The Inspire sleep apnea implant is a medical device that is implanted into the body for the treatment of snoring and obstructive sleep apnea syndrome (OSA).

Obstructive sleep apnea

Obstructive sleep apnea syndrome is a disease caused by recurrent episodes of sleep apnea. This is a condition in which breathing stops for more than 10 seconds, during which blood oxygen saturation drops by more than 4%.

OSA syndrome occurs during sleep, when the muscles of the upper respiratory tract relax, causing airway obstruction. This leads to impaired oxygenation of the blood and causes brief episodes of unconscious awakening throughout the night. An unhealthy sleep pattern puts stress on the body, which leads to increased blood pressure and the development of serious diseases. Illnesses caused by OSA can be physical, such as high blood pressure, heart attack, and stroke. They can also be mental, such as depression, chronic fatigue syndrome, loss of memory and concentration.

Before any treatment, a sleep study or polysomnography is necessary. Polysomnography calculates the apnea index, which is the frequency of apnea episodes during one hour of sleep, and determines the severity of the disease. The apnea index is considered significant if there are more than 20 apnea episodes per hour, regardless of the presence or absence of clinical symptoms.

The gold standard of treatment for OSA syndrome is CPAP therapy. However, CPAP therapy is not for everyone, as many people find it uncomfortable to sleep with the mask on their face, and the machine itself can be noisy, especially since it is usually placed close to the head. Only 25% of patients can use CPAP therapy for a long period of time.

Therefore, recently Inspire Medical Systems Inc. has introduced a highly effective solution with the Inspire Sleep Apnea implant.

How the Inspire implant works for sleep apnea

The Inspire sleep apnea implant is a battery-operated device that promotes electrostimulation of the sublingual nerve. Battery life is approximately 10 years.

The main unit of this device is placed under the skin on the right front side of the chest and monitors the phase of respiration. The other electrode is implanted to stimulate the sublingual nerve, which creates muscle tension. This opens up the upper airway and allows the tongue to protrude, and helps keep the airway open during sleep.

In addition to the two electrodes, this device also includes a handy little remote switch, which actually turns the device on before you sleep and turns it off once you wake up. This prevents the electrodes from disturbing the communication and feeding processes during the active phase of the day, when a person needs the physiological narrowing of the larynx and the movements of the tongue for these processes.

The patient may feel slight involuntary contractions of the larynx or movements of the tongue during initial use of the device. These movements do not cause pain, but only a little discomfort. These unpleasant effects disappear after the first few uses of the device.

Generally, the implant should be checked 1 or 2 times a year. However, depending on the situation, a physician trained in Inspire therapy may see patients more or less frequently.

The Inspire implant for sleep apnea is only suitable for:

• Patients older than 22 years.

• Patients who have been diagnosed with moderate or severe obstructive sleep apnea syndrome.

• Patients with an apnea index in the range of 20 to 65.

• Patients who are not comfortable with the use of CPAP therapy or who did not have the desired effect.

• Patients with a body mass index less than 32.

Body mass index (BMI) = weight (kg) / height^2 (m2).

A person with a weight of 80 kg and a height of 170 cm has

BMI=80kg/(1.7m^2)=80/2.89=27.68kg/m2

The Inspire sleep apnea implant could potentially replace CPAP therapy as the “gold standard” of treatment for obstructive sleep apnea syndrome. A study by Dr. Ryan J. et al. has shown that after implantation of the Inspire Sleep Apnea implant, snoring decreases considerably. A percentage of “no” or “light” snoring changed from 22% at baseline to 88% at 12 months and 91% at 24 months after treatment. In addition, the apnea index was reduced from 31 to 14. 82% of study patients reported nocturnal use of this therapy for five years. So it is obvious that this method is highly effective and easy to use!

There was also another interesting study done by Dr. Patrick J. of the University of Pittsburgh Medical Center. The study found that sublingual nerve stimulation at the base of the tongue reduced the severity of obstructive sleep apnea by 68% and reduced the number of sleep apnea episodes from 29 to 9. Blood oxygen saturation also improved; daytime sleepiness decreased and patients’ quality of life improved overall.

Inspire Sleep Apnea Cost

The Inspire sleep apnea implant costs approx. $15,000-25,000, not including operating costs. Also, the battery cannot be replaced once it is depleted and a new unit will need to be implanted. The implant can also move out of place over time. In comparison, the CPAP device costs approx. $1,500 to $3,000, which is much cheaper.

Inspire Sleep Apnea Side Effects

Implantation of the Inspire Sleep Apnea Implant is a surgical procedure with potential complications, just like any medical procedure. There are risks of infections after surgery, a temporary weakening of the tongue, postoperative bleeding, pain or discomfort in the area of ​​the implant.

People with the following concerns are not suitable candidates for this device:

• Patients suffering from central apnea or mixed apnea with more than 25% of the total apnea index.

• Patients who have anatomical problems that compromise the performance of upper airway stimulation, such as the presence of a complete concentric collapse of the soft palate.

• Patients with any existing condition or procedure that has compromised neurological control of the upper airway.

• Patients who cannot or do not have the ability to operate the remote sleep control.

• Patients who are pregnant or plan to become pregnant.

• Patients with an implantable device that may be susceptible to unwanted interaction with the Inspire system: allergic or rejection response to implanted materials.

The Inspire Sleep Apnea Implant therapy is FDA approved and has been shown to be an effective solution for obstructive sleep apnea syndrome. The therapy is currently being reviewed and approved by insurance companies on a patient-by-patient basis.

Talk to your doctor if this is a treatment you would like to explore further.