Snore No More: A Different Apnea Treatment

Does your bed mate constantly snore throughout the night? Does this person often spend nights on the couch or in a separate room, because of this ear-shattering noise? If so, it could be because of sleep apnea, and a new treatment may help fix it.

At the California Sleep Institute in Palo Alto, Dr. Donald Sesso is aiming to provide sleep apnea patients with options other than CPAP (Continuous Positive Airway Pressure) and surgery. Dr. Sesso is researching Inspire Upper Airway Stimulation (UAS) treatment that leverages neurostimulation (the stimulation of the nervous system through tiny electric pulses) to permanently address sleep apnea without machines or surgery. 

“We implant a small device that’s a stimulus to the hypoglossal nerve, and the hypoglossal nerve innervates or supplies movements to the tongue base,” Sesso said. “At nighttime, this device senses when the patient is taking a breath and then sends stimulation to the hypoglossal nerve, which in turn brings the tongue base forward, which clears the airway.”

The small device is similar to that of a pacemaker and is derived from pacemaker technology. It is elementary in UAS treatment and has an expending role in sleep apnea, he said.

“With CPAP, it is possible that [the patient's] positive pressure requirements may increase as they age, or the severity of their sleep apnea may change as they age," Sesso said. "So my concept  with this device is that for some patients, it is possible [UAS] can be the standalone single therapy where it makes their airway wider, and that’s all they need if they have a tongue base obstruction.” 

Sleep apnea is a serious health disorder. Persistent daytime sleepiness, consistently awakening at night out of breath and waking up in the morning with a headache or dry mouth are indications that you suffer from a form of sleep apnea. Untreated sleep apnea can result in life-altering consequences.

Sleep apnea comes in three different forms: central, obstructive or mixed. Of these three types, obstructive sleep apnea is the most common. 

Obstructive sleep apnea is caused when soft tissue near the rear of the throat collapses. The tissue blocks the airway and causes it to close, which obstructs breathing patterns. In central sleep apnea, the airways remains intact, and the brain fails to signal to the muscles to breathe. 

In all three forms of the sleep apnea, the sleeper is unaware of his breathing stoppages, because they do not cause him to awake. In each event, the brain eventually signals breathing to resume, but the patient’s sleep is fragmented and of poor quality.

If sleep apnea is left untreated, it can result in heart disease, stroke, high blood pressure, diabetes, depression, automobile accidents from falling asleep while driving, and other physical ailments.

Sleep apnea is as common as type 2 diabetes and affects more than 18 million Americans. Most patients are overweight males over the age of 40, but sleep apnea can affect anyone, even children. Unfortunately, a majority of people who suffer from sleep apnea are undiagnosed and untreated, despite the significant consequences of the disorder.

Often, the first step in diagnosing whether a person is suffering from sleep apnea is a sleep study. A sleep study is a six-hour evaluation of a person’s sleeping patterns. The study measures brain waves, eye and chin movements, heart rate, respiration, leg movement, and oxygen and carbon dioxide levels in blood. This study will deduce whether the patient has moderate, mild or severe levels of sleep apnea.

To combat the most severe level of sleep apnea, airway pressure treatment is most commonly prescribed to the patient. It consists of a nasal mask that applies positive pressure to keep airways from collapsing, so the patients do not have respiratory interruptions and sleep arousals at night. Unfortunately, about 50 percent of patients who start the therapy with the airway pressure machine don't continue, because of the nasal mask constriction, discomfort and inconvenience.

Surgery serves as another option for patients who suffer from sleep apnea. Surgery, however, is effective when treating snoring, but less effective when treating sleep apnea. During surgery, the doctor must determine what part of the airway is obstructing airflow, and sleep testing does not identify which area the doctor needs to alter. If a site of the airway is incorrectly treated, the possibilities of using an alternative sleep apnea treatment become diminished.

People interested in partaking in a research trial for UAS therapy can click here.