Inspire therapy: An alternative to CPAP

Kind of like a pacemaker, Inspire therapy is an implanted device that monitors your breathing and sends gentle electric pulses that keep your tongue from obstructing the airway, allowing you to sleep soundly.

Who benefits from Inspire therapy

Inspire therapy is not for everyone, but if you qualify, it might be something that allows you to sleep well and enjoy a much better quality of life.

Patients who qualify for Inspire therapy must first be referred by a sleep medicine doctor or provider. In addition patients need to:

• Have undergone an updated sleep study in the past two years showing moderate to severe OSA

• Have tried to use CPAP without success

• Be at least 18

• Have a body mass index (BMI) of 40 or less

• Have a collapsing tongue be the primary cause of your sleep apnea

• Be willing to have an outpatient surgical procedure to have the Inspire device implanted under your skin and a stimulation cuff implanted in the neck

If you have struggled with the daily irritability caused by obstructive sleep apnea (OSA) and have not had success using CPAP, you might be a candidate for Inspire therapy.

With no mask or hoses, Inspire is a device that is surgically implanted under your skin near the collarbone. Each night, you use a remote-control device to turn Inspire on and shut if off when you wake up for the day.

As you know, OSA typically occurs when the tongue relaxes into a position that blocks your airway, causing you to repeatedly wake up to take a breath.

With Inspire in place, your sleep won’t be interrupted because the implanted device sends repeated gentle pulses that move your tongue out of the way and keep your airway free.

Inspire does not help everyone who has tried it, but many patients have had success with it. It is also only for OSA patients whose tongue collapses into the airway. Patients with other types of sleep apnea, such as central sleep apnea or mixed sleep apnea, do not qualify for Inspire therapy.

About the surgery to implant the Inspire device

• This is an outpatient procedure, so patients go home the same day.

• General anesthesia is used during the procedure so patients do not feel pain or remember the surgery. Most patients spend about four hours in the hospital before going home.

• Two small incisions are made: one in the chest, below the collarbone, to place the battery device; the other under the chin to place a stimulation cuff on the hypoglossal nerve connected by a wire running underneath the skin to the battery device in the chest.

Once the device is implanted and connected to the stimulation wire, the incisions are closed.

Swelling at the incision sites is expected and will typically improve over the first two weeks. Most patients can expect some swelling under the jaw that will give the appearance of a “double chin.” This will improve over 2-4 weeks. Complete healing takes about one month, and the device is inactive during this time. One month after surgery, a doctor will activate the device. At this point, patients will be able to use the remote control to turn it on at bedtime and turn it off upon waking.

Does insurance cover Inspire therapy?

Most insurance plans, including Medicare, cover Inspire therapy for eligible patients. Patients should check with their insurance provider to confirm specific coverage.