Sleep apnea affects more than 18 million people in the U.S. The telltale pauses in breathing are caused by a blocked airway or abnormal collapses of the pharynx, the membrane-lined cavity behind the nose and mouth that connects them to the esophagus.
The associated sounds of snorting, choking or gasping for breath are indications of a larger medical issue.
Long-term impacts of sleep apnea can include neurocognitive and cardiovascular diseases such as memory problems, heart attacks, and strokes.
Sleep Apnea Treatment
Our sleep medicine experts offer a broad spectrum of treatments for sleep apnea.
CPAP: The first line of treatment for sleep apnea, the continuous positive airway pressure (CPAP) machine helps keep your airway open by gently blowing air down your throat. The CPAP machine takes time to adjust to, and there are many versions available depending on the patient's shape and size.
Oral appliance therapy: A small plastic device fitted to your mouth (similar to a mouth guard) helps prevent the collapse of the tongue and tissues in the back of your throat.
Weight loss and weight-loss surgery: People who are overweight or obese have extra tissue in the back of their throat that can block their airway while they sleep. Losing weight may help reduce, and in some cases even cure, sleep apnea. Learn about our weight management and surgical weight loss programs at UC San Diego Health.
Surgical procedures: Surgery is sometimes recommended for people with more severe sleep apnea. These procedures are performed by our head and neck surgeons. A promising new treatment is Inspire Therapy (see below).
Inspire hypoglossal nerve stimulation therapy is an FDA-approved implantable treatment option for people with obstructive sleep apnea who do not tolerate or benefit from continuous positive airway pressure therapy (CPAP). UC San Diego Health is one of the few health care providers in San Diego to offer this breakthrough treatment.
While you are sleeping, Inspire monitors every breath you take. Based on your unique breathing patterns, the system delivers mild stimulation to the hypoglossal nerve, which controls the movement of your tongue and other key airway muscles. By stimulating these muscles, the airway remains open during sleep.
Inspire therapy is controlled by a small handheld sleep remote that you can turn on before bed and off when you wake up. You can also increase and decrease the strength of stimulation and pause during the night if needed.
The Inspire system is usually implanted during an outpatient procedure and most patients return home the same day. About one month after activation, patients undergo a sleep study to customize their Inspire therapy
Who Can Benefit from Inspire Therapy?
Patients are evaluated at our Sleep Medicine Center and are considered candidates for Inspire therapy if they:
- Have been diagnosed with moderate to severe OSA with an apnea-hypopnea index (AHI) above 15 events per hour
- Struggle with or cannot get consistent benefit from CPAP treatment
- Are not significantly overweight
Successful Inspire therapy requires the close collaboration of multidisciplinary providers. Chris Schmickl, MD, PhD is currently the primary provider in the sleep clinic. He performs the initial evaluation for Inspire candidacy and manages Inspire patients long-term (such as providing activation and titration of the device). He works closely with Paul Schalch Lepe, MD, FACS, a head and neck surgeon who performs the procedure to implant the Inspire device.