Nerve 'Zap' Treatment Could Be Alternative to CPAP for Sleep Apnea

From Drugs.com - September 14, 2017

Nerve 'Zap' Treatment Could Be Alternative to CPAP for Sleep Apnea

THURSDAY, Sept. 14, 2017 -- People with more serious cases of sleep apnea may get lasting relief from an implanted nerve stimulator, a new study finds.

One specialist says the device might benefit those who ca not tolerate the current standard treatment for sleep apnea: continuous positive airway pressure (CPAP). CPAP involves wearing a mask over the nose and/or mouth every night, and many people balk at that.

The new device, called Inspire, works by sending electrical impulses to a nerve that controls the muscles of the tongue. When the stimulator is turned on before a person goes to sleep, it causes the tongue to protrude forward, which helps keep the airways open.

Inspire was approved in the United States in 2014, after a trial showed it was safe and effective over one year.

The new study followed 65 of those patients to the five-year mark, and found they were mostly still doing well.

On average, researchers found, the patients' ratings of their sleepiness and quality of life had "normalized." And they were still having far fewer apnea episodes -- pauses in breathing during sleep.

"This shows the improvements are durable," said researcher Dr. B. Tucker Woodson, an otolaryngologist and sleep specialist at the Medical College of Wisconsin.

Obstructive sleep apnea is a disorder in which the muscles of the throat fail to keep the airways open during sleep. That results in repeated interruptions in breathing -- along with symptoms like loud snoring and daytime grogginess due to poor sleep.

The disorder is common, affecting more than 18 million U.S. adults, according to the National Sleep Foundation.

Sleep apnea can be effectively treated with CPAP, but many patients wo not try it.

"About one-third of patients look at it and walk away," said Dr. Kathleen Yaremchuk, a sleep specialist who was not involved in the study.

Still others try CPAP but do not manage to use it consistently, said Yaremchuk, who is chair of otolaryngology at the Henry Ford Health System in Detroit.

The mask does not always fit well, she explained, and there's the inconvenience of having to travel with it and clean it.

So, Yaremchuk said, nerve stimulation offers a potential alternative for at least some patients.

The Inspire device has a few components, according to Minneapolis-based manufacturer Inspire Medical, which funded the current study. The pulse generator, which is implanted in the chest, has two wires. One senses the person's breathing patterns; the other, which runs through the neck, stimulates the hypoglossal nerve when needed. The hypoglossal nerve controls tongue movements.

The device is turned on and off daily via remote control.


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