Anyone have any experience or words of wisdom when it comes to the Inspire treatment/surgery as opposed to CPAP machines for severe sleep apnea?

Interesting. Never heard of this method.

George Costanza said:

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Anyone have any experience or words of wisdom when it comes to the Inspire treatment/surgery as opposed to CPAP machines for severe sleep apnea?

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Not 100% sure but I think it's only an option after you've tried and failed with CPAP machines…

Inspire Sleep Apnea Treatment
I posted this over a year ago and got no responses.
I have now done around 50 of them. For the right person, it works well. You definitely have to fail CPAP first. If you can tolerate CPAP and it works for you, you should not consider this procedure.
The criteria for most of the payors in my region have changed a bit, by and large the BMI for most commercial insurance is down to 32, Medicare is still at 35.
You have to have a recent sleep study (within the past two years) showing an AHI of 15-65, with no more than 25% of those events being central in origin (brain forgets to send out the signal to breathe, usually means neurologic or cardiac origin).

Inspire Hypoglossal Nerve Stimulus Implant

Thanks!

"If you can tolerate CPAP and it works for you, you should not consider this procedure."

Can you share why?

George Costanza said:

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Thanks!

"If you can tolerate CPAP and it works for you, you should not consider this procedure."

Can you share why?

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Because it isn't without risks. I have never had a significantly negative outcome with the procedure, but any time you go off to sleep there are possible adverse outcomes. The procedure first involves a Drug Induced Sleep Endoscopy, using Michael Jackson's magical sleeping medicine (Propofol) to determine whether or not you are a candidate. The implant procedure is extremely tedious and it doesn't always work. The largest studies show an average AHI reduction of from about 33 down to around 6, which is great, but CPAP should be able to get you down to that as well with no risk. In general, if there is a nonsurgical option that works, you should take it. That being said, if you genuinely fail CPAP (I doubt I could do it, to be honest), I think it is a great option. Provided, of course, you are anatomically correct for the procedure (which should be initially determined in the implanting physician's office and then confirmed during the Drug Induced Sleep Endoscopy (heretofore known as DISE).

Yoooo! My wife is a PA and was just thinking I would be a great candidate for this. I have 34 AHI, severe obstructive sleep apnea and insomnia.

I suck at wearing my CPAP at night unfortunately

I generally fail at CPAP

My doctor wants to have my tonsils removed to cure my mild sleep apnea. Said it would work wonders for me but I'm scared of the recovery.

If your tonsils are significantly enlarged, it can certainly help or even cure mild sleep apnea. That being said, the recovery for adult tonsillectomy is indeed horrific. Prepare for a week to 10 days of wailing and lamenting.

I was diagnosed with sleep apnea about 6 years ago. My sleep score was 92.

I use a Bi-Pap machine. Therefore, the implant is not a solution for me.

FYI - I had a MD one time tell me that if a doctor ever told me I needed to have tonsils removed to RUN.

theeyetest said:

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My doctor wants to have my tonsils removed to cure my mild sleep apnea. Said it would work wonders for me but I'm scared of the recovery.

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Like Kool said the recovery SUCKS! I did it 18 months ago and it's been worth it. On day 7 I told my wife if I hurt that bad on day 10 I would break down and cry but it never got there. My wife says I'm 90% quieter than I was before surgery and I don't wake myself up like I used to.

Kool said:

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If your tonsils are significantly enlarged, it can certainly help or even cure mild sleep apnea. That being said, the recovery for adult tonsillectomy is indeed horrific. Prepare for a week to 10 days of wailing and lamenting.

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My tonsils are indeed enlarged. ENT doc said they're grade 4 and also wants my uvula removed at the same time. My daughter had the same sized tonsils and had hers removed when she was 5 due to multiple bouts of strep throat and sleep apnea/snoring.

I know it'll fix my issue and that I should probably just man up and get it over with but I'm so scared lol

Anyone do an at home sleep study for sleep apnea? I most likely have it but don't care to spend the night somewhere to be monitored/tested.

clobby said:

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Anyone do an at home sleep study for sleep apnea? I most likely have it but don't care to spend the night somewhere to be monitored/tested.

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I've done two studies at sleep labs. It's not as bad as you think and more controlled.

Don't mind the weird sad face lol

theeyetest said:

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Kool said:

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If your tonsils are significantly enlarged, it can certainly help or even cure mild sleep apnea. That being said, the recovery for adult tonsillectomy is indeed horrific. Prepare for a week to 10 days of wailing and lamenting.

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My tonsils are indeed enlarged. ENT doc said they're grade 4 and also wants my uvula removed at the same time. My daughter had the same sized tonsils and had hers removed when she was 5 due to multiple bouts of strep throat and sleep apnea/snoring.

I know it'll fix my issue and that I should probably just man up and get it over with but I'm so scared lol

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If your tonsils are truly 4s, you really should get them out. As to the uvula, the observed trend in sleep surgery is away from uvulectomy. Trimming the end of the uvula AT MOST.

Does removing the adenoids help at all?

Bucketrunner said:

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Does removing the adenoids help at all?

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Adults rarely have much in the way of adenoid tissue. Pediatric population is a different story.

clobby said:

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Anyone do an at home sleep study for sleep apnea? I most likely have it but don't care to spend the night somewhere to be monitored/tested.

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I did and it was super easy. Just have your PCP refer you to a sleep specialist for an at home study.

Bumping this up, because not a lot of CPAP threads.

Finally did a sleep study this week, but according to Kool, my BMI is too low for Inspire. A friend/coworker has it and loves it.

Have BCBS and the in-office sleep study had a $50 co-pay, but at home was $700, so did the in-person. When the guy was taking off the electrodes in the morning, he commented on how poorly I slept and how much I snored, so pretty sure a CPAP is in my future.

Guitarsoup said:

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Bumping this up, because not a lot of CPAP threads.

Finally did a sleep study this week, but according to Kool, my BMI is too low for Inspire. A friend/coworker has it and loves it.

Have BCBS and the in-office sleep study had a $50 co-pay, but at home was $700, so did the in-person. When the guy was taking off the electrodes in the morning, he commented on how poorly I slept and how much I snored, so pretty sure a CPAP is in my future.

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You might be misunderstanding something. The BMI limits are UPPER limits. Lower than those cutoffs (and they're individualized by insurance companies) is great.

ETA: The Inpire reps have told me that the BMI cutoffs might be going up for Medicare. I sincerely hope that they don't - if anything, I hope they go down. Even though BMI has its limits, surgery for obstructive sleep apnea in the face of obesity is generally not helpful. I have already seen a patient who worked diligently to get his BMI down for the procedure, only to have the procedure, initially do well, and then gain all of his weight back and then some. Surprise, surprise, his Inspire really isn't working that well now (he can't tolerate the voltages necessary to move his tongue forward adequately).

Kool said:

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Guitarsoup said:

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Bumping this up, because not a lot of CPAP threads.

Finally did a sleep study this week, but according to Kool, my BMI is too low for Inspire. A friend/coworker has it and loves it.

Have BCBS and the in-office sleep study had a $50 co-pay, but at home was $700, so did the in-person. When the guy was taking off the electrodes in the morning, he commented on how poorly I slept and how much I snored, so pretty sure a CPAP is in my future.

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You might be misunderstanding something. The BMI limits are UPPER limits. Lower than those cutoffs ( and they're individualized by insurance companies) is great.

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I think I am misunderstanding and I blame the lack of quality sleep.

I get my Inspire activated Friday. Ill keep you posted!

I have been needing to do a sleep study for a while, but last time I checked it was $800. I have BCBS also guitar - where did you have it done at?

busdriver88 said:

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I get my Inspire activated Friday. Ill keep you posted!

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Good luck! Remember, Friday is just a starting point. Don't think you'll stop snoring, sleep great, etc. as soon as you're activated. It's a marathon, not a sprint. And watch all of the videos about the remote before your activation visit.

State of Texas said:

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I have been needing to do a sleep study for a while, but last time I checked it was $800. I have BCBS also guitar - where did you have it done at?

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I used Comprehensive Sleep medicine, but do not recommend them at all.

Kool said:

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busdriver88 said:

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I get my Inspire activated Friday. Ill keep you posted!

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Good luck! Remember, Friday is just a starting point. Don't think you'll stop snoring, sleep great, etc. as soon as you're activated. It's a marathon, not a sprint. And watch all of the videos about the remote before your activation visit.

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Thank you sir!

Freak the surgeon out. Tell him you're gonna guess sensation at 1.2 Volts and initial settings at 1.5 Volts before he hooks you up. Ask him how often he finds his patients need to go to "comfort settings".

I thought I would ask if I could pay a little extra and have the thing light up like Iron Man.

State of Texas said:

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I have been needing to do a sleep study for a while, but last time I checked it was $800. I have BCBS also guitar - where did you have it done at?

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Not sure where you are located but here's my post from the Houston board asking the same question: https://texags.com/forums/38/topics/3340990/replies/63591405#63591405

I ended up going to an Internal Medicine doc near Willowbrook who also specializes in sleep. She doesn't take insurance but the price was very reasonable: it was $175 for the initial appointment then $200 for the at home sleep study (they had one available in the office, so I was able to take it home and do my sleep study the same day as my initial appointment). That was about 2 weeks ago, I should be getting the results any day now. Apparently she's going to call me to talk through next steps, but any additional in-office appointments will be $75. Lmk if you want her info.

Results in, 65 obstructions per hour, so severe sleep apnea.

Comprehensive sleep, of course, wants me to get my machine through them, but there is a 3-4 week waitlist.

Asked them to send me my Rx.

Guitarsoup said:

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Results in, 65 obstructions per hour, so severe sleep apnea.

Comprehensive sleep, of course, wants me to get my machine through them, but there is a 3-4 week waitlist.

Asked them to send me my Rx.

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That's going to be at the upper limit of what Inspire will cover. There IS some wiggle room on the upper end (normal range for coverage is 15-65 events per hour), so if a person truly cannot tolerate CPAP, has had other areas of the upper airway addressed surgically, done oral appliance, etc., an appeal might be successful.

Kool said:

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Guitarsoup said:

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Results in, 65 obstructions per hour, so severe sleep apnea.

Comprehensive sleep, of course, wants me to get my machine through them, but there is a 3-4 week waitlist.

Asked them to send me my Rx.

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That's going to be at the upper limit of what Inspire will cover. There IS some wiggle room on the upper end (normal range for coverage is 15-65 events per hour), so if a person truly cannot tolerate CPAP, has had other areas of the upper airway addressed surgically, done oral appliance, etc., an appeal might be successful.

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My next step is probably consulting an ENT about my airway in addition to the CPAP.

Plus getting more strict on my diet, although my BMI is below 28, so I'm not super awfully fat, but there is some day to lose for sure

I have normal BMI and severe sleep apnea, too. Been in CPAP since 2023. Obviously, sucked at first but I got used to it. I cannot sleep without it. If i do, I jolt awake with my mouth wide open and a sore dry throat.

The ResMed Airsense 10 is my current unit. Hope to get a AirSense 11 this spring. I like the AirTouch N20 Nasal mask. I am currently using the TexAgs sponsor HeartStrong Sleep for supplies. I changed to them a few months back after my previous company got slower to respond, to check on refill needs, etc. HeartStrong has been great. Any supplier needs a copy of the sleep study and a prescription.

Candiru said:

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I have normal BMI and severe sleep apnea, too. Been in CPAP since 2023. Obviously, sucked at first but I got used to it. I cannot sleep without it. If i do, I jolt awake with my mouth wide open and a sore dry throat.

The ResMed Airsense 10 is my current unit. Hope to get a AirSense 11 this spring. I like the AirTouch N20 Nasal mask. I am currently using the TexAgs sponsor HeartStrong Sleep for supplies. I changed to them a few months back after my previous company got slower to respond, to check on refill needs, etc. HeartStrong has been great. Any supplier needs a copy of the sleep study and a prescription.

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Just sent them a message, do they use insurance or out of pocket/reimburse?