The term “apnea”, which means “without breath,” can also be referred to as interrupted breathing. Obstructive sleep apnea (OSA) is a condition that affects an individual’s ability to breathe at night due to a physical obstruction, either in the roof of mouth, tongue, throat, or nose.
Signs of Obstructive Sleep Apnea
Individuals with obstructive sleep apnea may experience the following symptoms:
- Persistent “tired” feeling
- Inability to achieve feeling of being fully rested
- Need to take daytime naps
- Difficulty staying awake during the day and/or while driving
- Headaches
- Mood swings
- Low energy
- Memory loss
- Low sex drive
Left untreated, symptoms of OSA may cause complications such as stroke, heart attack, high blood pressure, and even premature death.
How Obstructive Sleep Apnea is Diagnosed
Patients who exhibit symptoms of OSA should undergo a sleep study, or a polysomnogram, which is an overnight test that can be performed in a sleep laboratory or in the patient’s own home. During the study, sensors keep track of a number of important processes, including sleep state, heart rhythm (EKG), blood oxygen levels, and the number and duration of spells of interrupted breathing. Once the study has been completed, the collected data is analyzed and used to determine whether the patient has a snoring problem or obstructive sleep apnea.
How Obstructive Sleep Apnea is Treated
OSA can be treated with a relatively new treatment called Inspire® Upper Airway Stimulation Therapy. The treatment involves implanting a hypoglossal nerve stimulator that sends an electrical pulse to the nerve controlling tongue movement. With every breath an individual takes in their sleep, the device delivers a stimulus to the tongue, forcing the airway to open.
Patients who are not significantly overweight (BMI <35), have 15 to 65 blockages per hour in their throat (AHI 15-65), cannot tolerate CPAP, and do not have a high percentage of central apneas may qualify for this treatment. Once the patient is evaluated by a sleep surgeon and determined to be a candidate for upper airway stimulation therapy, they are scheduled for a drug-induced sleep endoscopy. If the endoscopy shows that the patient’s airway does not collapse in a complete circle (concentric collapse), they are likely to benefit from this type of therapy.
The surgically-implanted stimulator is composed of three elements: a generator, a sensor with a wire, and a wire with an electrode. The generator, which is implanted under the skin and on top of the chest muscles, delivers stimulus to the nerve. The sensor with a wire connected to the generator is placed in the rib cage and signals to the generator every time the patient is about to take a breath. A second wire with an electrode wrapped around the nerve that is connected to the patient’s tongue (hypoglossal nerve) is also connected to the generator. This second wire is responsible for activating the nerve and opening up the airway.
Once the surgery is completed, the stimulator can be adjusted and fine-tuned according to patients’ unique needs. Patients will use a remote controller to turn the device on and off, or pause the therapy briefly during the night.