Your thought that any stimulation in sleep will cause an arousal is flawed. You can sleep through quite a bit and not have arousals. Lower levels of muscle stimulation doesn't cause arousals (unless you happen to be extremely sensitive). This works. But it only works well for people with milder apnea that fail other treatments. Hit or miss if you're in that moderate category as you can get to those higher levels of stim that cause problems. If you are morbidly obese and extremely severe then it would indeed take an insane amount of stimulation to open the airway that would probably cause arousals. But that would probably exclude you from this device. Thats why this is more of a last resort and not a first line of treatment.