What Is Inspire Sleep Apnea Treatment and Does It Work?

In the United States, obstructive sleep apnea (OSA) affects an estimated 2% to 9% Trusted Source MSD Manuals First published in 1899 as a small reference book for physicians and pharmacists, the Manual grew in size and scope to become one of the most widely used comprehensive medical resources for professionals and consumers. View Source of the adult population, though experts believe there are a substantial number of undiagnosed cases. People with OSA cannot breathe properly Trusted Source National Library of Medicine, Biotech Information The National Center for Biotechnology Information advances science and health by providing access to biomedical and genomic information. View Source while sleeping due to a physical blockage in their upper airway. It can cause people to snore, stop breathing, gasp, choke, and wake up suddenly.

People with OSA report daytime sleepiness, headaches, shortened attention span, and brain fog. Living with OSA is also associated with more serious health risks Trusted Source National Institute of Neurological Disorders and Stroke (NINDS) NINDS aims to seek fundamental knowledge about the brain and nervous system and to use that knowledge to reduce the burden of neurological disease. View Source like stroke, heart disease, high blood pressure, and heart attack. Both lifestyle and genetic factors can cause sleep apnea. While there is no cure, treatment can reduce the risk of heart and blood pressure-related problems as well as increase sleep quality.

Besides OSA, there are two other types of sleep apnea: central sleep apnea (CSA) and mixed sleep apnea. People with CSA Trusted Source National Library of Medicine, Biotech Information The National Center for Biotechnology Information advances science and health by providing access to biomedical and genomic information. View Source have trouble breathing because their brain doesn’t communicate correctly with the muscles that control respiration. Those with mixed sleep apnea have a combination of OSA and CSA. The Inspire Sleep Apnea Treatment is only intended to treat people with OSA.

We’ll take an in-depth look at the Inspire Sleep Apnea Treatment, explaining how it works, who is eligible, and potential side effects. We’ll also cover success rates and what you should expect to pay for treatment. You’ll learn how it differs from CPAP therapy, what it feels like inside your body, and what to expect in the years following implantation.

What Is Inspire Sleep Apnea Treatment?

The Inspire Sleep Apnea Innovation is an upper airway stimulation (UAS) treatment designed to open your airway during sleep. Successful procedures make breathing easier and decrease OSA-related symptoms. After determining you meet the eligibility requirements, an Inspire-certified doctor inserts a monitoring device in your chest during an outpatient procedure. Another incision is made under your chin to implant a nerve stimulator.

The two components work together to monitor your breathing and deliver gentle pulsations to the nerve that controls your tongue’s movement. This stimulation forces your tongue forward to the front of your mouth, clearing your airway so that you can breathe more effectively. Though the device is implanted in your body, it only functions when you turn it on before bed using the accompanying remote.

What Is the Success Rate for Inspire?

Doctors measure sleep apnea severity using a scale called the apnea-hypopnea index (AHI). Scheduling a sleep study is the best way to determine your AHI Trusted Source National Library of Medicine, Biotech Information The National Center for Biotechnology Information advances science and health by providing access to biomedical and genomic information. View Source . During sleep studies, doctors observe the number of times a person stops breathing or breathes shallowly for 10 or more seconds. They calculate the AHI score by dividing that number by how many hours the person was asleep.

A clinical study found that after 12 months of using the Inspire device, 66% of study participants Trusted Source The New England Journal of Medicine (NEJM) The NEJM is recognized as one of the world’s leading medical journals. Published continuously for over 200 years, NEJM delivers high-quality, peer-reviewed research and interactive clinical content to physicians, educators, researchers, and the global medical community. View Source cut their AHI scores by at least 50%. The study also determined that 75% of participants had at least a 25% reduction in oxygen desaturation index (ODI), which measures how frequently a person’s blood oxygen level dips below normal for 10 seconds or longer. The median AHI score decreased by 68%, while the median ODI score fell 70%.

Is Inspire Approved by the FDA?

The Inspire Sleep Apnea Innovation is the only internal neurostimulation treatment for  obstructive sleep apnea currently approved by the Food and Drug Administration. While the initial approval in 2014 was for people at least 22 years old who met the eligibility requirements, the FDA expanded the age range in 2020 to ages 18 and up.

Is Inspire Covered by Medical Insurance?

Most major U.S. insurance providers, including Medicare, cover Inspire. Some Veterans Affairs and military hospitals also cover treatment. Your cost is largely determined by your policy’s deductible, copays, and out-of-pocket maximum. Be sure to check with your insurance provider to learn whether or not it covers treatment.

How Does Inspire Sleep Apnea Treatment Work?

Inspire Sleep Apnea Treatment opens your airway by moving your tongue forward inside your mouth so that it doesn’t block your breathing passages. The device consists of three major components: a monitor that measures your breathing, a nerve stimulator that adjusts your tongue placement, and a remote.

Before going to sleep, you turn on your device with the remote. Once activated, the device implanted in your upper chest begins to monitor your breathing. The device communicates with the nerve stimulator located under your chin each time you take a breath, and the stimulator sends a gentle pulse to the nerve that controls your tongue’s motor function. The stimulation causes your tongue to move toward the front of your mouth, clearing up more space for air to pass.

Because the treatment makes it easier to breathe, you’re less likely to snore, stop breathing, gasp, or choke. This increases your overall sleep quality. Users report noticing the pulsing sensation beneath their chins while awake but not after falling asleep. The stimulation should not be uncomfortable or painful, though it is noticeable. You should not feel discomfort related to the device in your chest.

Are There Side Effects With This Treatment?

Getting the Inspire Sleep Apnea Treatment requires outpatient surgery, which comes with inherent risks, like infection, pain, and swelling. Additionally, some individuals report temporary tongue weakness for a few weeks following the procedure.

The most common side effects associated with treatment are tongue abrasion, mouth dryness, and discomfort stemming from the nerve stimulator. In rare cases, some people experience muscle atrophy and partial tongue paralysis. Your doctor can fine-tune your device’s settings to help alleviate these side effects.

Follow-Up Care

Following installation, it takes a few days for basic recovery and about two weeks for most people to resume strenuous activities. You’ll consult with your doctor prior to turning on the device to ensure its settings are correct for your specific needs. Following the consultation with your doctor, you can turn on the device 30 days after the procedure and begin treatment. Your doctor should check your device and settings once or twice a year.

The breathing monitor uses a battery with a lifespan of approximately 11 years. When the battery runs low, an additional outpatient procedure is required to get a replacement.

Can You Receive an MRI After the Device Is Installed?

Once you have the Inspire device installed, you can have MRIs performed on your head, neck, arms, and legs as long as medical technicians follow specific guidelines. You cannot have an MRI on your chest or torso. However, you can have torso CT scans, ultrasounds, and X-rays. Those with medical conditions requiring frequent or regular MRIs should consult with their doctors before committing to treatment. Having a pacemaker does not necessarily disqualify you from getting the Inspire treatment.

Eligibility Requirements

The Inspire Sleep Apnea Innovation is not for everyone with sleep apnea. Eligible candidates must meet the following requirements:

• OSA diagnosis: You must already have an obstructive sleep apnea diagnosis with an AHI score between 15 and 65.
• Over 18 years old: You must meet the age requirement.
• Tried CPAP therapy: This treatment is only intended for those who have already tried CPAP therapy and found it unsuccessful or intolerable.
• BMI under 32: Inspire Sleep Apnea Treatment has not been tested on people with a body mass index (BMI) over 32.
• Airway exam: An Inspire-trained doctor must examine your sleep study results and perform a nonsurgical airway exam. The physician puts you to sleep with fast-acting medicine, then inserts a camera into your throat to see how your airway opens and closes.
• Other restrictions: People with a diagnosis that contains more than 25% central sleep apnea or mixed sleep apnea do not qualify. The treatment is also not appropriate for those with complete concentric collapse at their soft palate.

What Is the Difference Between Inspire and CPAP?

Continuous positive airway pressure (CPAP) therapy and the Inspire Sleep Apnea Treatment both have the same end goal — to open airways and improve breathing. However, each method achieves this differently.

CPAP machines blow pressurized air into your breathing passages through a mask. The constant pressure prevents your airway from closing and allows your respiratory system to function correctly.

The Inspire Sleep Apnea Treatment also clears your airway, but it uses nerve stimulation instead of pressurized air. The surgically implanted device monitors your breathing and sends a gentle pulse to the nerve that controls tongue motor function, moving it forward and out of the way so you can breathe properly.

There are other alternatives to CPAP therapy and the Inspire treatment. These include oral mouthguards that either retain your tongue or align your jaw to promote airflow. Some surgical procedures remove tissue to create more breathing room, while others alter your tongue or jaw placement.

CPAP therapy and the Inspire Sleep Apnea Treatment each have their own advantages and drawbacks. Some CPAP users find the masks uncomfortable Trusted Source National Library of Medicine, Biotech Information The National Center for Biotechnology Information advances science and health by providing access to biomedical and genomic information. View Source and hard to tolerate during the night. They can be especially difficult for side and stomach sleepers, as pillows can interfere with how well a mask fits and lead to leaks.

The Inspire Sleep Apnea Treatment is a major commitment that requires surgical intervention and regular checkups with your doctor. Not everyone with sleep apnea qualifies for this type of treatment, and it can be expensive depending on your health insurance.

When to Seek Treatment for Obstructive Sleep Apnea

Living with untreated OSA can be harmful and potentially life-threatening. In addition to the general drowsiness and irritability that accompanies sleep apnea, it has also been associated with strokes, heart attacks, hypertension, diabetes, and accidents relating to sleep deprivation. Getting effective OSA treatment can increase your overall quality of life.

If you experience any of the following on a regular basis, you may want to consult with a physician or medical professional:

• Loud snoring
• Long gaps between breaths
• Gasping or choking for air
• Multiple awakenings in one night
• Brain fog during the day
• Excessive sleepiness
• Insomnia
• Morning headaches
• Dry mouth upon waking

Scheduling a sleep study is an excellent way to understand any symptoms you may be experiencing. Speaking with a medical professional can help you better understand sleep apnea and lead you toward effective treatment.

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