Inspire Therapy to Treat Sleep Apnea

NOW AVAILABLE AT PENN STATE HEALTH LANCASTER MEDICAL CENTER

Sleep apnea patients who have not significantly benefited from use of a continuous positive airway pressure (CPAP) machine or other therapies now have access to an alternative treatment in Lancaster County.

Dr. Guy Slonimsky, a head and neck surgical oncologist at Penn State Health and assistant professor of otolaryngology at Penn State College of Medicine, recently completed the first Inspire therapy procedure at Penn State Health Lancaster Medical Center.

The treatment involves the implantation of a small device that delivers mild stimulation to the hypoglossal nerve, which controls the movement of the tongue. This helps keep airways open to allow for normal breathing during sleep. It is the first such treatment to be approved by the FDA following a five-year clinical trial.

Inspire therapy is meant to reduce or eliminate the symptoms of obstructive sleep apnea (OSA), a condition that affects about 22 million Americans. If left untreated, OSA can cause serious health problems, including cardiovascular issues such as arrhythmia, heart failure, or stroke; increased blood pressure; instability of oxygen levels; changes in the body’s response to insulin and glucose; chronic fatigue; and changes in mood and ability to function.

Slonimsky, who has performed about 20 Inspire implantations at Penn State Health Milton S. Hershey Medical Center over the past year, said the treatment has proven to be safe and effective. An experienced surgical team prepares patients for the outpatient surgery, which generally lasts for between one and a half to two and a half hours.

During surgery, a small pulse generator, battery pack, and a respiratory sensor are implanted just under the skin in the chest. An electronic lead connects the device to the hypoglossal nerve under the jaw. The procedure requires two small incisions, one over the upper chest and another under the jaw.

Once connected, the device monitors the patient’s breathing, sending an impulse that keeps the airway open during every breath. Patients control the device with a small, handheld instrument, turning it on before sleep and off upon waking.

Patients generally experience minimal side effects, the most common being temporary pain at the incision sites, temporary weakening of the nerves controlling tongue movement, and soreness of the tongue — all of which improve over time.

Slonimsky said his patients to date have experienced negligible, if any, side effects from the procedure.

“All of my patients over the past year have gone home the same day with no significant side effects, and more than 95 percent have highly benefited from this treatment,” Slonimsky said. “I see this as a game changer in the treatment of sleep apnea.”

Inspire is not meant to replace CPAP therapy, but to provide an alternative for patients who are unsuccessful in their attempts to use CPAP, explained Dr. Daron Kahn, a Penn State Health pulmonary and critical care medicine specialist and board-certified sleep physician.

Prospective candidates for the Inspire treatment must have tried CPAP and found they were not successful in using it or that it did not improve their condition.

“Some patients just medically fail CPAP, and they need another option,” Kahn said. “The more choices we have for patients, the more likely it will be that they’ll choose a therapy and be successful in treating their disease. We’re happy to be able to bring this treatment to patients at our Lancaster hospital.”

Other requirements to be considered for the treatment include a sleep study within the past two years that resulted in a diagnosis of moderate to severe OSA, having a body mass index under 32, and being age 18 or older.

Prospective patients should consult a board-certified sleep physician to see if they qualify for the Inspire treatment. A primary care physician may be able to provide a referral. Many insurances will cover treatment costs for qualified patients.