Severe OSA and claustrophobia, ultimately treated with hypoglossal nerve stimulation

Depression and untreated obstructive sleep apnea (OSA) may often overlap. When left untreated, OSA can be associated with antidepressant treatment failure, and treatment of OSA may lead to improved mood, decreased depression and anxiety, as well as overall improvement in psychological health and quality of life. Unfortunately, OSA treatment with continuous positive airway pressure (CPAP) can be limited due to claustrophobia and other reasons. Hypoglossal nerve stimulation (HGNS) is a novel and effective treatment approach for patients with moderate to severe OSA intolerant to CPAP. We describe a clinical case of a patient with refractory depression and untreated OSA, intolerant to CPAP, whereby HGNS was successfully used to treat OSA and substantially decrease symptoms of depression and improve quality of life measures up to 1 year post-implantation.