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Inspire – Upper Airway Stimulation and Sleep Apnea

About Griffin Chalmers

Griffin Chalmers is a high school senior attending Loyola High School in Los Angeles, California. Griffin has gained a vast range of experience through work in the corporate field, volunteering with doctors, and as a member of the Pre-Med Club. He has participated in sports for many years including football, lacrosse, and soccer. Griffin researched and wrote his articles as part of the Medical Scholars Program sponsored by the Osborne Head and Neck Foundation.

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About Dr. Ryan Osborne

Ryan F. Osborne, M.D. is the Director of Head and Neck Surgery at OHNI and is an internationally renowned expert in head and neck oncology. He has developed a special interest for the treatment of parotid gland tumors and focuses on the use of minimally-invasive techniques in the care of patients needing parotid surgery.

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Sleep Apnea is characterized by the process of one’s breathing pausing or becoming shallow during sleep, resulting in loss of sleep quality. Most people do not know they have sleep apnea as it occurs during sleep and the symptoms can overlap with common, everyday feelings such as fatigue, occasional headaches, etc. Therefore, one’s bed partner may be the first to notice this chronic disorder.

There are two main types of sleep apnea: central and obstructive sleep apnea. Central sleep apnea involves failure of the brain to signal the muscles of respiration to move. This is ultimately due to instability within the respiratory control area of the brain. In contrast, obstructive sleep apnea (OSA) is characterized by airway collapse or obstruction during sleep. The most common type of sleep apnea, OSA, is marked by loud snoring due to an obstructed airway. Although OSA is most common in overweight people, anyone can suffer from it.

Risk factors for OSA include:

  • Male gender
  • Overweight
  • Over 40 years of age
  • Large neck size (17 inches or greater in men and 16 inches or greater in women)
  • Large tonsils
  • Large tongue
  • Nasal obstruction

Most common effects of sleep apnea can be noticed during a person’s everyday life as the condition may be responsible for lack of awareness, lack of performance, falling asleep during the day, etc. In conjunction with these common symptoms, OSA can lead to the following:

  • High blood pressure
  • Increased risk of stroke
  • Heart failure
  • Diabetes
  • Depression
  • Worsening of ADHD
  • Headaches

An innovative upper airway stimulation (UAS) device, similar to a pace maker, has been invented to help the OSA patient keep their airway free of obstruction during sleep. This device is comprised of a pulse generator that is surgically inserted under the skin of the chest and a small, thin wire that is wrapped around the nerve responsible for the movement of the tongue, the hypoglossal nerve (cranial nerve 12). A breathing sensor is also attached to the generator and is placed near the patient’s right lung to monitor the breathing cycle. The device ultimately works to keep the patient’s airways open, through stimulation of the hypoglossal nerve and subsequent movement of the tongue. This stimulation promotes airway muscles to not collapse during sleep and to make sure that the tongue does not fall backwards into the opening of the throat or trachea.

Figure 1: Illustration of upper air way stimulation device placement.

With the use of upper airway stimulation, patients are able to regain sleep quality and significantly lower their chances of complications associated with sleep apnea. In addition, the generator needs to be checked only once or twice a year and can last 8-11 years. The device is controlled by the simple use of a wireless remote that turns it on when going to sleep and off during waking hours. This device helps patents forego the use of continuous airway pressure machines (CPAP or sleeping masks). Furthermore, upper airway stimulation devices such as Inspire can help to eliminate snoring and result in better sleep quality for one’s bed partner.

To learn more about sleep apnea or upper airway stimulation therapy, please visit: www.ohni.org.

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