Inspire Sleep Apnea Innovation

I think one of the most unique things about Inspire is that it is the first treatment option for obstructive sleep apnea (OSA) to actually work on airway tone. While all other previous surgeries have always addressed anatomy by enlarging the airway space, none had previously dealt with the issue of airway collapsibility during sleep. I started doing Inspire implantations 7 years ago and over that time have been continually impressed by the way which it helps patients who have been struggling to control their sleep apnea. By addressing the tone issue, that many patients face while asleep, it uniquely provides a solution for the treatment of OSA that previously was only possible with CPAP. Additionally, Inspire is a relatively noninvasive surgery compared to some of the other surgical options for the treatment of sleep apnea. The therapy has also progressed in the nearly 9 years since its FDA approval. The battery life has increased as well as the size of the battery has gotten smaller. Additionally, it is now Bluetooth capable, MRI compatible, and very easy to use by the majority of patients. In observing this technology for the past 7 years, I would say that the majority of my patients have had significant improvements in their sleep quality with utilization of Inspire. I recommend that this be considered for any patient with moderate or severe sleep apnea who are struggling to utilize their CPAP consistently. We know that the treatment of OSA is important for control of cardiovascular, endocrine, and neurologic diseases and therefore intervention needs to be considered in all patients with moderate or severe OSA.

Inspire therapy is typically initiated with an evaluation by an otolaryngologist. Importantly, we will ensure that the patient qualifies for this therapy based on their sleep study results, body-mass index, and areas and type of airway collapse. Once the patient has been determined to be a candidate, then the authorization process for the surgery begins and we plan for a date for implantation. I do warn my patients that the process for getting used to the device once it is in, does take a few months and patients should be aware of this prior to proceeding. We use a slow increase in utilization and strength of the device so as not to overstimulate the nerve controlling the movement of the tongue too quickly. However once acclimated to it, patients do quite well with this therapy and are able to stop using their CPAP completely in over 70% of cases. Additionally, approximately 95% of patient note an improvement in their sleep quality, while bed partners report an 88% decrease in snoring.

Overall, while not for everyone, Inspire provides a unique option for the treatment of OSA in patients who do not tolerate their CPAPs. Its ability to work on tone rather than anatomy is a truly novel method for addressing airway collapsibility while sleeping.