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What is Sleep Apnea?

Millions of people suffer from obstructive sleep apnea (OSA), which is characterized by a disruption in breathing during sleep and frequent awakenings. With OSA, the tongue or other soft tissue may block the airway, creating dangerous breathing problems during sleep.  

 

Treatment Options

Treatment of your sleep apnea depends on the severity of your diagnosis and can range from lifestyle modifications to surgery.

Lifestyle

If you have a mild case, you may be able to treat sleep apnea with lifestyle modifications, such as:

  • Lose weight
  • Avoid alcohol
  • Quit smoking
  • Change your sleep position

At Summa Health, our sleep team works collaboratively with other departments throughout the healthcare system, such as the Weight Management Institute, to ensure you get the support you need.

 

Continuous Positive Airway Pressure (CPAP) Machine

A CPAP is a common treatment method for OSA. CPAP machines deliver pressurized air to your nose, mouth or both, through a hose and mask into the airway while you sleep. The steady airflow keeps the airway open, improving respiration and sleep quality.


There are several benefits to using a CPAP machine that include:

  • Better quality of sleep
  • Less snoring
  • Feeling more alert during the day

With any treatment option, there can be side effects. Be sure to talk with your healthcare provider if you feel any discomfort or if you feel like the treatment is not alleviating your symptoms.

 

Surgery

Surgery may be a part of the treatment plan for some patients with OSA. Surgery may be recommended if you can’t tolerate CPAP therapy, which is the most effective treatment option for sleep apnea.

Some surgeries are minimally invasive, while others are more complex. The goal of surgery is to treat the areas of the airway that collapse and block your breathing during sleep. Surgery may stiffen, remove or reposition tissues in and around your throat.

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INSPIRE

Summa Health offers INSPIRE for those who struggle or cannot use other treatments, such as a CPAP machine. This minimally invasive procedure uses an FDA-approved implantable device to deliver mild stimulation to the hypoglossal nerve to prevent the tongue from blocking the airway. The device consists of three components: 
 
  • A programmable neuro-stimulator located in a chest pocket
  • A pressure-sensing lead that detects the patient’s breathing
  • A stimulator lead that delivers mild stimulation to the tongue nerve

How is the INSPIRE device implanted? 
For this procedure, a stimulator is implanted under the skin on the right side of the chest with electrodes tunneled under the skin to the hypoglossal nerve in the neck and the intercostal muscles (between two ribs) in the chest.
 
This procedure is generally performed as an outpatient procedure although some patients may require a one-night stay in the hospital for monitoring. This procedure is done under general anesthesia and generally takes two to three hours.
 
Recovery time is typically shorter than with other types of sleep surgery. Patients may experience mild discomfort the first few days and some scarring, but most report minimal pain. Side effects are usually very minimal and may include:

  • Pain and/or swelling at the incision site, which is usually mild and temporary
  • Tongue weakness/soreness, which improves over time

Most patients can return to their normal activities after a few days. The device is not activated for a month after surgery to allow for full recovery. After one month, patients will meet with their physician to establish their personal stimulation settings and learn how to use the INSPIRE sleep remote.
 
How INSPIRE works
The patient can turn the device on at bedtime. With each breath, the hypoglossal nerve is stimulated, the tongue moves out of the airway, and the airway is opened. The device battery lasts approximately ten to eleven years, after which it can be replaced during brief outpatient surgery.
 
Who is a candidate?
INSPIRE is not for everyone, and patients will have to meet several characteristics:
 
  • At least 18 years old
  • Have a moderate to severe OSA
  • Have been unsuccessful in using a CPAP machine
  • Have the appropriate palatal anatomy for the procedure to be successful
  • Body Mass Index (BMI) of 35 or less

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Oral Appliances

While they are not an appropriate solution for all sleep apnea patients, those with mild to moderate cases of obstructive sleep apnea may benefit from the use of an oral appliance. These oral appliances are also a good alternative for those who have difficulty tolerating PAP therapy.
 
Patients who are ideal candidates for an oral appliance, typically prefer this treatment because of the convenience and portability of these oral appliances. Newer appliances have embedded technology to log needed adjustments and remotely adjust optimize airway openness.
 
A patient consultation can help to determine if an oral appliance is an appropriate treatment plan. If selected, dental impressions or scans are obtained, and devices are ordered/produced. A patient must also have an appropriate number of teeth to accommodate using these appliances.
 
The effectiveness and adjustment of oral appliances are assessed through a combination of symptom improvement, ongoing evaluations by both dental and sleep medicine specialists, and possibly sleep testing. Some patients do experience side effects from this treatment, including TMJ pain, excessive salivation and changes in bite.
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If your situation is an emergency, call 911.

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