Sleep Better, Live Better Blog

Eric J. Kezirian, MD, MPH

Eric J. Kezirian, MD, MPH is a Professor in the USC Caruso Department of Otolaryngology – Head & Neck Surgery. at the Keck School of Medicine of USC. He is an international leader in snoring and obstructive sleep apnea surgery and one of the relatively few surgeons in the world with a clinical and research focus in this area. Dr. Kezirian is President of the International Surgical Sleep Society, the world’s preeminent organization in the field. Dr. Kezirian’s research has addressed the most important questions in sleep surgery, and he utilizes a wide array of procedures and the latest research, including his own, to provide his patients with the most appropriate, effective treatment plan. More information is available at www.sleep-doctor.com.

In this guest post, Dr. Eric Kezirian answers your questions about upper airway stimulation therapy with the Inspire device.

Positive airway pressure therapy (whether CPAP, BPAP, APAP, or another form) is the first-line treatment for obstructive sleep apnea (see the image of an obstructed airway to the right).

However, some patients cannot tolerate or sleep comfortably while wearing it. If you are having trouble with positive airway pressure therapy or if it is not helping you, you may want to consider alternative treatment options, including surgery.

Inspire Upper Airway Stimulation is an exciting new treatment that was approved by the United States Food and Drug Administration in 2014 for patients with obstructive sleep apnea who do not tolerate or do not benefit from positive airway pressure therapy. I was the first surgeon in the Western United States to offer Inspire Upper Airway Stimulation and have many years of experience with this approach to treating sleep apnea.

The Upper Airway Stimulation system works somewhat like a pacemaker for the tongue. There is a main unit (called a pulse generator) that sends a signal to the nerve controlling tongue movement (hypoglossal nerve) through a stimulation lead as well as a sensing lead that allows the system to send that signal only when the patient is breathing in and not through the entire night.

Upper Airway Stimulation is different from other treatments for sleep apnea in many ways, including the fact that it combines surgery and non-surgical treatment. Here are answers to some of the questions I receive about it.