No Mask. No Hose. Just Sleep.
By Robert J. DeFatta, MD, PhD, FACS
Obstructive sleep apnea (OSA) is a common, deadly disorder affecting approximately 17% of adults. It causes increased daytime sleepiness which can lead to workplace injuries, falling asleep while driving, and depression. OSA can also lead to strokes, heart attacks, an irregular heartbeat (a fib), uncontrolled high blood pressure, and even diabetes and cancer.
Obstructive sleep apnea is caused by airway collapse (Figure 1), which prevents oxygen from being delivered to your brain. This oxygen decrease arouses a person just long enough to breath. However, these frequent pauses in your breathing interrupt your sleep. The most common OSA symptoms include snoring, gasping for air while asleep, excessive daytime sleepiness, poor concentration and even morning headaches.
Medical and surgical treatments exist for OSA. The most common surgical treatments include rhinoplasty and uvulopalatopharyngoplasty (UPPP), which improve or eliminate a person’s nasal or throat obstruction, respectively. These procedures help some people significantly, but not everyone. Other options include dental guards that reposition the lower jaw, but tongue collapse often remains a problem. CPAP (continuous positive airway pressure) is another non-surgical option. Here, a mask is worn either on the nose, mouth or both. It blows continuous airflow through a hose connected to the CPAP machine, which keeps the airway open. Although effective, over 50% of patients stop using CPAP at one year either due to patient or spouse dissatisfaction.
In 2014 the FDA approved Inspire, which works with your natural breathing process, without the need for a mask or tying you to a machine. Inspire monitors every breath you take, and delivers a mild stimulation to the nerve controlling your tongue and other airway muscles. By stimulating these muscles, your airway remains open (Figure 2).
The system is placed during an outpatient procedure, and patients return to their regular diet and most activities of daily living quickly. There is no other equipment needed, and it is compatible with all imaging techniques.
Patients have been followed for up to 5 years after this procedure. Results have shown a 79% reduction in sleep apnea events, 88% reduction in snoring, 90% reduction in bed partners leaving the bedroom, and a significant increase in patient daytime energy. The most recent study showed 93% of patients were very satisfied and would recommend Inspire to friends and family. These benefits are why Inspire was ranked #2 in Cleveland Clinic’s annual list of Top 10 Medical Innovations in 2018.
If you or someone you know is struggling with sleep apnea, contact my office, DeFatta Health, at 715-828-2368. My staff will be happy to schedule an appointment so I can discuss Inspire more with you.
Airway obstruction seen during obstructive sleep apnea:
- Tongue and palate musculature falls back to obstruct the airway during OSA.
- Actual patient obstruction at the level of the palate.
- Actual patient obstruction at the level of the tongue base.
How Inspire opens the airway through mild hypoglossal nerve stimulation:
- Tongue and palate musculature does not fall back into the airway, preventing obstruction.
- Patient example of open airway at the level of the palate.
- Patient example of open airway at the level of the tongue base.