Inspire Sleep Apnea Treatment Review

Inspire Sleep Apnea Treatment Review

Our Verdict

Inspire is the only FDA-approved implantable upper airway stimulation (UAS) device for obstructive sleep apnea (OSA), a condition that causes pauses in breathing or shallow breaths during sleep. The device works inside the body, delivering stimulation to key airway muscles, allowing the airway to stay open during sleep.

Key Features of Inspire

Treats sleep apnea by reducing apnea events, such as waking during the night and snoring
Replaces the need for continuous positive airway pressure (CPAP) machine and mask
Controlled by a handheld remote, allowing users to easily turn the device on and off and adjust voltage levels, which stimulate the hypoglossal nerve to move the tongue out of the way
Inspire Medical Systems, Inc. is a Minneapolis-based company focused on enhancing care options for obstructive sleep apnea. The company was formed by its parent company Medtronic in 2007 and has treated more than 36,000 individuals with Inspire therapy to date, says Tim Herbert, CEO and president of Inspire. The Inspire sleep apnea device was first approved by the FDA in 2014. Inspire is an upper airway stimulation device that is implanted surgically and controlled by the patient with a remote. It can improve airway stability during sleep for people with OSA.

In 2023, Herbert says the company intends to upgrade its patient remote to Bluetooth technology, which enables remote patient monitoring for sleep doctors.

Not necessary to wear a CPAP mask while sleeping
Handheld remote allows individuals to make adjustments to the stimulation voltage within a certain range predefined by a physician
Reduces risk of sleep apnea-related complications, such as heart problems, stroke and diabetes, according to the company
Cosmetic changes may be necessary for device implantation, such as scarring on the neck and chest, as well as a potentially visible bump on chest
Inspire isn’t suitable for all people with sleep apnea, and potential candidates must qualify for treatment.
Device must be replaced every 10 to 11 years
Inspire at a Glance
Procedure: The surgery to implant the Inspire device takes 2 to 3 hours and requires two weeks of recovery.
Cost: Medicare and most private insurance companies cover Inspire if the criteria to receive the surgery are met. Patients may have to pay between $1,000 to $2,000 out of pocket even with insurance coverage.
Regulations: Inspire is currently the only FDA-approved implantable sleep apnea device. The implant is also considered safe for full body MRIs.
How Does Inspire’s Sleep Apnea Device Work?
Inspire’s sleep apnea device is a suitable alternative for adults with moderate to severe OSA who are unable to use CPAP machines and masks, which are the most common way to treat OSA.

“The primary causes of sleep apnea are typically related to physical [conditions], such as obesity or [a] blockage of the airway,” says Alex Dimitriu, M.D., who is double board-certified in psychiatry and sleep medicine and founder of Menlo Park Psychiatry and Sleep Medicine. “Essentially it’s a problem with the air intake and when people fall asleep, the walls [of the throat] relax and get floppy, which can result in blockage.”

Unlike CPAP machines, which are external devices worn during sleep, Inspire is an electrical device implanted inside the body and uses mild stimulation of a patient’s hypoglossal nerve (the nerve that controls the tongue) to maintain an open airway during sleep, says Herbert.

The Inspire device is implanted during a 90-minute outpatient procedure. A neurostimulator device is placed in the upper chest under the skin via small incision. Another incision is made under the chin, where the hypoglossal nerve is located. A wire connects the Inspire device in the chest to the hypoglossal nerve through this second incision. When the Inspire system is turned on by the user with the handheld remote, the device stimulates the hypoglossal nerve, gently moving the person’s tongue forward and out of the way of their throat as they breathe during sleep.

Candidates for Inspire therapy may include:

People with moderate to severe obstructive sleep apnea.
People who are unable to use or get consistent benefit from CPAP.
People who are not significantly obese.
People who are at least 18 years old.
All candidates preparing for Inspire must undergo a drug-induced sleep endoscopy, which allows doctors to make sure the shape of your airway will allow the device to work properly.

To qualify for Inspire, an individual’s airway must collapse from front to back rather than in a circle, according to Jason Yu, M.D., an Inspire-trained surgeon who is also double board-certified in sleep medicine and ear, nose and throat (ENT) surgery. “If you have a circular pattern of choking in the back of your throat, you may not be able to get Inspire.”

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The Cost of Inspire Sleep Apnea Treatment
Inspire is covered by most insurance companies, according to the company. Out-of-pocket costs—which may include any unmet annual deductible amounts, copays or coinsurance fees for surgery—varies depending on a candidate’s insurance provider and plan. Candidates enrolled in Medicare can pay about $1,400 for Inspire. This cost may be lower for candidates with a supplemental insurance plan.

For candidates with private insurance, the price of Inspire depends on their plan’s deductible. For example, a person with a deductible of $3,000 who has already spent $1,000 toward other medical expenses might pay about $2,000 for their Inspire treatment.

“We have resources on our website to help the patient understand the [insurance] reimbursement process, as well as an in-house prior authorization team to assist the [surgical] center with the insurance process,” says Herbert.

Potential Inspire candidates should speak with their ENT doctor and insurance provider to confirm their eligibility and out-of-pocket responsibility prior to the procedure.

What Experts Say About Inspire
Sleep medicine specialists and ENTs say patients must try first-line therapies, such as weight loss, positional therapy, CPAP therapy and other non-invasive measures, for OSA before considering Inspire. Inspire treatment is considered a second-line therapy, meaning it’s only considered an option if other methods like using CPAP don’t deliver consistent benefit.

“If someone has been intolerant of CPAP [therapy] despite numerous doctor visits, attempts at usage, different masks and trials of varying pressures, the next step may be to consider an implant, such as the Inspire device,” says Dr. Dimitriu.

Candidates who undergo surgery for an Inspire device implantation can expect pain and soreness around the incision sites, which can last three to seven days after surgery. Swelling may also occur and can take several weeks to subside, says Dr. Yu. “You may be prescribed pain medication to take, but by and large, most people are back to normal within a week or two.”

During recovery time, doctors advise patients against operating heavy machinery or making any major decisions due to medications, says Dr. Yu. Doctors typically see patients again one week after surgery to check stitches and monitor overall recovery The Inspire device is activated for the first time about one month post-surgery, after the body begins to heal.

Patients may gradually increase the stimulation amplitude of their device, which functions between 0 to 5 volts.

“We give them about two months to self-adjust the device to the strength that they can best tolerate,” says Dr. Yu. Some patients have to adjust the amplitude up or down a few times to find a happy medium, he adds.

An additional appointment may be necessary for people having trouble acclimating. A sleep study can be used to measure how much a person’s sleep apnea has improved and annual appointments with an ENT can help determine a device’s functionality.

However, it’s important to know that not all patients find relief from OSA with Inspire, and e devices can be removed if a person finds it to be ineffective.

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The Inspire Experience
Inspire sleep apnea treatment can take weeks or months and deserves careful consideration by all potential candidates, urges Dr. Yu. The decision to undergo treatment should be taken seriously..

Though uncommon, some adverse risks, such as tongue weakness, discomfort related to stimulation from the device, throat numbness or hoarseness, can occur.

Inspire devices do not stimulate sensory nerves and most Inspire users note barely being able to feel the device working when it’s turned on if it’s adjusted to the correct voltage.

According to an Inspire user Facebook group, individuals generally report satisfaction with their Inspire experience, though in some cases, people note the process of finding the correct voltage setting can take several months.

One user writes: “I started this journey one year ago with my original sleep study. Without a CPAP, I recorded 50 apnea events an hour! With a CPAP the events were reduced to 28. I just met with my sleep doctor and he reported that with my Inspire device the events were down to seven an hour. He said we can do even better, so he adjusted the device and his goal is to have five or less at our next study. As you can imagine, I’m extremely happy with my progress.”

Another user, who reports experiencing throat soreness with the device, writes that after their doctor adjusted the device, they experienced improved sleep and less sensation from the device.

One Reddit user notes experiencing a noticeable lump from their device on their chest, but writes they’re satisfied with their device overall.

Frequently Asked Questions (FAQs)

What are the negatives of Inspire for sleep apnea?

Inspire is not an overnight or simple solution for sleep apnea. Patients must try other methods of improving their sleep apnea before qualifying. Even after surgery, the process takes weeks or months before optimal results are achieved.

Is Inspire better than CPAP?

CPAP is still an effective treatment for OSA. Consult with your health care provider to determine whether you qualify for Inspire.

Is Inspire legitimate?

Inspire was approved by the FDA in 2014.



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