The primary treatment for obstructive sleep apnea is CPAP. Despite efforts to improve compliance only 40 to 60% continue to use CPAP on a long-term basis. Hypoglossal nerve stimulation is now being pursued as an alternative therapy in the treatment of obstructive sleep apnea according to a recent review in a 2015 issue of Laryngoscope magazine. Sleep endoscopy can indicate that specific subset of patients who may benefit from hypoglossal nerve surgery and potentially avoid the use of CPAP. The studies are in their infancy but the results are looking very promising in this subset of patients where the obstruction is at the tongue area.