Continuous positive airway pressure, otherwise known as CPAP, was always jokingly called “scuba gear” when I was in surgery training. It is a facial or nasal mask worn by patients to treat sleep apnea. Basically, pressured air keeps the airway open to prevent the throat from collapsing when sleeping. Most people find immediate relief of their daytime sleepiness and snoring, not to mention benefits to their sleep partners. In general, it can sometimes take a few weeks to get used to the machine, and often patients will need to try different masks or slowly ramp up the air pressure before enjoying a good night’s rest. Unfortunately not everyone is able to tolerate CPAP. If you wear a CPAP mask or know someone who has one, it is definitely not something you would dream about having, hence the humorous nickname of “scuba gear.” Some patients may even continue to have sleep apnea despite surgery and other options, such as the oral appliance, which is similar to a mouth guard worn at night to keep the jaw forward and thus open the airway.  

The Inspire therapy is a new implantable system that can treat obstructive sleep apnea for those who cannot tolerate CPAP. The system monitors breathing and delivers mild stimulation to the hypoglossal nerve, which controls movement of the tongue and other airway muscles, leading to improved breathing at night. The device is turned on and off with a remote and can be custom programmed for the individual’s needs. The device has been studied throughout the US and Europe and gained FDA approval in 2014. Clinical trials have shown significant improvement in sleep apnea events and snoring. The surgery is not for everyone, as eligible patients must have moderate to severe sleep apnea, are not significantly obese and are over the age of 22. The surgery takes a few hours and patients will typically either go home the same day or stay one night in the hospital. If you are considering Inspire therapy because you just can’t take the “scuba gear”, make sure you have a thorough discussion with a surgeon who is trained in Inspire therapy. Check out Inspiresleep.com for more information.

 

by Esther J. Cheung-Phillips, MD