Next-Generation Upgrades Make Simpler Sleep Apnea Therapy Even Better

Daytime sleepiness, increased risk of accidents, depression and chronic diseases are potential problems caused by obstructive sleep apnea (OSA). Not to mention snoring, which will irritate your partner. However, the standard treatment, the continuous positive airway pressure (CPAP) machine, is not always popular with patients.

“We discovered that, of the patients that were prescribed a CPAP, 50 percent couldn’t tolerate it and weren’t using it,” says otolaryngologist Jason Ohlstein, MD, LVPG Ear, Nose and Throat–Pocono. “So, we had a lot of patients feeling lost and living with untreated OSA, which is hard on the heart and the brain.”

A simpler OSA treatment, the Inspire system, was developed almost 20 years ago. Now, it has been substantially updated. Lehigh Valley Health Network is the first in the Lehigh Valley and northeast Pennsylvania (NEPA) and the third location in the entire Mid-Atlantic region to introduce Inspire V, the latest version of the system.

Inspire is a surgical solution. The device is implanted under the skin and delivers mild electric pulses to the tongue muscles, preventing them from blocking the airway during sleep. Patients turn the device on via remote control when they are ready to call it a night.

On the other hand, CPAP is external, requiring patients to wear a face mask and connect to the CPAP machine via a hose. A continuous stream of pressurized air keeps the person’s airway open and prevents it from collapsing during sleep. While CPAP is effective for many, some find it uncomfortable or experience side effects like dry mouth or nasal congestion.

“Inspire V offers many advantages over CPAP and numerous advantages over earlier Inspire versions,” says otolaryngologist Darren Hohn, DO, with LVPG Ear, Nose and Throat–Health & Wellness Center. “The previous model had two sensors, one in the neck and one in chest; Inspire V has only one that’s implanted in the neck. So, implantation is a simpler procedure and a quicker surgery with less time needed under anesthesia.”  

“Besides a faster surgery and easier recovery, Inspire V includes an updated neurostimulator and enhanced software for following patients’ sleep,” Dr. Ohlstein says. “It means we can track patients better and ensure we’re treating their sleep apnea well.”

“One of the criteria for Inspire V is that you have tried CPAP and cannot tolerate it,” Dr. Ohlstein says. “You also need to have a diagnosed apnea-hypopnea index (AHI) between 15 and 100.”

AHI identifies how many times your breathing slows or stops during an hour of sleep. A patient has mild OSA when they have five to fewer than 15 events per hour. Moderate OSA is 15 to fewer than 30 events per hour and severe OSA is 30 or more events per hour.

Both Dr. Ohlstein and Dr. Hohn have reported excellent results with the Inspire V surgeries they have completed so far in their respective regions. For example, Dr. Hohn successfully treated a 65-year-old woman with an AHI of 30 who underwent implantation. “Her five-month Inspire polysomnogram showed her AHI now to be less than 1,” Dr. Hohn says.

“Another plus is that OSA comorbidities such as atrial fibrillation and heart arrhythmias can be controlled and the risk for them reduced,” Dr. Ohlstein says. “Everyone we’re treated has been a success story, and that has been the most impactful part for me.”