Inspire Sleep Technology
"Sleep,” notes Nathan Eivaz, MD, “is a hot topic in medicine. We’re constantly learning more and more about it.
“What we’ve found,” adds Dr. Eivaz, an ear, nose and throat specialist with Beach Cities ENTS, “is the paradigm we used in the treatment of sleep apnea cannot be uniformly applied. Every individual’s sleep apnea is highly specified to that patient.”
Sleep apnea takes different forms. One of the most disruptive, and potentially harmful, is obstructive sleep apnea (OSA). “We are hearing about OSA more for a couple of reasons,” says Torrance Memorial Physician Network otolaryngology specialist Alexander Gertel, MD. “We’re recognizing the serious health problems sleep apnea can cause further down the line, and testing for OSA has become a lot easier. It no longer requires overnight evaluation at a sleep lab. Now it can be done at home using equipment delivered to your house.”
In one sense, OSA is a case of our bodies resting too well during sleep. “In sleep, muscles relax,” Dr. Gertel explains. “When we sleep, some of the soft tissues in the back of our throat can collapse and cause an obstruction. As we age, our muscle tone decreases, we tend to gain weight and we know weight gain adds weight in our neck and throat.”
“It’s a dynamic collapse of the upper airway,” Dr. Eivaz adds. “This is where new treatments such as Inspire come into play. They treat aspects of sleep apnea that couldn’t be treated before. Inspire works by stimulating the muscles in the palate, throat and tongue, which tend to be the areas we see in patients with dynamic collapse. Inspire senses when the patient is attempting to breathe and cannot, and it sends a signal to the nerve to tense those muscles and open the airway. It’s a strong enough impulse to alleviate the obstruction, but not strong enough to wake the patient.”
The Inspire sensor is implanted in the patient’s chest in an outpatient procedure. A slender lead connects the sensor to the patient’s hypoglossal nerve, which controls movement of the tongue and other key airway muscles. It’s only on when the patient is asleep and at risk of the airway collapse that causes OSA.
“Inspire was FDA approved in 2014,” note Dr. Gertel. “It’s already been around for a number of years with more than 40,000 surgeries in the U.S. since that approval.
“CPAP is a great treatment,” Dr. Gertel continues. “It’s still the gold standard for sleep apnea, but a very high percentage -- up to 50% -- of patients do not tolerate CPAP. They might feel claustrophobic, the mask may fall off or they may be uncomfortable and unable to sleep with air blowing constantly. In the past, there weren’t really any other options. Inspire is for those patients with moderate to severe OSA. Our Inspire program at Torrance Memorial is the only one in the South Bay, and we should be ready to go in the first half of 2023.”
Alexander Gertel, MD, practices at Torrance Memorial Physician Network ENT in Torrance and is located at 23550 Hawthorne Blvd, Ste 125. He can be reached at 310-891-6733.
