An estimated 18 million Americans live with sleep apnea, often using a continuous positive airway pressure (CPAP) machine to get a better night's sleep. But now there's a new approach for treating sleep apnea – Inspire therapy. This implantable device monitors your breath while you sleep at night to ensure your airways remain open.
The University of Kansas Health System is the only facility in Kansas, Missouri, Nebraska, Oklahoma or Arkansas to offer Inspire. Our team collaborates with registered polysomnographic technologists who perform sophisticated sleep studies to help doctors provide the best care.
What is the Inspire sleep apnea device?
The Inspire device is a surgical implant that monitors your breathing while you sleep and opens your airway. Inspire sleep apnea treatment is for those with moderate sleep apnea who are 22 years or older and not significantly obese. You control the device with a handheld remote.
Who can have Inspire sleep apnea treatment?
Inspire therapy is an implantable treatment option for people with obstructive sleep apnea who are unable to use or get consistent benefit from continuous positive airway pressure. You might be a candidate for Inspire therapy if:
- You have moderate to severe obstructive sleep apnea (AHI of 20-65)
- You are unable to use or get consistent benefit from CPAP
- You are not significantly overweight
- You are over the age of 22
An Inspire therapy-trained doctor will also evaluate your overall health status and perform a physical examination of your airway to determine if Inspire therapy might be a suitable CPAP alternative for you.
How does the Inspire sleep apnea device work?
Based on your unique breathing patterns, the Inspire system delivers mild stimulation to the hypoglossal nerve, which controls the movement of your tongue and other key airway muscles. By stimulating these muscles, the airway remains open during sleep. Inspire is controlled by a small handheld remote. The remote allows you to turn Inspire therapy on before bed and off when you wake up, adjust stimulation strength and pause during the night if needed.
Dr. Suzanne Stevens: We have a new technology, which is very exciting, called the hypoglossal nerve stimulator that is offering an alternative to the CPAP therapy for patients that can't tolerate CPAP.
Dr. Suzanne Stevens: Well, if you've tried the machine and have difficulty with compliance or tolerating the machine, some people go through many masks and can't find the right mask to make a seal for the air to be delivered correctly, those are people that would benefit greatly from this device.
Dr. Chris Larsen: We have 3 year data now following patients that have had the implant, and 90% of patients are still using the implant 3 years later. Whereas most patients that use CPAP or the statistics on CPAP, there's about a 40-50% compliance, meaning that 60% of patients don't use the CPAP adequately to treat their disease.
Dr. Chris Larsen: This device stimulates the nerve that moves the back of the pallet or the back of the throat and the back of the tongue forward to relieve that obstruction when a patient is sleeping.
Dr. Chris Larsen: The device is implanted in a pocket below the skin, and then you can see these 2 places where the electrodes can come in. One is tunneled down below the skin to between the ribs, and the other 1 is tunneled up into the neck and wraps around the hypoglossal nerve.
Dr. Chris Larsen: It's got a remote control so patients can turn it on before they go to bed, and then it's also programmed to start working at X minutes past turning it on. So depending how long it takes the patient typically to fall asleep, it's programmed to start working at that interval.
Ron Hofmann: Typically I was waking up about 2 o'clock in the morning and staying awake until 4 or 5 o'clock with all sorts of problems or just bizarre things to think about while you're laying there with nothing to do.
Ron Hofmann: It was getting really, really bad, and I said, "I don't know what else to do, and I'm going to give the CPAP one more chance." And I found a doctor here that took the machine in and said, "You know, this machine is not programmed right for what you're going through," and everything else. And we got that set up, and I still couldn't get used to the mask. And then I was referred to this program and said they may be able to help you. I was elated that there was something out there because I had no other choice.
This was just a godsend that we found out about this. Right place, right time. And being at KU and working with the doctors here, the best.
Benefits and risks of the Inspire device
Data indicates that the Inspire device eliminates sleep apnea or significantly reduces snoring and daytime sleepiness. In addition to daytime tiredness and irritability, people with sleep apnea are at higher risk for stroke, type 2 diabetes, metabolic syndrome and liver problems. Other complications of sleep apnea can include memory problems, mood disorders, heart attacks and heart rhythm disorders.
Once you have Inspire therapy, you should not have an MRI. The magnetic fields of MRI scanners can cause harm to components of the Inspire system and may also cause tissue damage. It is best to discuss your options with your doctor if an MRI is suggested. Alternative imaging technologies such as CT, ultrasound or others may be most suitable for you.
What happens during Inspire sleep apnea treatment?
Those who qualify for Inspire will require a minor outpatient procedure. The physician implants the small nerve stimulator device and battery pack under the skin in the chest. One electronic lead, or wire, connects the device to the nerve that stimulates the tongue. The other lead connects to a space in the ribs near the diaphragm. Once connected, the device monitors the patient's breathing. The device sends an impulse to the tongue during every breath while sleeping, keeping the airway open for oxygen.
After the procedure, it takes about 30 days to heal. You will then return to your physician, who activates the device. Once activated, you can use a handheld remote control device to turn Inspire on before you go to sleep each night. You can also pause, and turn it off in the morning. The battery pack is designed to last 7-10 years, much like a pacemaker.
Frequently asked questions about Inspire therapy
Obstructive sleep apnea occurs when breathing is repeatedly stopped and started due to a narrowed or closed airway. As the throat muscles relax, the airway closes, limiting the oxygen intake to the lungs. The brain senses a drop in the oxygen levels and arouses or wakes the sleeper, causing the airway to open. People with sleep apnea often awake with a gasp or snort, with the pattern occurring 5-30 times an hour all night long.
The gold standard treatment for sleep apnea is the CPAP machine. However, CPAP doesn't work for everyone. It can be uncomfortable, and the machine requires maintenance. With only the remote to keep track of, Inspire sleep apnea treatment is much more convenient than the CPAP machine.
Data from the Inspire clinical trial showed that 85% of bed partners reported either no snoring or soft snoring by their partners using Inspire sleep apnea therapy.
You should feel a mild sensation from the stimulation. Typically, patients feel a tingling sensation or mild contraction in their tongue muscles. The stimulation should not be painful or uncomfortable and the level is adjustable. Your Inspire therapy-trained doctor will make any adjustments as needed.
Generally, Inspire will not limit normal daily activities. However, you should ask your Inspire therapy-trained doctor about any activities that are particularly strenuous, like weight lifting, or those that use a large or unpredictable range of motion in your upper body and/or arms, such as working as a firefighter.
Yes, you can use a microwave oven and any common household appliances that do not emit strong magnetic fields. If you have concerns, consult with your Inspire therapy-trained doctor.
No, you do not need to have approval from your insurance company for the therapy prior to your first clinic visit. Your medical care team will work together to determine if Inspire therapy might be right for you. If you qualify for Inspire therapy, your Inspire therapy-trained doctor will work with you, the hospital and your insurance company for approval.
Every insurance plan is different. Generally, the copay costs for Inspire therapy should be similar to copays for other surgical procedures. Some patients may have secondary benefits or supplemental coverage that will offset their copay. Your Inspire therapy-trained doctor can help you through this process.
The Inspire system is typically implanted during an outpatient procedure under general anesthetic. The system is placed under the skin of the neck and chest through 3 small incisions. Specifics and any risks should be discussed with your doctor.
Most batteries last 8-11 years. The generator battery cannot be recharged, so once the battery runs out, you will need to have the generator replaced. This is a very common procedure with many surgical implants.