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For Sleep Apnea: An Alternative to the C-PAP Machine

March 06, 2019

If you suffer from sleep apnea and your C-PAP machine isn’t helping, there is another treatment option: an implantable device to treat moderate to severe obstructive sleep apnea. Dr. Carl Moeller is an ear, nose and throat specialist with the Hartford Hospital Sleep Center

Q: What is obstructive sleep apnea?

A: Obstructive sleep apnea is collapse of the tissue in the throat during sleep, blocking the airway, and temporarily disrupting breathing.  Sleep apnea causes snoring and excessive sleepiness and, over the long term, increases the risk of heart disease, high blood pressure, stroke, traffic accidents and cardiac arrest. We typically treat sleep apnea with C-PAP, which is a mask that blows air into the nose and throat, preventing obstruction. However, a large percentage of patients don’t tolerate C-PAP very well, upwards of 50% in many studies.

Q: Tell us about this implantable device?  Will this help with snoring?

A: The Inspire hypoglossal nerve stimulator is a small implantable device for the treatment of sleep apnea. A sensor in the chest wall senses when the patient is attempting to take a breath then sends a gentle stimulation to the nerve that controls the tongue, preventing an obstruction. We see a significant improvement in the overall severity of sleep apnea, with a 78% reduction in the number of obstructive events per hour, even three years after implantation. Additionally, 80% of implant patients’ bed partners reports soft or no snoring three years following surgery.

Q: What is involved in the surgical procedure and the recovery time?

A: The surgery is performed under general anesthesia and involves three incisions;  a generator below the collar bone, an electrode around the nerve that controls the tongue, and sensor in the muscles between the ribs.

Patients typically go home the same day or next day following surgery. Pain is typically mild and the patient may return to normal activity after a few days. The device is activated after one month and the patient undergoes a sleep study two months after surgery to ensure the device is relieving the obstruction.

Q: Is there a specific criteria patients must meet to qualify for this type of procedure?

A: The indications for hypoglossal nerve stimulation include failure or refusal to use C-PAP, moderate to severe obstructive sleep apnea (based on the number of times the patient stops breathing per hour, and lack of obesity, (body mass index less than 32). If the patient meets those criteria, we perform a brief airway evaluation under anesthesia to determine if they are a good candidate.

Learn more about this and other treatments for sleep disorders here.