New Treatments For Sleep Apnea Offer CPAP Alternative

An implantable device that stimulates breathing; how does it work?

CPAP alternative

For the millions with sleep apnea, the traditional treatment option is a CPAP machine. While CPAP is often effective, patients struggle to continue using it. Many patients become non-compliant, and then the symptoms and risks associated with poor sleep return, such as increased risk for heart attack, stroke, weight gain, high blood pressure and heart failure.

For those who have trouble with the masks, hoses, sleeping positions, etc. of positive airway pressure (PAP) therapy, newly FDA-approved treatment options have arrived: implantable breathing stimulators.

One such treatment is called the Inspire® upper airway stimulation (UAS) therapy, meant for treating obstructive sleep apnea. Inspire therapy is the first implantable device for treating OSA. In contrast to CPAP, Inspire therapy works from inside the body and with a patient’s natural breathing process. The implantable system includes a small generator, a sensing lead and a stimulation lead. Turned on by a handheld remote, it delivers mild stimulation to key airway muscles, which keeps the airway open during sleep.

Check out the video:

The Inspire system is meant for patients with moderate to severe obstructive sleep apnea (OSA) who are unable to use continuous positive airway pressure (CPAP) therapy.

Another implantable device is the Remedē® System for treating central sleep apnea. The Remedē System stimulates a nerve located in the chest that is responsible for sending signals to the diaphragm to stimulate breathing. The system is comprised of a battery pack surgically placed under the skin in the upper chest area and small, thin wires that are inserted into the blood vessels in the chest near the nerve (phrenic) that stimulates breathing. The system monitors the patient’s respiratory signals during sleep and stimulates the nerve to move the diaphragm and restore normal breathing. It is placed during a minimally invasive outpatient procedure by a cardiologist.

Respicardia-The remedē® System- 2018 from Respicardia® on Vimeo.

Does It Work?

The FDA evaluated data from 141 patients to assess the effectiveness of the Remedē System in reducing apnea hypopnea index (AHI), a measure of the frequency and severity of apnea episodes. In their press release, the FDA stated that “after six months, AHI was reduced by 50 percent or more in 51 percent of patients with an active Remedē System implanted. AHI was reduced by 11 percent in patients without an active Remedē System implanted.”

Additional studies showed that 87% of patients with this system had a reduction in the number of sleep apnea events.

Important to note is that the Remedē System is not intended for use in patients with obstructive sleep apnea, as the Inspire system is.

Studies conducted on Upper Airway Stimulation, as used in the Inspire therapy, also show positive results. The STAR Trial published in the New England Journal of Medicine found a 78% reduction in sleep apnea events per hour in patients undergoing UAS.

Other Studies:

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  1. Randy Livingston
    June 28, 2018

    I love my Inspire Sleep Implant. It has eliminated my Apnea from using it nightly. I have more energy and don’t fall asleep at work or driving anymore. Thank You Inspire for Changing my life!

  2. Timothy M.
    June 28, 2018

    This article is correct! I have had my Inpsire implant for 4 month now, my AHI has gone from 34.5 to 15.5. It is just amazing to feel alive again and currently working on lowering the AHI below 10. I highly recommend getting more information about the Inpsire implant from your sleep doctor.

  3. Lee O.
    July 1, 2018

    I am one of those blessed by Inspire. I was first diagnosed with Obstructive Sleep Apnea in 1986. I had surgery at that time to correct it. The surgery failed. I underwent another sleep study in 2006 and still had apnea and was prescribed a CPAP device. I was NOT compatible with the CPAP at all. My last sleep study was in December 2017. My AHI was near 50, a respiratory event almost once a minute.

    After receiving the Inspire device two months ago I am more rested than I remember being in decades. Instead of waking up after 10-12 hours exhausted, for the first time in decades, I wake refreshed after 6-8 hours. I no longer have episodes of stopping breathing while I am asleep, and my better half doesn’t have to sleep with one eye open worrying about me.

  4. Ellen Morrone
    July 3, 2018

    I have had my Inspire implant 2 1/2 years. It has completely changed my life back to normal. I get 8 hours sleep and I am full of energy. No napping anymore or feeling fatigued.

  5. July 13, 2020

    Inspire is an innovative way to treat patients who find the CPAP machine difficult or impossible to use. Will Inspire therapy help with snoring? Thank you for sharing!

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