NOTE: Dr. Kezirian has worked for over a decade as a paid consultant for Nyxoah, serving on their advisory board and then assisting with their clinical trials. He is a coauthor on the medical journal publication of results from the DREAM study that evaluated the Genio system for the treatment of obstructive sleep apnea.

 

In August 2025, the FDA approved the Nyxoah Genio, a technology using nerve stimulation to treat obstructive sleep apnea. The Genio sleep apnea treatment involves surgery to place a small device in an area of the neck below the chin. The treatment works by delivering stimulation to the hypoglossal nerve (the nerve that controls movement of the tongue) on both sides of the body, moving the tongue forward to open the space for breathing in the throat. The patient wears an adhesive patch on the neck and connects a device to the patch in order to provide the power supply for the Genio system. The system, internal implanted device, and the patch with the activation chip (power supply) are shown below.

How does the Nyxoah Genio system work?

The Nyxoah Genio for obstructive sleep apnea was developed for those individuals who do not sleep comfortably while wearing CPAP. Every person has a nerve that controls tongue movement (called the hypoglossal nerve) on both sides of their body. The Nyxoah Genio technology stimulates both of these nerves, keeping the throat open for breathing. The goal of treatment is to eliminate sleep apnea and the need for a CPAP machine, masks, or tubes. 

Dr. Kezirian is one of the world’s leaders in sleep apnea surgery, and the team at UCLA Health will be in the first group of centers in Los Angeles to offer the Nyxoah Genio. Dr. Kezirian and the team at UCLA Health will guide you through every step of the process, from consultation to surgery to ongoing support. They will assess your specific needs and ensure you are a good candidate. 

The Genio therapy involves an outpatient surgical procedure to place the system inside the body. The system is activated after a healing period, and patients can control their system, turning it on when they go to bed and turning it off in the morning when they wake up.

Wake up feeling refreshed and ready to embrace each day. Contact us today to schedule your consultation and take the first step toward a better night’s sleep with the Nyxoah Genio. Rediscover the joy of uninterrupted sleep—your body will thank you.

Is the Nyxoah Genio right for me?

There are 3 steps involved in determining whether you are a good candidate for the Nyxoah Genio system. First, you must have obstructive sleep apnea and have been unable to tolerate positive airway pressure therapy. Second, you would have an office evaluation with Dr. Kezirian. The third and final step is a short evaluation procedure called drug-induced sleep endoscopy. This is not absolutely required before treatment with the Genio, but Dr. Kezirian believes it is an important test to evaluate whether the Genio is right for them. Dr. Kezirian is an international expert in drug-induced sleep endoscopy and believes that this examination improves the ability to select procedures that would be right for each patient.

To schedule an appointment with Dr. Kezirian, please call (424) 259-6559 for the Santa Monica office or (310) 205-7310 for the Beverly Hills office.

 

RISKS

Bleeding

As with any procedure, there is a risk of bleeding. Bleeding in this area can be serious and life-threatening. Fortunately, this is uncommon, and usually there is only minor bruising. A major factor in preventing serious bleeding is to avoid the use of aspirin, NSAIDs (such as ibuprofen, Advil®, Motrin®, naproxen, or Aleve®), vitamin supplements, or herbal medications for at least two weeks before and after surgery.

Infection

To reduce the risk of infection, patients receive intravenous antibiotics prior to the procedure. They may receive antibiotics after surgery as well. The risk of infection with this precautions is low, but infections can be serious and require removal of the entire Nyxoah Genio system.

Tongue weakness or trouble swallowing

This procedure requires dissection of the nerve responsible for tongue movement: the hypoglossal nerve. The hypoglossal nerve can be injured during the procedure, but there are important precautions taken during the procedure to minimize those risks. Tongue movement is important for swallowing, and nerve injury or the swelling that can occur after this procedure can present some difficulty with swallowing. Damage to the hypoglossal nerve can recover over the course of days or weeks, but the damage can take months to recover or be permanent. Studies have shown that stimulation of this nerve during treatment with the Nyxoah Genio should not cause damage to this nerve or other nerves.

Tongue numbness or tingling

There is a nerve (lingual nerve) that is responsible for the senses of touch and taste for the tongue. This procedure involves dissection in the general area of this nerve, although it is typically not encountered during the surgery. If nerve damage or these symptoms do occur, usually the damage is temporary with recovery over the course of days or weeks, but the damage can take months to recover or be permanent.

Facial weakness

The neck incision can be close to a branch of the nerve that controls facial movement. There are a number of precautions taken to avoid injury to this nerve. If nerve damage or facial weakness does occur, usually the damage is temporary with recovery over the course of days or weeks, but the damage can take months to recover or be permanent.

Change in voice

Damage to the hypoglossal nerve can cause changes in voice. If a change in voice occurs, they will typically resolve soon after surgery. However, permanent changes are possible.

Tooth movements 

It would be extremely rare, but we have had a patient who had some movements of their lower (mandibular) teeth after treatment with a similar technology. This could be related to movement of the tongue forward repeatedly, somewhat similar to tongue thrust seen in children that can push teeth forward.

Need for additional procedures

The Genio system may not be effective in accomplishing the goals of surgery. Another procedure—either performed on the Tongue Region or on another area—may be necessary.

 

POSTOPERATIVE INSTRUCTIONS

NOTIFY DR. KEZIRIAN IMMEDIATELY IF YOU HAVE ANY TROUBLE BREATHING OR IF ANY BLEEDING DEVELOPS!

Pain control

Like most surgeries, there is pain in the recovery period. Most patients experience mild to moderate pain for 1-3 days. The pain should improve after the first 2 days. If there is a second spike up in pain, especially if there is any trouble in breathing or swallowing, contact Dr. Kezirian. You will receive a pain medication to take as you need it. Some people try to “hang in there” or suffer without taking pain medications. Controlling your pain is important for breathing, healing, and being able to swallow enough to maintain your nutrition.

Nutrition and fluids

It is very important to have good nutrition and avoid dehydration after surgery. This procedure has less difficulty with pain and swallowing after surgery than some others that are performed for sleep apnea, but it is possible that you will only be able to tolerate a liquid diet for the first 1-2 days after surgery.

Antibiotics

Most patients receive an antibiotic at the time of the procedure as well as after the procedure. This can be useful for preventing infection and decreasing swelling. Take the antibiotics as directed. When taking antibiotics, it can be helpful to eat yogurt that contains active cultures (usually a container will include these words) to minimize the risk of antibiotic-associated diarrhea. If you develop a rash or diarrhea (possible risks of antibiotics and other medications), stop the antibiotics and contact Dr. Kezirian immediately.

Avoid strenuous physical activity for 3 weeks

Most patients will return to normal, non-strenuous activity in 1 week. However, strenuous physical activity increases heart rate and blood pressure, raising the risk of bleeding. In addition, it is important that the Genio implant heals in place. Strenuous physical activity can result in movement of the system, resulting in possible additional procedures to rbplace them in the correct position.

Walking and breathing

Walking and taking deep breaths after surgery is important. Patients should walk at least 3 times a day starting the day after surgery. Taking 10 deep breaths every hour while awake is also very important. Walking helps prevent blood clots from forming in your legs. Taking deep breaths and spending more time out of bed (walking or in a chair) than in bed is helpful because your lungs fill up with air, lowering the risk of fevers and pneumonia. Not walking enough is a major cause of fevers after surgery, so please do remember to walk at least 3 times every day.

Gentle neck stretches

Maintaining neck range of motion is important for healing and overall movement after surgery. Do gentle, slow neck rolls 10 times in each direction (full circle), repeating this 3 times a day for the first month after surgery.

Do not use mouthwashes, lozenges, or throat sprays

Patients should not use mouthwashes, lozenges, or throat sprays following surgery because many of these contain alcohol that can irritate the lining of the mouth or numbing medication that can expose you to a serious complication when used for more than a couple of times.

Sleep with head elevated (at 45 degrees) for at least three days

Elevating your head during sleep decreases blood flow to the head and neck regions. Therefore, it decreases swelling and the associated pain. Elevating the head during sleep may also improve breathing patterns in other ways. Therefore, we recommend elevating your head during sleep at 45 degrees for at least three days following the procedure.

Nausea and constipation

Nausea and constipation can occur after any surgery. The anesthetic medications that you receive during surgery and the narcotic pain medication you receive after surgery can cause these. You will receive medications after surgery to decrease nausea and constipation, but please notify Dr. Kezirian if you feel constipated or have not had a bowel movement in any 3 days after surgery.

Postoperative appointment

Dr. Kezirian likes to see his patients about 1 week after surgery. If a postoperative appointment has not been scheduled, please contact the office to schedule this when you return home after your surgery.

Additional questions

For any emergencies, please call 911 or go to the nearest emergency room.  For other questions, please call the UCLA Health System page operator at (424) 259-6700 and ask for the Head and Neck Surgery resident on call.