Relief for sleep apnea patients could come not with machine, but with an implant

Medical Watch

An implantable device designed to help people breathe better at night can be a surgical fix for a common sleep problem.

It’s estimated up to 20 percent of the American population suffers with sleep apnea, a chronic condition that causes repetitive stops in breathing and decreased oxygen levels while sleeping.

Just this week a study showed a possible connection between sleep apnea and Alzheimer’s. That’s why relief is so critical.

Now some patients are turning to surgery to help end the nightmare.

Debbie Victor has wanted to end to her sleepless nights.

“I feel exhausted much of the time,” she said. “I feel like I could literally fall asleep.”

A sleep study revealed surprising results. Victor’s blood oxygen levels dropped to 66 percent at night, a number that should be in the high 90s.

Dr. Michael Awad is Northwestern Medicine’s chief of sleep surgery.

“It’s a real problem. This puts a lot of stress on all our vital organs and that’s why it can lead to increased risk of things like strokes and heart attacks,” he said. “And now we’ve seen increased literature that it is associated with increased Alzheimer’s risk.”

“There’s this huge misnomer about sleep apnea because I think people relate it to obesity or chronic smoking. And really it’s airway anatomy,” Victor said.

Victor is a cardiac sonographer who works long shifts at the hospital. She tried a CPAP machine and a dental device to help open her airway at night. Neither worked for her lifestyle.

Now she’s hoping an upper airway stimulator implant will help.

It looks like a pacemaker for the heart but the Inspire device helps regulate the airway by targeting the source of the blockage in sleep apnea patients.

“This device gets implanted in lower chest and then there is a lead that is connected to this which stimulates the nerve controlling the tongue,’ Awad said. “That pushes the tongue forward opening the airway and stops that repetitive obstruction that’s happening during sleep.”

Awad implanted the device in Victor’s chest about a month ago.

After connecting one lead to the nerve in the tongue, Awad attached another between Victor’s ribs.

“That lead is detecting breathing, sending a signal to the device and then stimulating the airway to open in line with breathing,” Awad said.

Four weeks after the procedure and once the incisions had healed, Awad officially fired up the device during an office visit. As he increased the level of stimulation on the nerve, Victor could feel her tongue move on its own.

“I could feel it,” she said. “I could feel the pressure in the back. It wasn’t painful. It was interesting but it was enough to know it was working.”

At home, Victor will use a remote control to turn on the device each night before bed.

“Anybody who is suffering from sleep apnea who hasn’t had success with traditional other therapies or those looking to get off of CPAP may be considered for this type of procedure,” Awad said.

The device’s battery in the chest lasts about 10 to 12 years and then will have to be replaced.

There are risks, though rare according to Awad, associated with the procedure including tongue numbness or weakness, which can be permanent.

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