Tonight, I was so fortunate to have dinner together with some French sleep surgery colleagues. This included some of the most prominent surgeons in the world who are also long-time friends: Dr. Frederic Chabolle and Dr. Marc Blumen. It was a wonderful chance to share experiences and think about the future of sleep surgery. Drs. Chabolle and Blumen have been innovative thinkers, while my impression of the French sleep medicine has been that they have a thoughtful and careful skepticism about sleep surgery.

The Inspire Upper Airway Stimulation technology was approved for use in France in 2024, but the real approval (for reimbursement) only occurred in 2025. While the United States is known for embracing the newest technologies and committing to being first in the race to adopt them, most of Europe, including France, has generally been more cautious, particularly with expensive technologies like hypoglossal nerve stimulation. There are always two sides to new technologies. A physician looking to treat patients with better options want to be first in line, but at the same time there are always lessons to be learned in the use of new technology. Since Inspire’s approval, there have been improvements in the technology, patient selection, and clinical management, particularly in the process of system activation and early acclimation (getting used to therapy). I shared some of my own experiences (and what I have learned the literature and other centers), and in many ways I was jealous of my French colleagues who have the benefit of lessons learned from around the world.

Hypoglossal nerve stimulation is a tremendous advance in our ability to treat patients with obstructive sleep apnea who are unable to tolerate positive airway pressure therapy (e.g., CPAP). We now have three technologies approved for use in the United States: Inspire Upper Airway Stimulation, the Nyxoah Genio, and the LivaNova Aura6000. Even though these three technologies are different, experience with Inspire therapy will also be of benefit to patients and centers as there is broader adoption of the Nyxoah and LivaNova systems. Clearly we are in an era where distances between countries are small and no barrier to knowledge sharing. The nice thing about sharing that knowledge in person is the opportunity to share some great company and good food in the process!