From the Guidelines
The Aspire Sleep Apnea Device, also known as the Inspire Upper Airway Stimulation system, is a recommended treatment option for patients with moderate to severe obstructive sleep apnea who cannot tolerate CPAP therapy, as it has been shown to significantly reduce sleep apnea events and improve quality of life 1.
Key Considerations
- The device works by delivering mild stimulation to the hypoglossal nerve, which controls tongue movement, during sleep, helping to keep the airway open and prevent apnea episodes.
- Candidates for Inspire therapy typically must have an AHI (Apnea-Hypopnea Index) between 15-65 and have failed or been unable to use CPAP.
- The procedure requires surgery under general anesthesia, with most patients experiencing minimal recovery time and able to return to normal activities within a few weeks.
- The device's battery typically lasts 8-11 years before requiring replacement through a minor procedure.
Treatment Outcomes
- Studies have shown that Inspire therapy can significantly reduce sleep apnea events and improve quality of life for appropriate candidates 1.
- The treatment has also been shown to improve sleep architecture, decrease risk of MVAs, and decrease neurocognitive and cardiovascular consequences associated with OSA 1.
Comparison to Other Treatments
- CPAP is still considered the first-line treatment for OSA, but Inspire therapy is a viable alternative for patients who cannot tolerate CPAP.
- Oral appliances and surgical procedures are also available for treating OSA, but Inspire therapy has been shown to be effective in reducing sleep apnea events and improving quality of life.
Patient Selection
- Patients should be carefully selected for Inspire therapy based on their AHI, CPAP tolerance, and overall health status.
- A thorough evaluation, including a sleep study and anatomical examination, should be performed to determine the patient's candidacy for Inspire therapy.
From the Research
Aspire Sleep Apnea Device
The Aspire sleep apnea device is related to hypoglossal nerve stimulation (HGNS) therapy, which is a novel treatment for obstructive sleep apnea (OSA) [ 2, 3 ].
How it Works
- HGNS therapy works by directly stimulating the hypoglossal nerve in synchrony with respiration to open the airway via tongue stiffening and protrusion [ 4 ].
- The Inspire® device is a minimally invasive operative option that constitutes a surgical alternative for patients with OSA who do not tolerate or accept continuous positive airway pressure (CPAP) therapy [ 3 ].
Effectiveness
- Studies have demonstrated significant reductions in both respiratory parameters, such as disordered breathing indices, and subjective sleep complaints, such as daytime sleepiness, with the use of HGNS therapy [ 2, 4 ].
- The quality of life impact of HGNS with the Inspire® device in patients with OSA intolerant to CPAP therapy has been shown to be positive, with improvements in usual activities and anxiety/depression [ 3 ].
Comparison to Other Treatments
- CPAP is the gold standard for treating OSA, but adherence to PAP therapy has been a major challenge, with an estimated adherence between 20% and 80% [ 2 ].
- Mandibular advancement devices (MAD) are a good alternative option if used in the appropriate patient, but are most effective in mild and moderate OSA, not severe OSA [ 2, 5 ].
- Surgical options are invasive, not appropriate for severe OSA, and associated with pain and long healing time, but upper airway surgical intervention remains a second- or third-line treatment class for moderate to severe OSA [ 5 ].
Special Considerations
- Patients with neuromuscular disorders (NMD) are particularly vulnerable to more complex sleep-related breathing disorders, and HGNS therapy may be a safe and effective treatment option for this unique patient population [ 6 ].