Beyond CPAP: An Alternative Treatment for Moderate to Severe Sleep Apnea

Sleep apnea is a type of sleep disorder, which is associated with loud, excessive snoring and repeated episodes of nighttime breathing cessation.

Untreated, sleep apnea can contribute to more serious health problems, including high blood pressure and heart arrhythmias. There are different types of sleep apnea, but the most common type is obstructive sleep apnea.

Obstructive sleep apnea occurs when the muscles at the back of the throat relax too much and collapse during sleep, closing off the airway.

Depending on the severity of the disorder, apnea events can occur anywhere from five to more than 100 times per hour, resulting in repeated sleep interruptions and a diminished quality of life. Symptoms may include:

• Loud snoring
• Nighttime choking and gasping for air
• Daytime sleepiness and morning headaches
• Depression and memory loss

Sleep Apnea Diagnosis and Treatment Options

When people report symptoms such as those listed above, their doctor often will refer them to a sleep medicine specialist. In most cases, a sleep study will be ordered to confirm a diagnosis of obstructive sleep apnea. Sleep studies may be conducted in a sleep lab or sometimes at home.

Conservative treatment options for obstructive sleep apnea may include lifestyle changes or the use of a continuous positive airway pressure (CPAP) mask at night.

CPAP is the most common form of sleep apnea treatment, but up to half of patients don't use the device consistently, often because they find the device noisy and too uncomfortable for sleep. For these people, surgical alteration of the facial and airway anatomy may be considered. These surgeries can be effective but often involve long and painful recovery times.

Inspire Therapy

Another type of sleep apnea treatment is Inspire therapy. Inspire therapy is a clinically proven treatment that can restore restful sleep in patients with moderate to severe obstructive sleep apnea who can’t tolerate CPAP.

“Inspire therapy is an implanted system that works inside the body. It monitors breathing patterns during sleep and delivers electrical stimulation to the airway, preventing collapse, says UH otolaryngologist and sleep surgeon Amy Schell, MD. "The stimulation seeks to keep the airway open without disrupting sleep."

Using a small handheld remote, patients control their treatment, turning Inspire on at bedtime and off in the morning.

In addition to being associated with less recovery time than other obstructive sleep apnea surgeries, the Inspire system can be implanted during an outpatient surgical procedure that requires two or three small incisions in the neck and chest. The device itself measures about 2 inches by 1.5 inches and may be visible under the skin if the individual has a thin build. Patients usually are able to return to non-strenuous activities after a few days.

First approved by the Food and Drug Administration (FDA) in 2014, Inspire therapy studies have shown that two out of three patients will experience a significant reduction of sleep apnea events, snoring and daytime sleepiness.

Are You a Candidate for Inspire Therapy?

You might be a candidate for Inspire therapy if you:

• Have moderate to severe obstructive sleep apnea
• Are unable to tolerate CPAP
• Are at least 22 years old and not significantly overweight

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University Hospitals is the first healthcare provider in Northeast Ohio certified to offer Inspire therapy. Our doctors have advanced training in the procedure and can evaluate and counsel patients to determine if they would be good candidates for this treatment. Learn more about Inspire sleep apnea treatment at University Hospitals.