Sleep Apnea Stimulator Implants

Sleep Apnea Stimulators Near You in Staten Island, NY

If you’re dealing with obstructive sleep apnea (OSA) and aren’t getting relief from a continuous positive airway pressure (CPAP) machine, a sleep apnea stimulator may be the next step. These devices are implanted in patients to provide relief from sleep apnea when CPAP isn’t effective. At Richmond University Medical Center, we provide treatment for sleep disorders, including sleep apnea, near you in Staten Island, New York. Learn more about sleep apnea stimulator implants, how they work, and who they’re best for.

Key Takeaways

• Sleep apnea stimulator implants may be an option for select adults with obstructive sleep apnea.
• Most patients are evaluated first with sleep testing and nonsurgical treatment, such as continuous positive airway pressure (CPAP), oral appliances, or lifestyle changes.
• Candidacy for a sleep apnea stimulator depends on several factors, such as sleep apnea severity, anatomy, and CPAP tolerance.
• Implant treatment involves evaluation, surgery, device activation, and ongoing follow-up.
• The multidisciplinary team at Richmond University Medical Center can help determine whether implant therapy is appropriate and safe.

What Is a Sleep Apnea Stimulator Implant?

Obstructive sleep apnea is a chronic sleep disorder that causes breathing to stop repeatedly during sleep. This happens when the throat muscles are too relaxed, leading the airway to collapse. It is commonly treated with a CPAP machine, which provides a steady, gentle flow of pressurized air via a mask to keep airways open during sleep.

For some patients, a CPAP machine can’t be tolerated or doesn’t provide effective relief. This is when a sleep apnea stimulator may be considered. These surgically implanted devices stimulate the hypoglossal nerve, which moves the tongue. By sending an electrical impulse to the nerve, the tongue moves slightly forward, helping to keep the airway open during sleep. This helps patients manage their OSA symptoms.

A sleep apnea stimulator generally includes these four parts:

• Stimulator device: This is the device that sends electrical impulses to the hypoglossal nerve, stimulating your tongue’s movement.
• Stimulation electrode: This is a wire that connects to your nerve, sending an electrical impulse that tells your tongue to move.
• Pressure sensor electrode: This sensor measures your breathing to tell the device when to send an electrical impulse.
• Remote: This turns the device on and off inside your body. It also controls the strength of the impulses.

What Are Sleep Apnea Symptoms, and What Does an Evaluation Include?

Before a patient gets a CPAP machine or sleep apnea stimulator, they have to be evaluated for the condition. Patients often come to a sleep specialist when they have symptoms of sleep apnea, such as:

• Loud snoring
• Gasping or choking during sleep
• Daytime fatigue
• Witnessed breathing pauses
• Morning headaches
• Dry mouth
• Irritability
• Difficulty concentrating

The physician will provide an evaluation, which includes a physical examination, an assessment of the patient’s airways, and a sleep study (polysomnography). Sleep studies can be done either in dedicated labs or at the patient’s home. They monitor oxygen levels, heart rate, and breathing to determine if sleep apnea is causing the symptoms.

What Are Conservative and Nonsurgical Treatment Options for Sleep Apnea?

Before resorting to a sleep apnea stimulator implant, there are other, more conservative treatment options that are tried first. They include:

• CPAP: This machine and mask combination delivers a steady flow of pressurized air that helps keep airways open during sleep.
• Bilevel positive airway pressure (BiPAP): This therapy uses a mask and machine that deliver pressurized air into the airway, providing higher pressure during inhalation and lower pressure during exhalation.
• Oral appliances: These are custom-made devices, such as mandibular advancement devices (MADs) and tongue-retaining devices (TRDs), that help prevent the tongue from dropping back into the throat and blocking the airway.
• Positional therapy: This involves avoiding sleeping on your back, which can increase the number of apnea episodes. Sometimes, devices are used that prompt the patient to change positions without waking them up.
• Lifestyle changes: Making adjustments to your lifestyle, such as losing weight, getting regular exercise, and quitting smoking, can help decrease the number of apnea episodes.

These non-invasive treatments are tried before resorting to surgical options like a stimulator implant.

When Might a Sleep Apnea Stimulator Implant Be Recommended?

If you’ve tried different nonsurgical treatments for sleep apnea with no relief, a sleep apnea stimulator implant might be the next step. The physician will first determine if you’re a viable candidate. You might be a candidate for a sleep apnea stimulator implant if you:

• Are at least 18 years of age or older
• Have a body mass index (BMI) under 33 to 40 (depending on insurance/guidelines)
• Have moderate to severe obstructive sleep apnea
• Can’t use a CPAP machine to treat OSA due to skin irritation, dry mouth, claustrophobia, or other reasons

Sleep apnea stimulator implant therapy may not be appropriate if:

• The patient’s BMI is over 40.
• They have a complete concentric collapse of their airway.
• They have central/mixed apnea exceeding 25% of their total apnea-hypopnea index (AHI), which measures the average number of times per hour of sleep that a person experiences pauses in breathing.

What to Expect Before, During, and After Implant Surgery

If your physician determines that a sleep apnea stimulator implant is the best solution for you, they will schedule a time for the procedure. It is an outpatient procedure that lasts anywhere between 90 minutes and three hours. Patients can expect:

Before the Procedure

Before the procedure, the sleep specialist will perform a diagnostic assessment to ensure you’re a candidate. Once confirmed, the procedure will be scheduled. The physician may advise you to stop certain medications, such as nonsteroid anti-inflammatory drugs (NSAIDs) and vitamins, for at least two weeks to reduce the risk of bleeding. Right before the procedure, you typically receive intravenous (IV) antibiotics to prevent infection.

During the Procedure

A stimulator implant procedure is performed under general anesthesia, so you will be put to sleep before it begins. Once you’re asleep, the surgeon will generally follow these steps:

1. The surgeon makes two or three small incisions: one under the chin (near the hypoglossal nerve), one on the upper-right chest (for the device), and sometimes, another along the lower rib area (for a breathing sensor).
2. The stimulator device is placed in the chest pocket.
3. The surgeon runs a lead wire to the nerve controlling the tongue and another to the ribcage to detect breathing.
4. The system is tested to confirm proper tongue protrusion.

The device will not be activated yet. It generally remains inactive for around 30 days to enable healing.

After the Procedure

Once the procedure is finished, the patient can typically go home the same day. They may notice some side effects, such as tenderness, swelling, and bruising, which are normal. Patients may use over-the-counter pain relievers to manage their pain. While healing, patients should limit lifting anything more than 10 to 15 pounds. Patients can generally resume their normal activities in two to four weeks. A follow-up appointment is often scheduled within one to two weeks to check the incision and remove any sutures.

Since the device isn’t activated yet, an activation appointment will also be scheduled around a month after the procedure. This involves turning the device on, programming it, and showing the patient how to use it. Once the device is activated, a follow-up sleep study is typically scheduled for a few months later to adjust the stimulation settings.

Learn More About Sleep Apnea Treatment at Richmond University Medical Center

If you’re getting less-than-restful sleep caused by sleep apnea, help is available. At Richmond University Medical Center, our comprehensive sleep and neurodiagnostic center, Suite Dreams, provides advanced sleep and brain health diagnostics and treatments for conditions like obstructive sleep apnea. To learn more about sleep apnea stimulator implants and whether you’re a candidate, schedule an appointment near you in Staten Island, NY, today.

Sleep Apnea Stimulator Implant FAQs

Is a sleep apnea stimulator only for obstructive sleep apnea?

Yes, sleep apnea stimulators that work on the hypoglossal nerve are exclusively for treating moderate-to-severe obstructive sleep apnea.

What nonsurgical treatments are tried before an implant is considered?

Many nonsurgical treatments are tried before resorting to a sleep apnea implant, including:

• Continuous positive airway pressure (CPAP)
• Bilevel positive airway pressure (BiPAP)
• Oral appliances
• Positional therapy
• Lifestyle changes

Are there any risks or possible complications with a sleep apnea stimulator?

Although sleep apnea stimulator implants are generally safe and effective, there are some side effects and complications to be aware of. They include infection at the implant site, swelling, bleeding, or pain in the neck and chest. There may also be temporary weakness or soreness of the tongue or stimulation discomfort.

How do I prepare for a sleep study?

To prepare for a sleep study at a lab, bring any items you use for your normal bedtime routine, including any medications you take. You should also abide by any rules given, which may include:

• Not using alcohol or nonprescription drugs
• Not drinking coffee or caffeinated beverages after 12:00 p.m.
• Not eating after 7:00 p.m.

Ask your sleep specialist about any specific questions you have about preparation.