Imagine a treatment that was 25 percent effective. That we kept using. The cost of which, when it fails, can be stroke, sleep loss and an increased risk for cancer. It’s called CPAP therapy by most people, and it’s the machine many with sleep apnea use. A new device recently approved, however, may just change the sleep game for people who have obstructive sleep apnea. Meet Inspire.
“It’s the technology of the future,” says Dr. David Foreman, an ear, nose and throat specialist with Camellia ENT.
Foreman, who will perform the procedure at Lafayette Surgical Specialty Hospital (the closest spot currently for the implant is in Alabama) says it’s a game changer and highly effective — 85 percent of bed partners reported no or soft snoring after implantation.
Inspire is an implanted device much like a pacemaker. It looks like the stuff of science fiction with a remote used to turn it on at night. The outpatient procedure is simple, and those who suffer with sleep apnea are seeing rates like a 68 percent reduction in episodes of sleep apnea, according to a clinical trial published in the New England Journal of Medicine.
Over the years several approaches have been attempted to reduce the disorder that affects at least 25 million adults each year, according to the National Healthy Sleep Awareness Project. Surgery has proven widely ineffective, according to Foreman, and the alternative for years has been CPAP or BPAP, which is continuous positive airway pressure that is often misused or not used by patients or proves not entirely effective. Inspire takes a different approach than the continuous airway pressure.
The device monitors the body’s breathing pattern during sleep and delivers mild stimulation to key airway muscles, which keeps the airway open.
“For 10 or 15 years we’ve been looking at what else we can do, and in March this was approved,” Foreman says. “It’s made for people who cannot tolerate CPAP.”
He says that failure of CPAP is a prerequisite for Inspire. In addition to the use of CPAP without success, patients must also meet other requirements like a certain Body Mass Index. Patients must be at least 22 years old and have a certain type of sleep apnea as determined by an endoscopic procedure. The pre-screening process to have Inspire implanted ensures only those likely to benefit undergo the procedure, Foreman says.
“It’s a very rigid vetting process,” he says.
“They must have a BMI of 32 or less and true failure of CPAP.”
Foreman performs an endoscopic test while the patient is asleep to determine if Inspire is a viable option. Inspire, perhaps more than anything, is the result of a new understanding of the true cause of sleep apnea.
First discovered in the 1980s, sleep apnea was thought to be caused by different areas of the ear, nose and throat area, but recently experts discovered causation is connected to the drooping of the palate, which causes the tongue to collapse. It’s a process that often takes decades to create a true problem, and it begins with nasal congestion and sleeping with the mouth open for decades.
Inspire stimulates areas that help the tongue to function properly and open airways.
Some insurance companies cover Inspire, and while it’s not a cheap procedure, Liz Hebert of Lafayette Surgical Specialty Hospital says the facility can navigate the insurance process and set up payment plans as needed.