Inspire® Upper Airway Stimulation™ is a new treatment available for patients with obstructive sleep apnea who do not tolerate or do not benefit from positive airway pressure therapy. Keck Medical Center of USC was the first center in Los Angeles to offer this therapy. Our team has substantial experience with this approach with specific expertise in selecting patients who will respond best to this treatment and then performing the surgery.
The tongue can play a major role in obstructive sleep apnea. During sleep, the muscles in the body relax, which may lead to the tongue falling back and blocking breathing in the throat. The Upper Airway Stimulation™ system uses similar technology to that in heart pacemakers to stimulate the hypoglossal nerve, the nerve that controls tongue movement. All components of the system are placed inside the body during a surgical procedure. A pulse generator is placed on top of the chest (pectoralis) muscle and is connected to two leads. The system is turned on during sleep using a remote control. When on, the pulse generator sends a signal through a stimulation lead to the hypoglossal nerve in the neck. This moves the tongue forward and can pull the soft palate (roof of the mouth) forward, as well, opening up the entire throat for breathing. A sensors lead measures breathing patterns so that the nerve stimulation occurs only when a patient is breathing in. The nerve stimulation in the system does not wake patients from sleep because the device is inside the body and does not cause any pain.
Research results have been published in major scientific journals, including the New England Journal of Medicine. Studies have shown that two out of three patients who received the Upper Airway Stimulation™ device achieved substantial improvement or resolution of their sleep apnea. An interesting part of the study examined patients that responded well to Upper Airway Stimulation™. In half of them, the device was kept on at night, and they maintained the same benefit in treating their sleep apnea. In the other half, the device was kept off for a month and then turned back on. Results showed that the sleep apnea returned when the device was turned off and then cleared up when it was turned back on. The study showed a clear benefit to treatment with the Upper Airway Stimulation™ system.