Forty percent of American adults snore, and 80 percent of snorers have a common, but serious sleep disorder called obstructive sleep apnea (OSA). While OSA is a very common sleep disorder, it often goes undiagnosed. Even children can have sleep apnea, called pediatric sleep apnea. While this form of sleep apnea is common, it usually goes away on its own.
However, as an adult, sleep apnea will not go away on its own, and treatment is required to help you breathe unrestricted while you sleep.
CPAP therapy is the recommended treatment for nearly every apnea patient; but for patients who find CPAP ineffective after sustained use, sleep apnea implant surgery may be an option. Before discussing the treatment option with a sleep specialist, review the numerous eligibility requirements for the implant listed below.
Here we’ll discuss the sleep apnea implant procedure, risks, eligibility, and effectiveness in an attempt to answer all your questions about sleep apnea implants.
How Does A Sleep Apnea Implant Work?
A sleep apnea implant, also known as hypoglossal nerve stimulation or upper airway stimulation therapy, treats sleep apnea by moving your tongue slightly so that it doesn’t obstruct your upper airway. There are four main components to a sleep apnea implant:
- Breathing sensor: This is implanted into your chest. When you struggle to breathe, it signals the generator to produce electrical signals to help clear your airway.
- Stimulation electrode cuff: Placed around the hypoglossal nerve with a stimulation lead. These stimulate the nerve to move your tongue.
- Generator: This component produces the electrical signals that stimulate your hypoglossal nerve.
- Remote control: This turns the device on or off, pauses any stimulation from the device, or allows you to adjust how much stimulation the device produces.
Implanting the device requires a surgical procedure, where the implant is put into the upper right part of your chest under your collarbone. When your upper airway is obstructed, the device’s breathing sensor sends a signal to the stimulation electrode and generator.
This sends mild stimulation to your hypoglossal nerve, stimulating and moving your tongue. This helps clear your airway, letting air through and helping you breathe more easily.
Are Sleep Implants Effective?
A sleep apnea implant is an effective way to treat obstructive sleep apnea (OSA) symptoms, although not everyone is eligible for the implant.
A study from the European Respiratory Journal observed 27 sleep apnea patients in three countries who used these implants to address their symptoms. During the study, they observed any changes in the patients’ OSA symptoms, as well as their daytime sleepiness, snoring, and quality of life while they used the devices. Most participants used the devices around five nights a week, for about 5 hours per night. [1]
After six months, each patients’ body mass index (BMI) was unchanged, but significant improvement was recorded in the other parameters. The study observed a significant decrease in sleep apnea events, and an increase in oxygen saturation. Participants also saw significant improvement in daytime sleepiness and in their quality of life. The participants’ bed partners even reported that they snored significantly less following the procedure.
Are There Any Risks?
Like any surgical procedure, there are some potential risks associated with getting a sleep apnea implant. Some of these risks may include:
- Difficulty moving your tongue, or weakness in your tongue
- Discomfort from the nerve stimulation
- Swelling or irritation
- Nerve damage or injury to the hypoglossal nerve
Who is Eligible for a Sleep Apnea Implant?
An implant is not approved for everyone, and not every sleep apnea patient may be a good candidate for hypoglossal nerve stimulation.
In order to be considered for the surgery, you must be 18 years old, have moderate to severe obstructive sleep apnea with an AHI (apnea-hypopnea index) between 15 and 65. The surgery is not approved for anyone with a BMI greater than 32.
If you meet the above eligibility, you will be required to confirm that you have failed and are unable to tolerate PAP treatment.
Additional considerations are needed prior to gaining approval for the implant surgery. Other treatment options are needed if you meet any of the following criteria:
- You have central sleep apnea rather than obstructive sleep apnea
- You have any devices, such as a pacemaker, that might interact with the implant
- You are pregnant
- You have a blockage in your upper airway, or a neurological condition that affects your upper airway
- You require frequent MRI scans
How Does A Sleep Apnea Implant Compare to CPAP?
While both treatment options have the same purpose of improving breathing by opening the airway and reducing the severity of sleep apnea symptoms, the methods of treatment vary drastically.
CPAP— continuous positive airway pressure— is a popular and effective sleep apnea treatment that uses a special machine and a nasal or oral appliance to help you breathe more easily. The CPAP machine produces a continuous stream of pressurized air, which is delivered into your airways through those appliances. This stream of air gently holds your airways open, which allows you to breathe more easily.
CPAP is considered the gold standard and best treatment for sleep apnea, at the most affordable rate, with the majority of people eligible for treatment.
When working with a sleep center, respiratory therapists work with patients struggling to follow CPAP treatment consistently, and find the right comfort level. If CPAP fails, sleep specialists can explore other options and alternatives to CPAP therapy.
Sleep apnea implants require surgery is to install one. If you prefer to treat your sleep apnea without surgery, this may not be an ideal option. However, if you meet the eligibility requirements, have failed CPAP, and insurance will cover the procedure costs in excess of $30,000, a sleep apnea implant may be a worthwhile treatment option for you.
Related: Sleep Apnea Treatment Without CPAP? When to Try Alternative Therapies to CPAP
When to Seek Treatment for Obstructive Sleep Apnea
Regardless of how you choose to treat your sleep apnea, what’s important is that you treat it properly. Many people who have OSA don’t even realize they have it, because many of its main symptoms occur while they’re sleeping. Some of these symptoms include:
- Loud, chronic snoring that can be heard even outside the bedroom
- Daytime sleepiness or fatigue
- Pauses in breathing during the night
- Waking up tired, even after a full night’s sleep
- A sore or dry throat in the morning
- Choking or gasping for breath while you sleep
If you’re concerned that you may have sleep apnea, it’s important to schedule an evaluation and a sleep study as soon as possible. Properly evaluating your symptoms or your sleep needs will make it much easier to find the right treatment option for you.
To get started, contact us at the Sleep Centers of Middle Tennessee today! We can help you get back to the restful and rejuvenating night’s sleep that you need!
References
1. Eastwood, Peter R, et al. “Bilateral Hypoglossal Nerve Stimulation for Treatment of Adult Obstructive Sleep Apnoea.” European Respiratory Society, European Respiratory Society, 1 Jan. 2020, erj.ersjournals.com/content/55/1/1901320.