Hypoglossal Nerve Stimulator
(Inspire implant)

What is Sleep Apnea?

Sleep apnea is a sleep disorder characterized by interruptions in a patient’s airflow while they are sleeping. There are two reasons a person may experience interruptions or pauses in breathing while asleep:

• A failure of the brain mechanism that triggers breathing
• Obstructions in the airway that cause the airway to collapse during sleep

Obstructive sleep apnea is the most common form of this sleep disorder, affecting between 10% and 30% of adults in the United States. Obstructive sleep apnea (OSA) can cause a range of symptoms, including:

• Snoring
• Sleepiness during the day
• Moodiness
• Morning headaches
• Gasping during sleep
• Chest pain
• Weight gain
• High blood pressure
• A feeling of inadequate rest, even after a long sleep
• x Trusted Source What is Sleep Apnea? The American Sleep Apnea Association Go to Source Irregular heartbeat
• Risk of sudden death during sleep

What is the Inspire Implant?

The Inspire hypoglossal nerve stimulator (HGNS) was approved by the FDA for the treatment of moderate to severe sleep apnea in 2014. Inspire is a small device similar in appearance to a pacemaker that is implanted over the muscles on the upper chest, usually on the right side of the body. A small incision in the neck on the same side is used to place an electrode around the portions of the hypoglossal nerve that open the airway. Once implanted, a sensor in the Inspire device identifies when a person is inhaling. Inspire then triggers a gentle pulse of electrical signals to stimulate the hypoglossal nerve, allowing the tongue to move slightly forward and opening the airway. After implantation with the Inspire device, patients simply use a remote control to turn it on at night and off in the morning
 
 

Inspire Implant vs CPAP

For most people who suffer from obstructive sleep apnea (OSA) a CPAP/APAP machine is the first line of treatment. CPAP machines worn during sleep provide continuous air pressure so that the airway remains open (unobstructed), and can be very effective in treating sleep apnea. However, the truth is that many patients are unable or unwilling to use their CPAP machine as they should. In fact, x Trusted Source Long-term compliance with continuous positive airway pressure in patients with obstructive sleep apnea Wolkove N, Baltzan M, Kamel H, Dabrusin R, Palayew M Go to Source one study showed that up to 66% of patients are not fully CPAP compliant.

Some reasons people don’t receive the full benefits of their CPAP include:

• They find the masks uncomfortable or claustrophobic
• The masks are displaced by moving frequently during sleep
• They are unable to find a mask that avoids bothersome air leaks
• The machine takes too long to set up or is difficult to travel with
• Cleaning the machine is too time consuming
• Maintaining their CPAP is too expensive

For qualified patients who struggle to use their CPAP effectively, find the CPAP to be intolerable or uncomfortable, or who wish to find a more permanent solution to sleep apnea, the Inspire hypoglossal nerve stimulator is a potential alternative.

Benefits of the Inspire Upper Airway Stimulation System include:

• No equipment to clean and maintain
• No ongoing supply costs
• No travel inconvenience
• No permanent changes to the airway tissues

Preparing for the Inspire Implant

The first step in preparing for the Inspire implant is to undergo a sleep study to properly diagnose or confirm the severity of sleep apnea (results are generally considered adequate from prior testing if within 2 years from the date of Inspire surgery). Next, Dr. Allen will conduct a Drug-Induced Sleep Endoscopy (DISE) under IV sedation to evaluate the nature of your airway obstruction and confirm that Inspire therapy would adequately address your airway needs. Once Dr. Allen determines that you are a good candidate for sleep apnea treatment with the Inspire hypoglossal nerve stimulator implant, your procedure will be scheduled and you will be given detailed pre- and postoperative instructions.

The Inspire Implant Procedure: What to Expect

Surgery to place the Inspire hypoglossal nerve stimulator is typically an outpatient procedure performed under general anesthesia. To begin the procedure, Dr. Allen will make two small incisions (generally right upper chest and right neck below the jawline). He will then place the battery-operated Inspire generator over the chest wall muscles and place the breathing sensor electrode against the muscles of the rib cage. The stimulation electrode is then applied to the hypoglossal nerve in the neck, where it is wrapped around the branches of the nerve that move the tongue forward. The device is fully tested and evaluated once in place. Once confirmed, Dr. Allen will close the incisions and the patient will be gently awakened from anesthesia and discharged to go home after a x Trusted Source Upper Airway Stimulation/Hypoglossal Nerve Stimulator American Thoracic Society Go to Source brief recovery period .

Recovery After Inspire Implant

The Inspire placement procedure takes between 2 and 3 hours on average, and you will be free to go home and rest after that. Some mild pain and swelling of the incision sites is to be expected, but most of Dr. Allen’s patients find adequate relief by taking over-the-counter medications. Dr. Allen will advise you to rest for the first few days after your procedure, and then you can resume most of your normal daily activities. You should wait a few weeks before engaging in more strenuous activities like working out or lifting your arm high above your head on the side of the incisions. Detailed instructions are given to avoid any confusion.