It has been less than a year since the Food and Drug Administration gave its approval to Inspire Upper Airway Stimulation Therapy, a device that is implanted into a patient’s airway and that stimulates key muscles in order to keep the airway open and allow the patient to breathe. Still, despite the short amount of time that has gone by, this breakthrough treatment has proven to be of tremendous value to obstructive sleep apnea sufferers who are unable to use or tolerate the more traditional Continuous Positive Airway Pressure, or CPAP device.
Sleep apnea is a chronic condition in which people stop breathing for extended periods when they are asleep. The episodes can take place hundreds of times per night, and puts those who experience them at risk for cardiovascular problems, stroke, high blood pressure and other serious medical conditions. In most cases sleep apnea is a problem of tissue blocking the airway. This may be a result of physical problems within the sinuses, but in many cases it is tied to being overweight. The CPAP machine delivers continuous air into the airway, keeping it open, but it involves wearing a mask that many find uncomfortable or impossible to sleep with. Over half of those who are prescribed CPAP devices end up giving up on the device within a few months.
The Inspire system is designed to be an answer to that problem. According to Dr. Ryan Osborne of Pomona Valley Hospital Medical Center, who recently implanted one of the devices into his patient Irwin LaBlanc, the surgery is extremely simple, and involves three tiny incisions in order to install a battery pack. “A signal is sent to the battery,” he explains. “The battery then stimulates the nerve that moves the tongue forward so the patient is able to continue to breathe normally.”
According to LeBlanc, the surgery has been life changing. “When I wake up in the morning, I can just tell how much better I feel when I get out of bed. I’ve slept so much better.” His physician agrees. Dr. Heather Davis-Kingston says, “He had at least 75 percent fewer episodes where he stopped breathing. Having a device like this will save lives.”
The Inspire system consists of three separate parts, as well as an external component. One is the generator, and the other two are a sensing lead and a stimulating lead. The external component is a remote that turns the device on and off when the patient goes to bed and wakes up in the morning. The sensing lead then detects when breathing patterns are interrupted and sends a signal to the battery, which sends stimulation to the muscles and keeps the airway open. The surgery is minimally invasive and has a short recovery time, and the impact has been significant.
“This therapy represents a major advance in sleep apnea treatment for some patients who are unable to use or tolerate CPAP therapy,” said Meir Kryger, MD, professor, Yale School of Medicine. “Patients with moderate to severe OSA who are not on effective treatment are at an increased risk for cardiovascular disease, accidents and death. There is a significant need for safe, effective and well-tolerated new treatments in the sleep medicine field.”