Obstructive sleep apnea (OSA) is a kind of disorder in which a person’s breathing frequently stops during sleep. If you have obstructive sleep apnea (OSA), you may need continuous positive airway pressure (CPAP). With CPAP, a machine delivers a steady stream of pressurized air through a mask that you wear over your nose or mouth. This flow keeps your airway open during sleep, stopping pauses in breathing and preventing snoring.
CPAP machines have become more comfortable over the years, and some people find that they are less bulky to sleep with. Still, this is a continual challenge for many people. Many people find it uncomfortable or inconvenient to use. An alternative to a CPAP machine is a sleep apnea implant. This involves a device that opens your upper airway by changing the placement of your tongue and upper lip.
Working On Sleep Apnea Implant Device
Sleep apnea is a potentially serious problem that causes you to stop breathing during sleep. This can lead to many symptoms, including snoring, gasping for air, and waking up tired. A sleep apnea implant may help you breathe easier at night. It is also called an upper airway stimulation device (UASD) because it stimulates the muscles in your throat and chest so you can breathe better. It is also called a hypoglossal nerve stimulator or upper airway stimulation device. The implant has four parts:
- Generator: This generator is implanted under your collarbone to capture the electrical signals that are present in the brain. It has batteries and produces electrical signals that can be transferred to a computer.
- Breathing Sensor: The breathing sensor is implanted in the side of your chest near your ribs. It is connected to the generator that powers your life-support system, so it can detect, analyze and store your body’s vital signs even when you are asleep.
- Stimulation Electrode Cuff: Electroneurographic electrode cuff for stimulation or recording of neural activity. It is placed around the hypoglossal nerve and connected to the generator.
- Remote Control: The remote is an external handheld component. One can control the strength of the stimulation, for example, it can be used to turn off and on the device, pause the stimulation, and it can also be used to increase or decrease the level of the stimulation.
When you do exercises that require you to pull your tongue back, the breathing sensor sends electrical signals to the generator. This triggers the generator to send signals to the stimulation electrode, which stimulates the hypoglossal nerve. This contracts your tongue muscles, moving your tongue slightly forward. As a result, the airway becomes less narrow, which lets air flow through.
Are The Internal Sleep Apnea Device Effective?
As per the 2015 scientific review, upper airway stimulation has been used to manage OSA for several decades. It is also noted that this therapy has increased within the last decade. If we talk about the trials, then the first long-term clinical trial was published in 2014. The study was conducted over for 12 months, and the researchers thus examined the safety and effectiveness of the people who were given the upper airway stimulation device.
The results of this trial found that a hypoglossal nerve stimulation device significantly reduced the severity of OSA. In addition to their overnight sleep studies, the participants reported themselves to be less sleepy and less tired than usual during the day. Using scales that measure the severity of sleep apnea and self-reported surveys, researchers determined that this device also improved people’s quality of life by reducing sleepiness and morning snoring. A separate 2020 study involving 51 people found that hypoglossal nerve stimulation improves OSA as well as severe cases in which patients cannot use CPAP machines. While as, a 2021 review notes that the therapy is effective for people who have severe OSA and cannot use CPAP machines. The review analyzed 31 studies in total.
Potential Disadvantages And Side Effects
As we all know that if anyone goes through any surgery it has its own potential risks, so the device implant also has some, such as:
- swelling at the incision sites
- excessive bleeding
- reactions to the anesthesia
Apart from the above mentioned, having a device implanted in your body can also cause some problems such as:
- blood vessel damage near the implant
- nerve damage or injury
- allergic reaction to the device materials
- discomfort caused by nerve stimulation
- changes in stimulation caused by loose device connections
- tongue weakness
- difficulty moving your tongue
Tongue Sleep Apnea Device
If you snore, you have heard the sleep apnea treatment being advertised on TV. These products are meant to prevent a major health epidemic obstructive sleep apnea from affecting you and your partner. It is important to know that sleep apnea is more than just loud snoring. This disorder can cause repetitive, brief pauses in breathing (apneas) throughout the night which means no restful slumber for many people. One treatment, a hypoglossal nerve stimulator, has recently caught mainstream attention. But it is unclear how it compares with other options available today.
A Second Choice Therapy For Sleep Apnea
Inspire is a second-choice therapy. Inspire is a wearable inhaler that provides a slower, steadier flow of air through the lungs. It is approved by the FDA, but it is not a common treatment. It is intended only for people who cannot tolerate positive airway pressure (known as PAP or CPAP).
Sleep apnea can be a challenge for those who struggle to fall asleep, so it is important to get help from an expert. The gold standard therapy for sleep apnea, polysomnography (PSG), gives your healthcare provider a detailed look at the body’s natural sleep cycle and demonstrates that you have obstructive sleep apnea (OSA). When you have OSA and do not take PAP therapy, your brain does not get the rest it needs, which can lead to reduced blood flow throughout the body and increased high blood pressure. This can upgrade a measurement called the apnea-hypoxia index (AHI) by approximately 90%, decreasing it below 5 in most people. The AHI is a score that tells about the severity of sleep apnea. An AHI between 5 and 14 is considered mild; between 15 and 29 is moderate; 30 and higher is severe.
Is Targeting Tongue Muscles Effective?
Inspire is a way to help people use their PAP systems before they get too used to them. The company makes a device that sits in front of your mask and keeps the airway open over a longer period, reducing the chance of pressure changes that lead to disrupted sleep and other issues. It is designed to be more effective than PAP by targeting the muscles of the tongue rather than the entire airway. A benefit is that it does not cause as much soreness and drowsiness as wearables as CPAP does; some studies have shown that wearing different styles of masks can affect sleep quality and delay treatment. But some research suggests that a quarter to a third of people have a hard time using PAP. When that is the case, inspire may be an alternative.
For Whom Hypoglossal Nerve Stimulation May Be Good?
Along with trying PAP without success, one should also have the following mentioned conditions to see whether hypoglossal nerve stimulation is good or bad for a particular person:
- One should have moderate to severe sleep apnea (an AHI score of 15 to 65)
- A person should also have a body mass index (BMI) of 32 or lower (although some centers allow BMI values as high as 35), which means the device is not right for people in some weight ranges.
Thus if a person meets the above-mentioned criteria, one can ask the doctor for a referral to a sleep specialist or an ear, nose, and throat surgeon. After all of this then comes the next step which is sleep endoscopy. While you are sedated, a doctor passes a small tube with a light and a tiny video camera on one end through a nostril to examine your upper airway.
What Is Needed In A Surgical Process?
The device is implanted during a short, same-day procedure done under general anesthesia. A generator is placed just below the collarbone, a breathing sensor at the side of the chest by the ribs, and a stimulation electrode around the hypoglossal nerve under the tongue. The device provides you with devices that are adjustable, non-invasive, and wireless. It is wireless to ensure that you can breathe through your nostrils and mouth simultaneously which makes swallowing more efficient. As with all surgery, risks include bleeding and infection. Some people experience tongue weakness, which can cause slightly slurred speech and minor swallowing problems. But this usually resolves within a few days, or for most people, within a few weeks. It is also seen that the device starts working after a month after surgery
How Does It Feel After The Implantation Surgery?
After checking in regularly at the sleep lab, you will be given the remote to use at home. You will place a tube on each nostril and have it gently massaged by a small battery-operated mechanism that runs through a circuit board attached to your pillowcase. The remote lets people adjust the amount of stimulation they receive overnight as needed. Most people will reach their optimal range in one night or two. It may take several nights to figure out your exact settings. Once it is working, hypoglossal nerve stimulation is convenient: no maintenance, cleaning, or buying supplies as required with a PAP machine.
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