The hypoglossal nerve comes off the base of the brain, travels through the bottom of the skull, passes through the upper neck and to the tongue. It is the nerve that is responsible for tongue motion. There is another nerve, the lingual nerve, that gives the tongue sensation and taste; it is not used during the implantation of the stimulator.
Inspire therapy is a mask-free solution for people with obstructive sleep apnea (OSA), who have tried and struggled with CPAP. Patients must have moderate to severe OSA and not tolerate the positive airway pressure therapy.
It has three components:
These are activated with a handheld remote control and monitored with a smart phone app.
The Inspire therapy device isn’t recommended for everyone with sleep apnea. There are specific requirements patients must meet before an Inspire implant can be placed:
The drug induces sleep endoscopy (DISE) must be done before the actual stimulator implantation, usually in a separate procedure. The patient is brought into the operating room and sedated. As they fall asleep, a small, flexible scope is placed through the nose and the airway is observed while the patient is falling asleep. This is done to look at the pattern of closure/obstruction in the throat.
In order to be eligible for the implantation there cannot be a “circumferential closure” of the throat—I describe this as a “purse-string” type closure. It has to be mostly an anterior-posterior blockage as the soft palate closes against the back wall of the throat. Ninety percent of patients pass this evaluation. The results are then sent to your insurance company for approval. Some insurances allow us to do the DISE and the implantation on the same day.
The implantation process is performed under general anesthesia. Once asleep, the Inspire-surgeon makes two incisions: One below the right side of the chin and the other just below the collar bone. The stimulation lead is placed on the hypoglossal nerve under the chin, and its wire is tunneled under the skin, over the collarbone, and to the stimulator. The breathing sensor is placed between the second and third ribs, using the same incision under the collar bone, where the stimulator is placed. Once the implantation is done, we test the stimulation levels and the respiratory sensors for proper function and adjust the placement as necessary. The incisions are then closed with absorbable sutures and sealed with skin adhesive and tape strips. The typical surgery takes 1-1/2 to 2-1/2 hours.
As with any surgery, there are risks. These are typically minor and resolve on their own.
After a successful Inspire stimulator implantation, typical results include a significant reduction in sleep apnea events (often around 70 80% decrease), marked improvement in snoring severity, and noticeable reduction in daytime sleepiness, with most patients experiencing a significant improvement in their sleep quality overall; this is usually accompanied by a lowered apnea- hypopnea index (AHI) score and better quality of life.
Key points about successful Inspire results:
Studies show a substantial decrease in the number of sleep apnea events per hour after Inspire implantation.
Due to less sleep apnea and snoring, patients often report better overall sleep quality and less daytime fatigue.
Improved sleep quality can lead to better concentration, mood, and overall daily functioning.
Most patients experience a significant reduction in snoring intensity and severity.
A significant drop in the apnea-hypopnea index (AHI) score is typically observed after Inspire treatment. This means improvement in sleep apnea.
Same and next day appointments available
Proliance Surgeons Puget Sound ENT
Care Center
21911 76th Ave W Suite 211
Edmonds, WA 98026
Proliance Surgeons Puget Sound ENT
Care Center
515 Minor Avenue Suite 140
Seattle, WA 98104
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