Inspire Medical Systems / UCHealth
Jeannie Lancaster / For the Reporter-Herald
Physicians and researchers frequently remind us that getting a good night’s sleep is very important. The National Sleep Foundation notes that, “If sleep is cut short, the body doesn’t have time to complete all of the phases needed for muscle repair, memory consolidation and release of hormones regulating growth and appetite.”
“When you don’t sleep well and you’re not rested, the effect on your awake time is profound,” said Dr. Mark Petrun, a UCHealth pulmonologist who specializes in sleep medicine. “It affects your concentration, alertness and ability to get things done.”
Driving and working while sleep deprived can lead to serious injury.
There are several causes of interrupted sleep. One disorder, sleep apnea, affects 18 million Americans. “The most common type of sleep apnea is obstructive sleep apnea,” notes the National Institutes of Health. “In this condition, the airway collapses or becomes blocked during sleep. This causes shallow breathing or breathing pauses.”
Besides wreaking havoc on a person’s daily life, sleep apnea also has serious and life-shortening consequences such as high blood pressure, heart disease and stroke, Petrun added.
Many individuals are able to treat their sleep apnea using a CPAP (Continuous Positive Airway Pressure) machine while they sleep. The machine provides a continuous steady flow of air. There are several different CPAP designs and when used properly they are effective approximately 90 percent of the time.
But the device must be worn to be effective. Some individuals struggle with wearing the CPAP for the required length of time, and “the number of people actually wearing the device longer than four hours per night drops to about 60 percent,” said Cindy Crosby, manager of Poudre Valley Hospital’s Sleep Disorder Center.
A new option, Inspire® Upper Airway Stimulation Therapy, was developed for individuals who struggle significantly with using a CPAP. The procedure, which was approved by the FDA in 2014, involves a surgeon implanting a small battery under the skin in the upper part of the chest (see illustration). “From that device, one wire is directed [under the skin] to the hypoglossal nerve, which controls the tongue, and another to the rib cage area so that it can sense the patient’s natural breathing patterns,” noted a recent UCHealth release.
“When you’re breathing in, the sensor on your rib notes the inspiration,” said Dr. Matthew Robertson, an otolaryngologist with Alpine Ear, Nose and Throat in Fort Collins and Loveland. Robertson is currently the only surgeon in the state and surrounding region approved to implant the device.
“It gives a little impulse to the tongue, which prevents the tongue from flopping back and moves it similarly to when you touch the inside of your front teeth with your tongue, coming forward just a few millimeters,” added Robertson. “The device is controlled by a remote control. When you go to bed you turn it on. When you wake up you turn it off.”
The new outpatient procedure will be performed at UCHealth’s Poudre Valley Hospital. Robertson noted that preparation has been going on for 2 to 2 ½ years. Before PVH began preparing to offer the procedure, the closest places offering it were Stanford and Baylor, he added. Receiving insurance approval can be a long process taking three to six months.
Individuals must meet certain criteria to be considered for the procedure including: a BMI of 32 or less; a diagnosis of moderate to severe obstructive sleep apnea and have legitimately failed using CPAP. “You have to have given it a fair shot,” said Robertson. “It’s not just for someone who doesn’t like it.”
Some pre-existing health conditions may also exclude a patient from obtaining the device. A review of health history is a vital part of determining if Inspire therapy is an option.
“Once a person is deemed a candidate by Dr. Petrun, we do a DISE (drug induced sleep endoscopy), said Robertson. “We give them an anesthetic to induce snoring and use a scope to determine if the tongue is indeed the cause of the apnea. That’s the final determining factor.”
Robertson was chosen by the company which created the Inspire therapy to be trained in the new procedure because of his extensive experience performing other forms of cranial nerve stimulator surgeries.
The surgery will be done as an outpatient procedure and last approximately two hours. Patients will be monitored for an extended period of time in the months following surgery.
To learn more about the Inspire Upper Airway Stimulation Therapy, please visit uchealth.org/inspire or call 970-495-8670.