20 Feb What Is the Inspire Sleep Apnea Device and How Does It Work?
According to the Journal of Thoracic Disease, obstructive sleep apnea (OSA) “was first described as a specific clinical entity in the late 1950s,” and the earliest observations of its symptoms recorded in medical literature date back centuries. Since then, many have invented devices and treatment options for the highly prevalent condition.
CPAP (continuous positive airway pressure) machines and oral sleep therapy appliances are the leading devices in OSA treatment; both have been used successfully in clinical testing and patient use for years in the sleep medicine sector.
However, not even the “best” treatments work for every patient. After all, some patients are CPAP intolerant, and some patients have sleep apnea that is too severe for oral appliance therapy (OAT).
Thus, inventive, alternative devices continue to develop, like the one our dental sleep medicine experts focus on in today’s blog: the Inspire® sleep apnea device. Keep reading to learn more about this emerging sleep therapy treatment, including the types of sleep apnea it can treat, how it measures up to CPAPs and dental appliances, and more!
About the Inspire Sleep Apnea Device
Inspire: More than a Single Device. It’s a System.
Although it is commonly referred to as the Inspire “sleep apnea device,” the treatment is more accurately called the Inspire Upper Airway Stimulation (UAS) system because it involves more than a single piece of medical equipment. You can also refer to the overall treatment as “Inspire Therapy.”
What It Is: a Hypoglossal Nerve Stimulation Therapy
Inspire Therapy is a patented and FDA-approved OSA treatment developed by Inspire Medical Systems, Inc., and is medically known as “hypoglossal nerve stimulation therapy.”
As its generic medical name implies, the UAS system stimulates a patient’s hypoglossal nerve—the cranial nerve that spans from the brain, down the spine, along the back of the throat and connects to the muscles in the tongue—to keep the tongue from obstructing the airway.
How It Works
The Inspire Upper Airway Stimulation (UAS) system comprises the following five pieces of medical equipment, the first three of which are surgically placed into the patient’s body:
- Implantable pulse generator (IPG)
- Breathing/Inspiration Sensing Lead
- Nerve Stimulation Lead
- Physician Programmer
- Patient Remote
Implantable pulse generator (IPG)
People often refer to this when they call the treatment the “Inspire Sleep Apnea Device.” It is implanted behind the clavicle bone through an incision in the skin. As you’ll read in the following sections, it is the central catalyst of the system.
Leads
The UAS system also includes two leads, thin, coated wires that connect on one end to the IPG and attach at the other end to another specific part of the body. In essence, both leads communicate with the IPG. However, they transmit different signals with separate functions and connect to different body parts.
The two types of leads are the breathing/inspiration sensing lead and the hypoglossal nerve stimulation lead.
#1 Breathing/Inspiration Sensing Lead
A surgeon inserts the breath-sensing lead through an incision behind the patient’s clavicle. The surgeon attaches one end of the sensing lead to the IPG, carefully maneuvers it behind the rib cage, and weaves it between the external and intercostal muscles. When the IPG is on, the sensing lead detects each time a patient inhales and sends the information to the IPG.
When the sensing lead detects a pause in breathing (known as an apnea), the IPG sends signals through the hypoglossal nerve stimulation lead.
#2 Nerve Stimulation Lead
A surgeon inserts the nerve stimulation lead through an incision under the chin. Then, the surgeon internally maneuvers one end down the side of the neck to connect it to the IPG. They then snake the other end through the upper neck and attach it at the back to the hypoglossal nerve.
When the sensing lead detects an apnea and signals to the IPG, the IPG transmits electrical pulses to the hypoglossal nerve through the stimulation lead. The hypoglossal nerve controls tongue movement. So, the electrical impulses stimulate the tongue to extend forward, opening the airway.
Physician Programmer
The Inspire System does not run immediately after the hour-and-a-half-long outpatient procedure. At a follow-up appointment, the medical team will connect the patient’s IPG to a physician programmer. This programmer allows the patient to connect a remote controller to turn the device off and on.
Patient Remote
At the same follow-up appointment, your medical team will teach you how to connect the IPG through the physician programmer to the remote via Bluetooth. This will allow you, the patient, to use a remote control to dictate when the IPG detects breathing and stimulates the tongue.
Inspire Therapy FAQ
In this section, our experts in sleep therapy will answer common questions patients have about this device.
Are patients asleep during the Inspire procedure?
Our Answer: Yes, patients who undergo the procedure to implant the Inspire UAS are put to sleep with general anesthesia. It is an outpatient procedure that only lasts an hour and a half, which means patients can go home the same day; no overnight hospital stay is necessary.
Is Inspire safe?
Our Answer: Inspire is approved by the FDA and has a ~72% success rate. Side effects are typically minimal to none, but as with any form of invasive surgery, there are risks. Thus, many patients would prefer an external or interdental device than have wires threaded through the back of the neck.
As always, you should carefully consult your primary care provider and any specialists actively treating you before considering Inspire.
Does your office offer Inspire?
Our Answer: As a dental sleep medicine practice, we specialize in oral appliance therapy, so we do not offer Inspire. However, if one of our patients is CPAP intolerant and is not responding well to oral appliance therapy, we can refer them to an Inspire-certified sleep apnea clinic.
It’s also worth noting that OSA sometimes requires more than one type of therapy, not just a CPAP, oral appliance, or Inspire therapy. If you already have Inspire, we can still offer more relief with dental sleep appliances to use in conjunction. After all, Inspire does not treat the snoring, but when paired with a dental sleep appliance, this can change.
Your Guide to All Things Sleep Apnea
At TMJ & Sleep Solutions of Alabama, our mission is to provide personalized care to restore quality of life through better sleep, one patient at a time. If you are experiencing sleep issues, don’t hesitate to contact us today and book an appointment!
Thanks for reading today’s blog on the Inspire sleep apnea device as an alternative to CPAP! Next time, we’ll explore the trending magnetic nose clip for snoring.