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News Americas

A study has shown that a new implantable device could lead to significant improvements in the severity of obstructive sleep apnea. (Photo courtesy of Inspire Medical Systems)
Jan 14, 2014 | News Americas

New implantable device could help sleep apnea patients

by Surgical Tribune

PITTSBURGH, USA: Continuous positive airway pressure (CPAP) is most commonly used to treat obstructive sleep apnea (OSA). However, a major issue with this therapy is noncompliance. Now, an international team of researchers has investigated the efficiency of a new implantable device that could be an alternative for OSA patients who are unable to use CPAP owing to discomfort or other problems.

The study involved 126 male and female participants (22 years old or older) who suffer from moderate to severe OSA and have had difficulty either accepting or adhering to CPAP therapy. All patients underwent surgery at various medical institutions in Belgium, Germany, France, the Netherlands or the U.S. to implant a device for Inspire Upper Airway Stimulation (UAS) therapy, which stimulates the nerve of the tongue during sleep, thereby enlarging and stabilizing the airway and improving control of breathing.

Twelve months after implantation of the device, patients were found to experience 68 to 70 percent fewer sleep apnea episodes per hour, decreasing from 29 events per hour to 9 events per hour. In addition to the reduction in the effects of sleep apnea, the patients reported improved quality of life.

In contrast to other surgical procedures, Inspire UAS therapy, which was developed by Inspire Medical Systems, a company specialized in neurostimulation systems to treat OSA, does not require removal or alteration of a patient's facial or airway anatomy because it targets the muscle of the throat rather than just the anatomy, explained Dr. Ryan Soose, an assistant professor and sleep disorder specialist at the University of Pittsburgh, which was one of the clinical centers involved in the study.

In the surgery, a stimulator is positioned near the clavicle in the upper chest and connected to a stimulation electrode placed on the hypoglossal nerve and to a lead pressure sensor between the rib muscles to detect breathing effort. The stimulation contracts a patient's upper airway muscles to maintain airway patency in order to keep the airway open during inspiration. Patients use a controller to turn the device on and off, so that it is only in use when they sleep.

According to the researchers, more than 8 million men and 4 million women in the U.S. alone are affected by OSA. They frequently stop breathing during sleep, often for a minute or longer. Over half of OSA patients are overweight. OSA is also associated with daytime sleepiness and increased risk of heart attack, stroke and high blood pressure.

The study, titled "Upper-Airway Stimulation for Obstructive Sleep Apnea," was published online on 9 January in the New England Journal of Medicine.

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