For adolescents with Down syndrome and severe obstructive sleep apnea (OSA), upper airway stimulation is safe and effective, according to a study published in JAMA Otolaryngology-Head & Neck Surgery. Phoebe K. Yu, MD, MPH, and colleagues examined upper airway stimulation in 42 adolescents with persistent, severe OSA after adenotonsillectomy. The investigators observed a mean decrease in the apnea-hypopnea index (AHI) of 12.9 events per hour. With use of a therapy response definition of a 50% decrease in AHI, the response rate was 65.9% at 12 months; 73.2% of patients had an AHI of less than 10 events per hour at 12 months. Temporary tongue or oral discomfort was the most common complication (11.9%), and two patients underwent re-operation (4.8%). The OSA-18 quality of life total score improved by a mean of 34.8; mean improvement in the Epworth Sleepiness Scale score was 5.1. Mean duration of nightly therapy was 9.0 hours, and 95.2% of patients used the device for 4 or more hours per night.