If you have obstructive sleep apnea, your airway tends to collapse when you sleep. After snoring, gasping and choking through the night, you’re squeaking by on very little rest the next day.
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The most common solution is CPAP (continuous positive airway pressure). While your partner may appreciate quieter nights, chances are you’re not a fan of CPAP.
“It’s the standard treatment for obstructive sleep apnea, but about half the people don’t like it very much,” explains surgical sleep medicine specialist Alan Kominsky, MD.
A recent Cleveland Clinic study found that just 44 percent of the patients prescribed CPAP for obstructive sleep apnea were still using it three years later.
“That means a significant number of patients are not being treated for obstructive sleep apnea, which can lead to hypertension, stroke and cardiac problems,” he says.
A new implantable device
Dental appliances can help patients with mild to moderate obstructive sleep apnea. Surgery to remove obstructive tissue is also an option. But it’s invasive and requires an extensive recovery.
A new option is an implantable, programmable device approved by the U.S. Food and Drug Administration in 2014. The Inspire® Upper Airway Stimulation device looks like a heart pacemaker.
It has two leads. One senses your breathing. The other stimulates the nerve that controls the tongue, to move it forward and open your throat.
“A pivotal trial demonstrated the device’s safety and efficacy in a small group of patients with moderate to severe obstructive sleep apnea,” says Dr. Kominsky. “The researchers reported a 68 percent mean reduction in symptom scores.”
The airway stimulation device is available at select U.S. medical centers, including Cleveland Clinic. To be eligible for it:
- You must be age 22 or older
- Your AHI (apnea-hypopnea index) must be between 20 and 65
- Your body mass index must be lower than 32
- You must have failed to respond well to prior CPAP
Eligible patients must have a recent sleep study or get a new one. The next step is to perform sleep endoscopy. This outpatient procedure begins with sedation so that doctors can insert an endoscope into the airway. This lets them view the pattern of airway collapse to confirm the device will help.
The nerve stimulator system is then implanted under general anesthesia in an outpatient procedure.
“One month after the procedure, we turn the device on. One month after that, we will perform a repeat sleep study. This helps us make adjustments to ensure the device will deliver the maximum benefit,” says Dr. Kominsky.
Where to find help
Don’t let obstructive sleep apnea keep you from getting the rest you need or increasing your risk for heart disease and stroke.
Get help from a center where a team of sleep medicine experts, ear, nose and throat physicians, oral surgeons and dentists will evaluate and treat you, says Dr. Kominsky.