High-tech sleep solution comes to Kansas City - KCTV5 News

High-tech sleep solution comes to Kansas City

Inspire is the brand name for the surgically implanted device that can replace CPAP therapy for some sufferers. (KCTV5) Inspire is the brand name for the surgically implanted device that can replace CPAP therapy for some sufferers. (KCTV5)
More generally it is known as a hypoglossal nerve stimulator or upper airway stimulator. Inspire received FDA approval in 2014. (KCTV5) More generally it is known as a hypoglossal nerve stimulator or upper airway stimulator. Inspire received FDA approval in 2014. (KCTV5)

Being sleep deprived is something many people complain about. For some though, that's a result of a life-threatening condition called sleep apnea.

“It can cause you to have heart arrhythmias," said Dr. Suzanne Stevens, a neurologist and sleep specialist at The University of Kansas Hospital. "It's a risk factor for heart attacks and strokes.”

It also has a tremendous effect on quality of life. Sufferers have been known to nod off at work, at school, and on the road.

"I hear of people dozing at stop signs all the time, which is very disconcerting," said Stevens.

Now there is a high-tech solution for that sleep problem that just recently became available in the metro.

The surgical implant, called Inspire, works much like a pacemaker does, but instead of sending electrical impulses to the heart, it stimulates the nerve that affects sleep apnea.

"I was elated that there was something out there because I had no other choice," said Ron Hofmann of Kansas City.

Hofmann was diagnosed with sleep apnea nearly a decade ago and recently became one of the first in the metro to receive the new treatment. 

"I had pretty much given up and said, 'It's going to be what it's going to be,' because I've been going through this for eight years now," said Hofmann.

Many people connect sleep apnea with snoring. It's a common symptom, but sleep apnea can exist without snoring. That was the case with Hofmann.

The impact on him was constant fatigue and significant decline in memory function, something that began in his 30s. It took approximately ten years and multiple doctors to finally pinpoint the cause of his memory loss to sleep apnea.

“Sometimes I would be driving to someplace that I had been to many, many times before, and I would just find myself driving someplace else, and then I would get there and I would say, 'Where am I? Why am I here?'" Hofmann said.

His memory loss was due to loss of oxygen to his brain. 

It's hard to understand the significance of the new technology and how it works until you know what sleep apnea is and the limitations of the gold standard treatment.

What causes sleep apnea?

Sleep apnea is caused by the tongue moving backward into a person's airway when they sleep.

That blockage causes the person to stop breathing momentarily. The brain then kicks in and wakes up, so to speak, to stimulate the muscles to move the tongue out of the way so the person can breathe again.

The risk isn't that the sufferer will stop breathing long-term but what happens to the body when the that cycle continues frequently.

“That’s the biggest thing people worry about is stopping breathing for good at night, but your body always wakes yourself up from this sleep apnea episode. It’s the long-term consequences that are bad," said Stevens. “If it happens a lot, it stresses your body out. You’re not getting oxygen. Your heart is struggling to keep up with what your body needs.”

A sleep study revealed that was happening to Hofmann 56 times per hour. That's almost one episode per minute.

Limits of typical treatments

Year after year, Hofmann tried new treatments.

The standard treatment for decades has been cumbersome, uncomfortable and sometimes downright intolerable masks often referred to as CPAP masks. They work by using forced air to push the tongue out of the way.

“The first device he got was almost like sleeping with Darth Vader," said Hofmann's wife, Jane Signorelli.

Hofmann would rip of his mask unknowingly when he slept. The surgeon who is treating Hofmann says Hofmann is not the only sufferer who found the masks unbearable.

“People talk about feeling claustrophobic or just the pressure in their nose or even their ears," said Dr. Chris Larsen, an ear, nose and throat surgeon at The University of Kansas Hospital. “Some say the feel like they're trying to sleep in a wind tunnel. Many complain of dry mouth and severe sinus drainage associated with the mask.”

A high-tech sleep solution

Inspire is the brand name for the surgically implanted device that can replace CPAP therapy for some sufferers.

More generally it is known as a hypoglossal nerve stimulator or upper airway stimulator. Inspire received FDA approval in 2014.

Stevens learned about it at a conference in 2015 and pushed to bring it to The University of Kansas Hospital, which has the interdisciplinary team essential to implementing the technology. That includes a sleep lab, a sleep specialist and a surgeon.

“Some of the people at Medtronic, which does a lot of cardiac pacemakers, had the idea that, ‘Why can't we pace the tongue like we pace the heart or anything else?’” explained Larsen.

The University of Kansas Hospital is currently the only hospital in the region to offer the surgery. The first surgery took place in August. Hofmann was the fourth patient to receive the implant. As of late December, a total of seven patients had been implanted.

Hofmann had the device installed in November.

There are now two electrodes under his skin. One runs to an area between his ribs and near his diaphragm. That connection senses his breathing. The other goes to the hypoglossal nerve, which is the nerve that moves his tongue. The device comes with a remote control so that it is only pulsing when he is intending to sleep.

“I am really looking forward to this working for him,” said Signorelli.

“So am I,” echoed Hofmann.

Four weeks after getting the device installed, Hofmann says he’s already getting a more restful night’s sleep. He’s still working to wean off some medication, so he’s not yet prepared to credit all of the improvements to the Inspire device, but he is hopeful and optimistic that he will be able to reverse or at least halt his memory loss and to finally get a good night’s sleep.

“Because there is a lot of crankiness when you’re not sleeping,” said Signorelli, chuckling. “I hope for him to get a lot of sleep and just to feel better and enjoy life again.”

The device isn’t for everyone. There are restrictions based on body type and severity of sleep apnea.

It is approved only for moderate to severe sleep apnea, which means stopping breathing 20-60 times per hour.  It is also approved only for patients who cannot tolerate CPAP therapy, so an effort must be made to explore CPAP.

To qualify, you must have a BMI of 32 or less.

“For people who are obese, no amount of stimulation of the tongue prevents obstruction,” explained Larsen.

Asked about the down side, Larsen said patients will be left with three scars. He added that with any prosthetic implant, there is a theoretical risk of infection. He said the track record for Inspire dates to 2013, when it was approved outside the United States.

“We have a track record of a thousand done worldwide and so far there have been no reports of infections,” said Larsen.

Click here to find out how to connect with The University of Kansas Hospital to see if you qualify.

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