DESTIN, Fla. (WKRG) — Doctors and staff at Ascension Sacred Heart Emerald Coast successfully completed a new Inspire sleep apnea procedure this month, the only hospital in the region to offer this service.

The Inspire procedure is a hypoglossal nerve stimulator to replace CPAP machines for those with obstructive sleep apnea. The device is implanted surgically into the body and operated by remote control.

“They don’t need the CPAP, they turn the device on with a little remote control at night, and the device senses when they’re about to have an obstructive event, it sends a pulse to the tongue to give it tone so it doesn’t collapse back in their throat and block off their airway,” said Dr. Gegg, who performed the first surgery at Ascension Sacred Heart Emerald Coast.

The American Sleep Apnea Association estimates that about 22 million Americans live with sleep apnea. It occurs when the airway collapses during sleep and blocks oxygen from flowing to the brain. The brain senses a lack of oxygen and wakes the body up just long enough to take a breath. The cycle repeats throughout the night and causes poor, disruptive sleep. When left untreated, the consistent lack of sleep can sometimes cause other health issues like high blood pressure, depression, and heart issues.

Ascension Sacred Heart Emerald Coast

How the procedure works

“We can make a cut in their neck and I find the nerve that controls their tongue and I specifically have to find the divisions of the nerve that causes the tongue to protrude out of the mouth,” said Dr. Gegg. “So once I find the right parts of the nerve and put a little stimulating device around the right part of the nerve. Then I make another incision down in their chest and I put a sensor in the muscles right above the lungs, along with a little generator. Then I plug the cords together in the generate that stays in the chest. The generator is very similar to what a pacemaker looks like.”

Dr. Gegg said the procedure is not for everyone, and those interested would have to seek treatment with a CPAP first. Dr. Gegg said there is a list of requirements to meet Inspire candidate eligibility.

Inspire candidate requirements:

“There are essentially 5 guidelines that determine if there if patients are a candidate for Inspire,” said Dr. Gegg.

  1. Must have moderate or severe sleep apnea. 
  2. Must complete an initial trial of CPAP and prove they cannot use it. “You don’t want to put someone through a surgery that they don’t need, said Dr. Gegg. “So this gold standard, they have to prove that they cannot tolerate C pap.”
  3. The patient must have a body mass index of less than 35.
  4. Patient must have had a sleep study in the last two years.
  5. Patient must complete a drug-induced sleep evaluation. “Come to the operating room to determine if their candidate, we give them an anesthetic called propofol,” said Dr. Gegg. “We put them in a drug-induced sleep state and I go through their nose with little scope. I look in the back of their throat to make sure that their throat is collapsing in the right orientation that would make them a candidate for Inspire.”

The first successful procedure was on a man in his 50s. Hospital staff said the patient found Inspire online and talked about it with Dr. Gegg.

Inspire procedure recovery time

“The recovery is about a week,” said Dr, Gegg. “That’s just from the wounds from having put the implant in. We don’t actually activate the device for a month after we’ve implanted it, just to make sure everything heals correctly.”

Risks of the surgery include implant infections, blood clots near the incisions, and damage to the nerves and lungs operated on. Dr. Gegg said there is a less than 5% chance for those risks.

Dr. Gegg said Inspire is not a solution for those with central sleep apnea. Those with CPAP machines or those recently diagnosed with sleep apnea should discuss Inspire or other options with their doctors.

“The bottom line is if there’s if anyone has any concerns or questions about sleep apnea and different options they have, there are certainly things we can do inside their nose actually, to open their nose up that can make their CPAP more tolerable to use. There are other options to help sleep apnea you know as well outside of this Inspire,” said Dr. Gegg. “So even if they’re not a good candidate for Inspire, for different reasons, you know there are things that we can still help them with.”