Treating Sleep Apnea: An Alternative to the Mask

CU Medicine provider Dr. Amy Schell is an otolaryngologist and sleep surgeon. She discusses what sleep apnea is, how it's traditionally treated, and how alternative treatments, such as an implant, can help patients with obstructive sleep apnea.

Sleep apnea is a type of sleep disorder in which breathing can repeatedly start and stop throughout the night.

“When we fall asleep, the muscles of our upper throat tend to relax. Those muscles can either fully or partially close off at night, keeping air from the outside world from getting down to our lungs, where it needs to be,” explained CU Medicine otolaryngologist and sleep surgeon Dr. Amy Schell.

Those with sleep apnea experience symptoms such as loud, excessive snoring, feeling tired throughout the day, and waking up gasping for air. “Their bed partner might frankly tell them that they stopped breathing during their sleep,” added Dr. Schell.

There are different types of sleep apnea, but the most common type is obstructive sleep apnea.

Treatments for obstructive sleep apnea continue to evolve. The standard treatment is continuous positive airway pressure (CPAP) where the patient wears a mask that delivers pressurized air to hold the throat open at night.

Some people can’t tolerate the mask or don’t like to wear it to sleep at night. For those patients, there are other options such as surgical alteration of the jaw or throat – but those involve long recovery times.

A newer treatment known as Inspire Upper Airway Stimulation Therapy involves a simpler, typically outpatient surgery, to implant a device that stimulates the airway to open while patients sleep.

We talked with Dr. Schell about how the Inspire implant works and who qualifies for it.


Inspire Upper Airway Stimulation Therapy

The Inspire implant for obstructive sleep apnea involves a few components. First, a battery pack sits in the right side of the chest, and underneath that is a pressure sensor between the ribs. “That pressure sensor is able to sense each time we try to initiate a breath during sleep,” said Dr. Schell.

A small second incision is made under the chin and a stimulator cuff is placed on the nerve that controls the tongue. With every breath, the patient’s tongue muscle moves forward. “If you can move the tongue forward, you can open up the airway,” added Dr. Shell.

Once healed from surgery, the device gets activated and settings can be adjusted so the patient is comfortable. The patient is then given a remote that is used to turn the device on before they go to sleep.

Are You a Candidate for the Inspire implant?

Inspire received FDA approval in 2014 for certain patients with obstructive sleep apnea. To determine the type of sleep apnea a patient has, a sleep study is conducted, followed by an upper endoscopy to see the pattern of collapse.

Candidates for Inspire:

- Have moderate to severe obstructive sleep apnea with at least 15-65 pauses in breathing per hour
- Have tried a CPAP mask and were unable to tolerate it
- Are not significantly overweight
- Are an adult 18 years of age or older

It is important to treat sleep apnea if you have it. Left untreated, patients are more at risk for high blood pressure, diabetes, strokes, heart attacks, cognitive impairment and even death.

Those with sleep apnea are also just plain tired and finding a treatment that works is life changing. “’If you’re not getting good sleep, it’s difficult to have a really good quality of life,” Dr. Schell said.

Click here to learn more about Dr. Amy Schell.

TAGS: otolaryngology, sleep, sleep apnea, surgery

CATEGORIES: CU Medicine Providers, Health Education

This post was originally posted on June 1, 2022