March 1, 2023

Inspire Sleep Apnea Device Surgery

Imagine how frustrating it would be to sleep a full eight hours and still wake up feeling tired. If you are one of the estimated 30 million adults in the United States who suffer from sleep apnea, this is an exhausting reality.

Previously, there was one main treatment option for sleep apnea – a Continuous Positive Airway Machine (CPAP). Today, there is an alternative – FDA-approved Inspire.

What is Inspire?

Inspire is an internal alternative to a CPAP machine that works while you sleep. The Inspire team comes from the world’s leading medical device companies. They worked together to invent a groundbreaking obstructive sleep apnea therapy.

The United States Food and Drug Administration approved Inspire for adults 22 years old and up in 2014 and expanded it to patients 18 and older in 2020. Most major U.S. insurance providers, including Medicare, cover Inspire.

Similar to a pacemaker, Inspire works internally. It has three major components that your doctor will place inside your body under the skin of your neck and chest during outpatient Inspire surgery. They include:

• A breathing sensor
• A pulse generator
• A stimulator lead that delivers mild stimulation to one of the nerves of your tongue

After your Inspire surgery, your doctor will work with you to fine-tune the device. The fourth component of Inspire is a remote that is about the size of a cell phone that you turn on before you go to bed.

Most patients have minimal discomfort following their Inspire surgery. You can expect to resume your regular activities within a few days and more strenuous ones in a couple of weeks.

Most importantly, Inspire is proven to work. A study published in the New England Journal of Medicine found that 66% of participants had less severe sleep apnea after using the device for 12 months. In addition:

• 90% of Inspire bed partners report no snoring or soft snoring
• 91% of people are satisfied with Inspire
• 79% have a reduction in sleep apnea events
• 94% of patients say it’s better than CPAP and would recommend it to others

If CPAP isn't sustainable and you're curious about Inspire, chat with us to find an Inspire specialist near you who can confirm whether you're a candidate and what the procedure looks like from start to finish.

What is Sleep Apnea?

Obstructive Sleep Apnea is a disorder in which breathing stops and starts during sleep because of a temporary blockage of the airway. Sleep apnea can cause life-threatening complications such as high blood pressure and stroke when untreated. It also increases your chances of developing Type 2 diabetes, metabolic syndrome, and liver problems.

Even more frightening, an estimated 38,000 people in the United States die each year from heart disease with sleep apnea as a complicating factor. And although rare, people can die if their breathing doesn’t restart after a pause.

Lastly, sleep apnea can cause serious tension in your home. No one likes to be deprived of their precious rest. Your partner may find themselves awakened again and again by your loud snoring, which ultimately causes them to feel angry and resentful.

Sleep apnea is incredibly common, affecting an estimated 2 to 9% of the adult population, or 30 million people, in the United States. However, only about 6 million are diagnosed yearly.

Sleep apnea severity is measured using a scale called the apnea-hypopnea index (AHI). Your AHI can be determined during your sleep study when your doctor will observe the number of times you stop breathing or breathe shallowly for 10 or more seconds. Your doctor then calculates your AHI score by dividing that number by how many hours you were asleep.

The main types of sleep apnea are:

• Obstructive sleep apnea (OSA): This more common form occurs when throat muscles relax and block airflow into the lungs
• Central sleep apnea (CSA): This occurs when the brain doesn't properly signal the muscles in charge of controlling breathing
• Treatment-emergent central sleep apnea: Also known as complex sleep apnea, this type occurs when someone has OSA that develops into CSA after starting therapy

What is the Main Cause of Sleep Apnea?

Obstructive sleep apnea occurs when the muscles that support the soft tissues in your throat temporarily relax. When this occurs, your airway becomes obstructed. The result is that your oxygen levels drop, and your breathing is momentarily cut off.

Symptoms of OSA include:

• Feeling exhausted when you wake up
• Loud snoring
• Episodes in which you stop breathing or gasp for air during sleep
• Feeling tired or exhausted after you wake up
• You wake up repeatedly through the night
• Waking up with a headache
• Insomnia
• Difficulty concentrating while you’re awake
• Night sweats and difficulty falling asleep
• Waking up with a dry mouth
• Depression, anxiety, and irritability

Sleep apnea is more common in men, who are two to three times more likely to have it than women. Other risk factors include:

• Being overweight or obese, as fat deposits around your upper airway can obstruct breathing
• If you have a large neck circumference or narrow throat, developing sleep apnea is more likely
• If you are middle-aged or older, you are more likely to suffer from sleep apnea
• Having another family who has suffered from sleep apnea increases your chance of developing it
• Alcohol, sedatives, or tranquilizers can relax the muscles in your throat and worsen sleep apnea
• Smoking makes you three times more likely to have sleep apnea because it can increase the amount of fluid retention in your upper airway
• Consistent, chronic nasal congestion can double your risk
• Medical conditions such as congestive heart failure, type 2 diabetes, asthma, and chronic lung diseases can also increase your risk of developing sleep apnea

How Do I Know if Inspire is Right for Me?

A CPAP machine is the most common treatment for sleep apnea. It works by putting a stream of pressurized air in your throat to keep your airway open and encourage stable breathing.

A CPAP machine includes a motor, hose, and mask. The motor draws natural room-temperature air into your mouth and nose, according to the pressure setting. This allows your airways to stay open so you can breathe normally while you sleep. Some also include a water tank to moisturize the air.

But CPAP machines don’t work for everyone. The mask may cause you to feel claustrophobic or anxious, making it difficult for you to sleep, or you may have difficulty falling asleep. It can also cause skin irritations where the mask touches your face, nasal congestion, a dry throat, nosebleeds, or an uncomfortable feeling of being bloated with air. A CPAP requires significant maintenance and is bulky and inconvenient for travel.

If you’ve been diagnosed with moderate to severe sleep apnea and are struggling with the CPAP, schedule an appointment with your doctor who can help determine if Inspire surgery is right for you. When you meet with your physician, bring a copy of your most recent sleep study and any prescription sleep medications you take, and be prepared to discuss your experience with the CPAP machine.

You’ll also need to meet the following additional criteria:

• You are not significantly obese
• You are over 18 years of age
• You passed an airway exam

Before the airway exam, your doctor will give you a short-acting medication that puts you to sleep. While you sleep, a camera will record how your airway opens and closes. The entire process only takes about 20 minutes.

How Does the Inspire Sleep Apnea Treatment Work?

Inspire is an upper airway stimulation therapy that treats the root cause of sleep apnea. Unlike CPAP machines, which blow pressurized air into your breathing passages, Inspire CPAP surgery uses nerve stimulation.

Inspire monitors your breathing while you sleep so that every time you take a breath, it delivers a gentle pulse to stimulate your throat muscles and move your tongue out of the way so you can breathe freely.

Every night, before going to bed, you will turn on your Inspire device using the handheld remote. The remote also allows you to turn Inspire off when you wake up, increase and decrease the stimulation strength, and pause it during the night if you need to.

A clinical study found that after 12 months of using the Inspire device, 66% of study participants decreased their AHI (apnea-hypopnea index ) scores by at least 50%. There was also a 25% reduction in oxygen desaturation index (ODI), which measures how frequently a person’s blood oxygen level dips below normal for 10 seconds or longer, in 75% of participants.

Risks and Side Effects of the Inspire Sleep Apnea Innovation

Like most surgeries, the Inspire sleep apnea device surgery does have some risks, including infection, pain, and swelling. You may also have tongue weakness or tongue soreness for a few weeks following the Inspire sleep device surgery.

Other possible complications of Inspire include:

• Dry mouth
• Discomfort during stimulation
• Mechanical pain
• Headache
• Mild infection

Usually, the side effects resolve over time or after your doctor adjusts the Inspire settings.

More serious but rare side effects associated with Inspire include an allergic reaction, nerve damage, or damage to your blood vessels around the site of the Inspire procedure.

However, the FDA determined that the "probable benefits outweigh the probable risks" for approved obstructive sleep apnea patients who aren't benefiting from traditional CPAP.

Talk to your Doctor About Inspire Surgery for Obstructive Sleep Apnea

Speak with your doctor if you suffer from Obstructive Sleep Apnea and think you may benefit from Inspire device surgery. They can meet with you to determine if you are a candidate. Rest easy knowing that you have another treatment option for sleep apnea so you can get the restful sleep you’ve been dreaming of.