'Tongue pacemaker' helps sleep apnea patients

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If you snore or gasp for air at night, or if you always wake up exhausted, there’s a chance you may be one of the 18 million Americans with sleep apnea.

Experts say those numbers have soared over the past decade or so because of an increase in obesity and also a growing awareness of the condition.

For the right patient, an FDA-approved, implantable device might be the key.

Sixty-eight-year-old Brenda Lepuschitz relies on this palm-sized controller every night to bring her a good night’s sleep.

One touch before bed and it engages a system that automatically moves her tongue.

"Once I was relaxed, my tongue was blocking my airway and I would stop breathing 20-40 times an hour," Brenda explains.

"What that does is have an impact on someone’s quality of sleep, their ability to stay awake, their ability to concentrate at work," says Tabarak Qureshi, MD, a Critical Care Medical Doctor at Central Florida Pulmonary.

Doctors monitored Brenda in a specialized sleep lab and diagnosed her with sleep apnea. At first she tried a CPAP machine, but she hated it and could not use it.

"I would wake up and panic like I was suffocating," Brenda recalls.

That’s when doctors recommended the pacemaker for her tongue known as the Inspire upper airway stimulation system.

"It is an implantable device that we implant in the right side of the chest and run a stimulation lead under the skin to the tongue," explains Kiran Tipirneni, MD, an ear, nose and throat specialist.

Doctors made three small incisions to insert the device. It operates on a battery, much like a pacemaker. Brenda says she began to feel more alert during the day, just a few weeks after the implant.

"I feel younger because I feel so much more rested," she says.

Doctors say the overnight stimulation to the tongue is so subtle that most patients can’t tell it’s happening.

They also say this surgical treatment is not for everyone and not all insurance companies cover it.

The CPAP machine is still the gold standard, but as many as 50 percent of all patients with sleep apnea have a tough time adjusting to the CPAP.



PACEMAKER FOR THE TONGUE
REPORT #2371

BACKGROUND: According to the National Commission on Sleep Disorders Research, at least 40 million Americans suffer from chronic, long-term sleep disorders and another 20 to 30 million experience occasional sleep problems. Ignoring sleep problems and disorders can lead to disease, weight gain, and strain on daily activities. Sleep specialists are specifically trained in sleep medicine, and may find the underlying cause of a lack of sleep and provide treatment options. Lifestyle changes, medications, breathing or sleeping devices may be part of a treatment for sleep disorders such as insomnia, circadian rhythm sleep disorders, and sleep apnea. If self-help remedies for sleep are unsuccessful, it is wise to schedule an appointment with a sleep specialist or family doctor.
(Source: http://www.helpguide.org/articles/sleep/sleep-disorders-and-sleeping-problems.htm)

SLEEP APNEA: The Mayo Clinic defines sleep apnea as a “potentially serious sleep disorder in which breathing repeatedly stops and starts.” If you often wake up feeling unrested or snore loudly, you may have sleep apnea. There are three main types of sleep apnea:

* Obstructive sleep apnea: most common form and happens when throat muscles relax
* Central sleep apnea: occurs when proper signals to muscles controlling the breathing aren’t sent to the brain
* Complex sleep apnea syndrome: otherwise known as treatment-emergent central sleep apnea, this is when a person has the combination of obstructive and central sleep apnea.
Symptoms between obstructive and central sleep apnea are often the same, making it hard to determine which it is. Symptoms include loud snoring, stopped breathing while sleeping, abrupt awakenings followed by shortness of breath (more likely to be central sleep apnea), dry mouth/sore throat when wakened, morning headache, trouble staying asleep, daytime sleepiness, attention problems and irritability.
(Source: http://www.mayoclinic.org/diseases-conditions/sleep-apnea/basics/treatment/con-20020286)

TREATMENT: In the past, the most common treatment for sleep apnea was continuous positive airway pressure, or CPAP. This machine is a mask that delivers air pressure while you sleep. This air is just enough to keep the upper airway passages open so you can continuously breath, stop snoring, and therefore, sleep. Some people find this uncomfortable and cannot sleep with the mask on. Now there is a new procedure known as the Inspire Upper Airway Stimulation System. The Inspire system consists of three components: a small generator, breathing sensor lead and a stimulation lead, which can all be controlled with a small handheld remote. The machine operates on a battery, like a pacemaker. This therapy is for patients who are 22 years or older, have moderate to severe sleep apnea, have had no success with the CPAP and are free of complete concentric collapse at the palate. Go to www.inspiresleep.com for more information and to see if you are the right candidate.
(Sources: http://www.mayoclinic.org/diseases-conditions/sleep-apnea/basics/treatment/con-20020286, https://www.inspiresleep.com/for-healthcare-professionals/our-technology/)