Shown in photo: Patient Briggs Latham demonstrates the Inspire sleep apnea solution.
A “mini stroke” was a wake-up call for Briggs Latham: He knew he had serious sleep apnea, and if he didn’t do something about it, his life was at risk. Untreated, it’s about much more than getting a bad night’s sleep; it can significantly increase the risk of high blood pressure, diabetes, stroke, and heart attack.
Latham turned to Richard Kanak, MD, a Montage Health sleep medicine specialist, and started using a continuous positive airway pressure (CPAP) device. CPAPs are the first and best line of defense in treating sleep apnea, a common disorder where breathing suddenly stops and starts. But for many people, the CPAP’s mask, hose, and air pressure machine are difficult to tolerate. That was Latham’s case and what led him to an alternative: an implant called Inspire that stimulates tongue movement to keep it from blocking the airway during sleep.
“I've had very positive results from the start," Latham says. "No more snoring at night, feeling more rested in the morning, and my wife didn’t notice any disrupted breathing.”
An innovative alternative to CPAP
. . . they always talk about how much better their sleep is and how they have more energy during the day.
— Martin Mwangi, MD, sleep medicine, Montage Health
The use of Inspire resulted from a collaboration between Kanak, his colleague Martin Mwangi, MD, also a Montage Health sleep medicine specialist, and Joel Jacobson, MD, an ear, nose, and throat specialist at Central Coast Head and Neck Surgeons and doctor at Montage Health’s Community Hospital of the Monterey Peninsula.
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Joel Jacobson, MD, left, implanted a device to reduce Briggs Latham’s sleep apnea.
Candidates for Inspire must have moderate-to-severe obstructive sleep apnea, be at least 18 years old, have a body mass index (BMI) of less than 40, and have tried CPAP therapy. They must also have the right airway anatomy — something Jacobson determines through an endoscopy, using a tiny camera to see the patient’s throat and tongue.
The Inspire device is implanted during an outpatient procedure at Community Hospital, placed under the skin near the collarbone, like a pacemaker. A wire goes from the device to the hypoglossal nerve in the brainstem, which controls tongue movement. A second wire detects when the person inhales, then sends a signal to the first wire, stimulating the tongue to move slightly forward, opening the airway.
The surgery takes about 2.5 hours and patients go home the same day. A handheld, wireless remote is used to turn on the device before sleep and control the level of stimulation.
“It’s very innovative and creative,” Jacobson says. “CPAP is still the gold standard for sleep apnea. It works, as long as you use it. The problem is that about 50 percent of people don’t use it. For them, Inspire could be a good option.”
About a month after surgery, once the incisions heal, patients begin working with Kanak or Mwangi to set the level of stimulation. The level is gradually increased, usually about once per month for three months, then a follow-up sleep study is done. The treatment is covered by most insurance providers.
“The first folks who have gone through the process are doing really well,” Mwangi says. “They’ve gone from severe to mild levels of sleep apnea, and they always talk about how much better their sleep is and how they have more energy during the day.”
“If, after a consultation with your primary care provider, sleep medicine doctor, and surgeon, you meet all of the criteria and you understand the risks and rewards, I would recommend it,” he says.
Treatments
Is Inspire right for me?
You may be a candidate for Inspire if you:
