulation
Genio uses a small, battery-free stimulator implanted under the chin through a single incision. Each night, you attach a lightweight external activation chip under your chin that powers the implant wirelessly and delivers stimulation to both sides of the hypoglossal nerve using a timed on-and-off pattern. You manage settings through a smartphone app.
Side-by-Side Comparison
Key differences at a glance
| Feature | Inspire | Genio |
|---|---|---|
| FDA Approved | Yes — 2014 | Yes — 2025 |
| How It Stimulates | Unilateral (one side of the nerve) | Bilateral (both sides of the nerve) |
| Implanted Components | 2 parts: pulse generator and stimulation lead | 1 part: small stimulator chip under the chin |
| Incisions | 2 incisions (neck + chest) | 1 incision (under the chin) |
| Implant Battery | Internal battery (~11 years), then outpatient replacement | No implant battery — powered externally each night |
| Daily Use | Turn on with a handheld remote at bedtime | Attach external activation chip + disposable patch nightly; manage via smartphone app |
| Stimulation Pattern | Stimulation is synchronized with your breathing via a built-in sensor, delivering therapy when you inhale | Duty-cycle algorithm delivers stimulation in a timed on-and-off pattern; no internal sensor needed |
| MRI Compatibility | Conditional — newer models (3028) allow full-body MRI; older models (3024) are not MRI compatible | Full-body MRI conditional at both 1.5T and 3T |
| Eligible BMI | Up to 35 (some coverage up to 40) | Up to 32 in clinical studies (FDA label up to 35; efficacy may decrease above 32) |
| AHI Range | 15–100 | 15–65 |
| DISE Required? | Yes — must rule out complete concentric collapse (CCC) | Not required — approved for both CCC and non-CCC patients (US: non-CCC only) |
| Typical Procedure Time | ~40–80 min | ~45–90 min |
| Clinical Evidence | 10+ years of data; STAR trial, ADHERE registry (5,000+ patients); 350+ peer-reviewed publications | DREAM study (115 patients); FDA PMA approval 2025; growing evidence base |
| Insurance Coverage | Widely covered by most major insurers and Medicare | Coverage growing; check with your insurer |
Results That Speak for Themselves
Am I a Candidate?
Both devices require a prior trial of CPAP therapy. What does it mean to fail CPAP? Your surgeon will evaluate which option — or whether either option — is right for you based on your anatomy and medical history.
Inspire Candidacy
- Age 22 or older
- Moderate to severe OSA (AHI 15–100)
- BMI up to 35 (some insurers cover up to 40)
- Unable to tolerate or benefit from CPAP
- No complete concentric collapse on DISE
- Central + mixed apneas must be ≤25% of total AHI
Genio Candidacy
- Age 22 or older
- Moderate to severe OSA (AHI 15–65)
- BMI up to 32 in clinical studies (FDA label up to 35)
- Unable to tolerate or benefit from CPAP
- Approved for both CCC and non-CCC patients (EU); non-CCC in U.S.
- No significant central sleep apnea
What to Expect: Surgery & Recovery
Inspire
Pre-Surgery
Sleep study, DISE procedure to evaluate airway anatomy, insurance authorization.
Implant Procedure
Outpatient surgery under general anesthesia. Two small incisions: one below the jaw and one on the chest for the pulse generator. Typically 40–80 minutes.
Recovery
Most patients go home the same day. Soreness and swelling for 1–2 weeks. Avoid strenuous activity for ~3 weeks. Pain is typically mild and managed with over-the-counter medication.
Activation & Titration
Device is activated approximately 1 month after surgery. Settings are fine-tuned over subsequent visits and an in-lab titration sleep study.
Genio
Pre-Surgery
Sleep study, consultation, and insurance authorization. DISE may or may not be required depending on your surgeon's evaluation.
Implant Procedure
Outpatient surgery under general anesthesia. A single small incision under the chin. The battery-free stimulator is secured near the hypoglossal nerve. No chest incision, no leads, no tunneling. Typically 45–90 minutes.
Recovery
Most patients go home the same day. Swelling under the chin for 1–2 weeks. Avoid strenuous activity for ~2 weeks. The single incision is discreetly hidden in the chin fold.
Activation & Titration
Device is activated approximately 2 months after surgery. Stimulation settings are adjusted at follow-up visits, and patients can fine-tune comfort levels at home through the smartphone app.
Find Out Which Option Is Right for You
Every patient's anatomy and needs are different. Dr. Nord will work with you to determine whether Inspire, Genio, or another approach is the best path to better sleep.
Contact UsThis page is for educational purposes only and does not constitute medical advice. Individual results may vary. Clinical data referenced from published peer-reviewed studies including the Inspire STAR Trial, ADHERE Registry, and Nyxoah DREAM Study. Both Inspire and Genio are FDA-approved devices for the treatment of moderate to severe obstructive sleep apnea in patients who meet specific eligibility criteria. Always consult with your physician to determine the best treatment option for your individual needs.