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Info on INSPIRE
#1
Hi again, My sleep apnea Doctor referred me to an ENT Doctor to see what the cause of my severe apnea is (AHI 57). He thought perhaps I had an enlarged lingual tonsil as he could see nothing else obvious. I had a CT and he said it didn't give him any information he could use to tell me the source of the problem. He thought perhaps it was the base of my tongue.
He suggested I see a nearby specialist in Iowa City - (90 miles from where I live) to see if I am a candidate for Inspire, and he suggested I read up on it Online and ask on the Forum to maybe get some first hand opinions.
He didn't know about insurance coverage and said to find out from their office. Do any of you know if Medicare would pay for it? I know it's government approved, so I would think so.
So if any of you forum members have Inspire, I would love to hear about your experience with it.
One thing I would wonder about is how do you know it is working properly? I suppose they would check it after installation, but then it seems like it would just be blind faith. But I suppose blind faith comes into play with many things associated with our Heath. (We have faith our water is not poisoning us and that the air we breath is safe.) He compared it to trusting your pacemaker.
So thanks in advance to you Inspire people out there. Maybe once you got Inspire you stopped visiting the Forum, but I think there will be some info coming forth.
Sleepytimegal
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#2
This is the first I have heard of it. The results of the Stimulation Therapy for Apnea Reduction (STAR) clinical trial look very good. This was a three year trial, and key findings are that the improvements observed at one-year were sustained at the three-year follow up mark. The outcomes include:

A 78% reduction in apnea-hypopnea index (AHI) from baseline
An 80% reduction in oxygen desaturation events from baseline
80% of bed partners reported soft or no snoring as compared to 17% of bed partners at baseline
Quality of life measures, including daytime sleepiness and functioning, showed clinically meaningful improvements and a return to normal levels over baseline

Abstract is here: http://oto.sagepub.com/content/early/201...8.abstract

It's not perfect, and not recommended for those that tolerate CPAP therapy, but for sleep apnea patients with moderate or severe obstructive sleep apnea, and intolerance or poor efficacy for CPAP, it looks pretty good.
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#3
I would consider anything like this to be a last-ditch effort for sleep apnea treatment. If a person cannot use an xPAP for whatever reason and events are limited to OSA, then something like this is a possibility.

Not sure I would ever go for it though. I just might consider a trach before I'd do this. Why? Because these nerve stimulators only deal with one part of OSA - the tongue. There are a lot more tissue involved.

I wish there was some way to monitor the throat's tissue movement when the patient is asleep. Like a moving CT scan or something. Knock the patient and out film the events happening.
PaulaO2
Apnea Board Moderator
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Breathe deeply and count to zen.

INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.




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#4
Paula02, Yeah, it's not something I would jump into. It sounds like STAR is the same thing as Inspire. I might go talk to the doctor there, since it's relatively close (90 miles) and I know just where it's located. I'd like to hear what they had to say. I'd check to see if my insurance would pay. They might, since my ENT Doctor referred me.

My ENT talked about how they could evaluate the cause if a pulmonologist examines you under anesthesia. He didn't say they would do that for the Inspire - but just saying that's how you know for sure what's happening. I wouldn't want to have it though if they weren't sure that it would help.

He (the ENT Doctor) said he would check into it himself if he had sleep apnea. He thought it a big breakthrough for certain apnea patients.
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#5
May I ask why you are so interested in the "cause"? With OSA, there isn't much that can cause it, but there is a lot that can cause it. LOL

I mean, it only happens in one area of the body. And while there is only so much tissue there, it is a lot of tissue. Here, check out this thread and the image I posted in the first post.
http://www.apneaboard.com/forums/Thread-Throat-Anatomy

I just don't understand why anyone would want to chase after "the" reason for their OSA when there may not be a single reason, but a multitude of reasons.
PaulaO2
Apnea Board Moderator
www.ApneaBoard.com


Breathe deeply and count to zen.

INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.




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#6
I'm not familiar with Inspire, but many of these interventions report an improvement in AHI which is less than that obtainable with CPAP. For example the study that Sleeprider mentioned above gives a 78% reduction in AHI - from a baseline of 57, this still leaves a residual AHI of 12.5, which is not clinically "treated". (I admit I haven't read the paper, so I'm just going off the headline results).

CPAP therapy is a relatively cheap, non-intrusive and reversible treatment which is proven to work. I would only consider any surgical or quasi-surgical intervention if CPAP has been proved not to work for me. As Paula said, the cause of obstructive apnea is not something we normally worry about - try CPAP (or APAP, BiPAP or whatever flavour of PAP you need) and only worry about the cause if PAP doesn't work.
DeepBreathing
Apnea Board Moderator
www.ApneaBoard.com


Bed

INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#7
As an FYI, I looked into the Inspire Procedure last year. A required first step is to have a sleep endoscopy to see if the cause of your sleep apnea will best respond to this type of therapy. Because I had complete concentric collapse, I didn't qualify.

It didn't seem like it at the time but for me, that turned out to be a good thing because based on recent success (although limited), it looks my issues with sleep in addition to sleep apnea were due to a very messed up circadian rhythm problem.

I agree that looking into the cause is definitely not important unless you plan on having any type of sleep apnea surgery and not just the Inspire Procedure. In your case, it doesn't sound like you have tried pap therapy.

If I am right, that should be your first option which would include working with this board to resolve difficult issues.

Best of luck to you.

49er

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#8
http://www.bizjournals.com/twincities/ne...dical.html has a nice story on the company behind Inspire and their plans to convince insurance companies to accept their treatment option as normal and customary instead of experimental.
"The object in life is not to be on the side of the majority, but to escape finding oneself in the ranks of the insane." -- Marcus Aurelius
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#9
Thank you all for your attention to my post. I have tried cpap and find it difficult, although I'm sticking with it because I feel I have no choice. The Forum has been very helpful, believe me! I really appreciate all the help I've received, not just from my own posts, but reading other people's. It seems like there is a lack of enthusiasm about Inspire. I get that.
However, I think I am going to have a consultation because there is a doctor who does it (recommended by my ENT doctor), and I have nothing to lose talking to him about it.

You wonder why I'm interested when cpap is first line and I seem to be benefiting and you wonder why I am interested in the cause of my apnea.

I think there are 2 reasons:
My ENT doctor is very interested in the cause of my apnea and is pushing me in the Inspire direction. I know it's my choice, but if he said, 'don't bother,' I probably wouldn't have developed this interest in it.
Also, I am very familiar with the head and neck anatomy because of my career (retired now). I was a x-ray technologist and then a radiation therapist administering radiation to many patients with neck cancer. So, understanding the anatomy of the neck made me curious about what was really happening to cause the apnea.

I don't know if I'll be a candidate, but will post anything I think you'd find informative.
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