How does the surgery for the hypoglossal nerve stimulator, calledInspirein the United States, treat obstructive sleep apnea?
Learn how an implanted tongue pacemaker equipment works.
The stimulation does not cause pain.
tommaso79 / Getty Images
It can effectively treat moderate to severe obstructive sleep apnea.
When this obstruction occurs, the airway completely collapses and normal breathing during sleep cannot occur.
There are certain conditions that might predispose someone to this sort of obstruction.
It may become more common with aging.
It is certainly more likely among people who are overweight.
The hypoglossal nerve stimulator is meant to kick off the airway by moving the tongue forward during sleep.
When it is activated, it electrically stimulates the hypoglossal nerve to the tongue.
This causes a muscle contraction that brings the tongue forward.
The timing of this stimulation may be constant during sleep or synchronized to correspond with your breathing pattern.
But it can be used only in people with abody mass index (BMI)less than 32.
Surgical Procedure for Placement
The hypoglossal nerve stimulator must be placed surgically.
This component includes the battery as well as the part that generates the electrical stimulation.
From here, there is a wire that actually stimulates the tongue extends to the hypoglossal nerve.
A second wire is directed to the chest wall to detect the breathing pattern.
As with any surgery, there is a risk of bleeding and infection.
The hypoglossal nerve stimulator could potentially dysfunction.
This might mean that it stops working entirely.
It may also fire or activate inappropriately, leading to discomfort during wakefulness.
Certainly, CPAP is the first-line treatment and you may learn to tolerate it better by following somebasic guidelines.
It may be as simple as learninghow to choose a mask.
There are even other surgical options, including palatal implants (pillar procedure) andtracheostomy.
Even something as simple asweight losscan be effective.
2008;31(8):1071-8.
2005;172(11):1363-70. doi:10.1164/rccm.200412-1631SO
Food and Drug Administration.Inspire patient manual.
2018;12(11):919-929. doi:10.1080/17476348.2018.1522253
Eastwood PR, Barnes M, Walsh JH, et al.
“Treating Obstructive Sleep Apnea With Hypoglossal Nerve Stimulation.“Sleep.
2011;34(11):1479-86. doi:10.5665/sleep.1380.
Eisele DW, Schwartz AR, Smith PL.
“Tongue Neuromuscular and Direct Hypoglossal Nerve Stimulation for Obstructive Sleep Apnea.
“Otolaryngol Clin North Am.
2003;36(3):501-10.
Kezirian, EJet al.
“Electrical Stimulation of the Hypoglossal Nerve in the Treatment of Obstructive Sleep Apnea.
“Sleep Med Rev.
2010 Oct;14(5):299-305.
“Treating Obstructive Sleep Apnea With Hypoglossal Nerve Stimulation.
“Curr Opin Pulm Med.
2011;17(6):419-24. doi:10.1097/MCP.0b013e32834b7e65.
