New Lenox — Obstructive sleep apnea patients who still aren’t getting a good night’s rest may have a new option.
And Edward Meyers Jr., 68, of New Lenox, who received his Inspire Therapy in November 2021 at Silver Cross Hospital in New Lenox, said he loved it.
Inspire Therapy is a small implantable device that delivers a mild electrical stimulation to the tongue to keep the airways open during sleep, according to Dr. Rajeev Mehta, a board-certified otolaryngologist at Silver Cross Hospital in New Lenox. Otolaryngology is a medical specialty which is focused on the ears, nose, and throat.
The patients turn the device off and on with a small handheld remote. The device starts working in 30 minutes, giving the user time to fall asleep, Mehta said.
“Every time they inhale, a little electrical impulse goes throughs the nerves that move the tongue,” Mehta said. “Patients tell me it feels like a 9-volt battery on the tongue, a little bit of a tingle. That’s why we titrate (measure) the level, to see the ideal level they can tolerate and cure the sleep apnea.”
Mehta said candidates must be 18 or older with a body mass index (BMI) of 35 or less and have moderate to severe obstructive sleep apnea.
Candidates also can’t use or not consistently benefit from continuous positive airway pressure (CPAP) therapy, Mehta said.
The Cleveland Clinic said about 25% of men and 10% of women have obstructive sleep apnea. The majority of patients are over age 50 and overweight, although sleep apnea can affect babies and children, too, Cleveland Clinic said.
Feedback from patients is encouraging, Mehta said.
“Even when titrating up the levels, they comment they have not slept this well in decades,” Mehta said.
Although installing the implant is typically a one-hour, outpatient surgery, the entire process of healing and determining the optimal settings takes about eight weeks, Mehta said.
“Every week we increase the level,” Mehta said. “They [patients] slowly get used to it.”
Mehta stresses that Inspire Therapy is not a first-line treatment for sleep apnea. Patients must try CPAP first, he said.
Mehta said reasons why CPAP doesn’t work for some include claustrophobia, discomfort, poor seal on the mask, bloating and belching from the air pressure, spousal complaints about the noise, not being a back sleeper, and challenges in compliance when traveling or camping.
“We’ve had patients who, just for some unknown reasons, take it off in the middle of the night and wake up in the morning with the mask lying on the floor,” Mehta said.
Inspire Therapy isn’t the first surgical option for sleep apnea, Mehta said. But the cure rates were “not as good as we’d hoped” with other procedures and recoveries were longer than with Inspire Therapy, he said.
That cure rate is important. Untreated sleep apnea can lead to daytime fatigue, heart issues, high blood pressure, liver problems, metabolic syndrome, type 2 diabetes and even complications with certain medications and having surgery, according to Mayo Clinic.
Mehta said the oral device is also an option for mild sleep apnea. But because it pulls on the jaw, the oral device may cause temporomandibular disturbances and movement of the teeth, Mehta said.
Inspire Therapy may also case side effects. Mayo Clinic reported “temporary pain at incision sites, transient tongue weakness and tongue soreness” and that “tongue soreness improved over time with acclimatization, device reprogramming or both.”
So when elective surgeries were halted in the early days of the pandemic, Mehta looked into Inspire Therapy, he said.
Mehta said he liked the better cure rates, short recovery time and high compliance that studies were showing with the implant.
“We’re not actually doing anything in their airways; it’s just a neck procedure,” Mehta said. “It allows the patient to sleep normally without wearing anything externally.”
Sleep study - and a surprise
Meyers said he didn’t know he had sleep apnea. He didn’t snore, wake at night or feel tired in the daytime, he said. But Meyers’ wife noticed he occasionally stopped breathing at night. That alarmed Meyers because his friend with sleep apnea had a stroke.
“He stopped breathing long enough where he had actually wound up having a stroke from oxygen deprivation to the brain,” Meyers said.
So Meyers had a sleep study and said a doctor told Meyers he’d stopped breathing 46 times in an hour. Meyers couldn’t believe he was still alive.
“I looked him in the face and said, ‘Why am I still here?” Meyer said.
Meyers first used a CPAP with “nose pillows” – but it didn’t work well with his deviated septum, he said.
The full-face mask option didn’t seal well around his beard and the high velocity air flow severely dried out his mouth and throat, he said.
So Meyers was excited about the implant option and shrugged off the idea of surgery.
“I’ve had so many surgeries, you can’t scare me anymore,” Meyers said.
Meyers said he had gall bladder surgery in 1997, hiatal hernia repair in 1998, spinal fusion in his lower back in 2012, endoscopic bypass surgery in 2015 and “another round of spinal fusion” in 2017.
Two weeks before receiving the implant, Meyers had the deviated septum repaired, he said.
For the implant itself, Meyers received two small incisions and said the implant is barely perceptible to him.
“If I went swimming, for example, I don’t think people would notice it,” Meyers said. “But I can feel it obviously.”
For more information, visit inspiresleep.com.