While the use of continuous positive airway pressure (CPAP) machines is the standard for people with moderate to severe obstructive sleep apnea (OSA), growing accustomed to sleeping with the CPAP machine can prove difficult for some people. While CPAP machines can lead to little to no snoring, less fatigue, better overall sleep, and the prevention of potential complications, some people get claustrophobic and simply cannot adjust to sleeping with a CPAP machine. For people 18 and older who have already tried CPAP machines and are searching for an alternative treatment for OSA, Methodist Hospitals might have the solution: Inspire® therapy.
Since 2023, Methodist Hospitals has offered the FDA-approved Inspire® therapy, which uses a surgically implanted device to push the tongue forward when patients take a breath and dilate the airway.
“The device has three components,” Otolaryngologist Khaled Kashlan from Methodist Hospitals said. “The first component is a small, little pressure sensor that we place close to the lungs. It detects when you take a breath and that sensor sends a signal to a pulse generator implanted in the chest, which is the second component. When the pulse generator sends that signal, it extends a little electrical signal that stimulates the third component, which is an electrode implanted through the neck and wrapped around the hypoglossal nerve. The hypoglossal nerve is the nerve that causes the tongue to protrude forward.”
While the implementation process may seem like an intimidating surgery, it is actually a brief, 90-minute outpatient procedure with a mild recovery. Kashlan revealed that patients do not need to take narcotic pain medication following the procedure and require only a few days of rest to recover. The outpatient procedure entails only two incisions: one in the chest and one under the jaw.
“We make an incision on the chest where we place that first component, that pressure sensor. Through the same incision, we place that little pulse generator in the chest and then we tunnel the electrode to the neck. From there, we create a small little incision under the jaw where we wrap this electrode around the nerve that moves the tongue,” Kashlan said.
The device is turned on two to three months after the surgery depending upon how the patient feels. Three to six months after the implantation, patients participate in a repeat sleep study once the settings are ideal to see how the patient is responding to Inspire® therapy. During this repeat sleep study, Kashlan has seen patients display a significant reduction in the apnea-hypopnea index (AHI), which is the same measurement used in patients’ initial sleep study to determine if they have OSA.
While Inspire® therapy may be the perfect OSA solution for some people, Kashlan tells his patients that CPAP machines are the gold standard. Inspire® therapy should only be used in cases when a patient has given CPAP machines a thorough try and cannot tolerate them.
“If a patient can tolerate the CPAP machine and that AHI number jumps down to the normal levels, that's ideally what we want. We want those secure, significant results,” Kashlan said. “However, in patients who use Inspire® therapy, we do also see significant results. A study published a couple of years ago showed results that placed Inspire® therapy patients in the category of mild sleep apnea. We're seeing these patients who have severe sleep apnea become either completely cured or, at the very least, have a reduction in their AHI.”
To learn more about Inspire® therapy or schedule a visit to Methodist Hospitals, visit methodisthospitals.org.
