When it comes to treating obstructive sleep apnea, the only device on the market is the Inspire CPAP machine, which has been approved by the Food and Drug Administration (FDA). The manufacturer claims that its product outperforms CPAP machines in terms of ease of use.
In this article, we will examine the evidence supporting the Inspire device’s suitability for treating sleep apnea, discuss its potential drawbacks, and explain why we believe it is preferable to the CPAP machine in some cases.
How Does Inspire Sleep Apnea Work?
Hypoglossal nerve stimulation therapy is at the heart of the Inspire’s innovative design. Sleep apnea, caused by the tongue falling back and narrowing the airway, can be treated with an implanted medical device that sends electrical signals to the brain.
Since we have no conscious control over our tongue during sleep, it is impossible to achieve this on our own.
To place the Inspire device, a surgeon makes a few small incisions in the patient’s skin during an outpatient procedure. The device is implanted through a single incision just below the collarbone. An electrode is placed under the chin, where electrical stimulation is most effective.
For some patients, a second incision is required on the chest, according to Inspire.
Does Inspire Sleep Apnea Really Work?
Thanks to funding from Inspire, several clinical studies have been conducted with the Inspire device and published in prestigious medical journals.
In 2018, a major otolaryngology journal published the results of the first medical study of the Inspire device. The study tracked the outcomes of 126 patients over a 5-year period. The device improved patients’ self-reported quality of life, such as snoring and daytime sleepiness, as well as objective sleep apnea measures such as oxygen desaturation.
Because of the lack of a placebo control group and comparison with other therapies for sleep apnea, including continuous positive airway pressure (CPAP), we consider these results to be relatively unconvincing.
Although these data suggest that the Inspire device is better than doing nothing, the question of whether it is superior to CPAP is more important from a therapeutic standpoint.
The results of a recent clinical trial with the Inspire device were consistent with those of an earlier study. Patients who used the Inspire device reported an improvement in quality of life, less daytime sleepiness and fewer sleep apnea events.
Many of the study authors have received grants, honoraria, and travel reimbursements and other forms of compensation for their work on this experiment, as indicated in the footnotes of the article. For this reason, we believe that the reliability of the study results will suffer.
The research suggests that the Inspire device is likely effective, so we can draw that conclusion.
Despite the fact that none of the studies funded by the company were particularly well-designed and that there were conflicts of interest, it appears that using this device to treat sleep apnea is far better than doing nothing at all.
Because sleep apnea is a life-threatening condition associated with increased risk of mortality and a variety of chronic diseases, any progress in this area benefits patients.
Inspire Sleep Apnea Vs. CPAP
Many people are curious about whether the Inspire device or CPAP machines are more effective in treating sleep apnea.
It would be ideal if there were a medical study comparing the two treatments side by side for a group of people with sleep apnea, but there does not seem to be one.
Although CPAP is better researched than Inspire, medical statistics suggest it may not be as beneficial for mild to moderate sleep apnea as it is for severe sleep apnea. There is also the issue of compliance. Many people who are prescribed a CPAP machine do not use it consistently because it can be annoying to wear a bulky face mask while sleeping.
More than one-third of CPAP patients do not use the device frequently, according to a comprehensive medical adherence survey.
The individual causes of sleep apnea require patients to consult with their physicians to select the most effective treatment method. Deciding which CPAP device is best is best left to a physician familiar with the patient’s medical history and unique biology, as there does not appear to be clinical evidence to support which type is better or whether the Inspire is superior to the CPAP.
Inspire Sleep Apnea Makes Misleading Patient Outcomes
Patient results are presented on the Inspire website. Statistics show that 94% of users prefer Inspire to CPAP and would recommend it to others.
Medical records of patients who switched from CPAP to Inspire due to intolerance form the basis of their claim.
Since Inspire bases its claim on a sample of people who have already had bad experiences with CPAP machines, we consider this highly misleading and unethical.
Inspire’s claim makes it appear that a group of patients who had not used either CPAP or Inspire were tested with both devices and the vast majority of them preferred the Inspire.
In addition, it is important to remember that hypoglossal nerve stimulation devices such as Inspire are often not recommended as the first choice in the treatment of sleep apnea, but rather as a backup plan when CPAP intolerance is present.
Inspire Sleep Apnea Side Effects
Adverse reactions to Inspire were noted in the medical study mentioned earlier. A small percentage of patients, about 2%, experienced complications during the induction period.
Most commonly, “stimulation-related discomfort” was reported by 23% of patients both immediately before the procedure and during regular use. There were no catastrophic or even potentially fatal adverse effects.
We think that the profile of adverse effects is comparable to that of CPAP users. Minor adverse effects such as nasal congestion, uncomfortable mask pressure and skin irritation were observed in about 30% of CPAP patients in a medical study.
The Inspire device appears to be a viable alternative for people who have been prescribed a CPAP machine but do not use it regularly, and it is effective on average in treating sleep apnea.
The Inspire device and similar devices are described in the current medical literature as a secondary treatment for sleep apnea rather than a primary treatment.
We disagree with Inspire’s marketing claims that their device is far preferable to CPAP, as the study referenced to support these claims only included patients who had previously reported dissatisfaction with CPAP.
Considering that sleep apnea is associated with a significant increase in overall mortality, the benefits of the Inspire sleep apnea device seem to outweigh the dangers to sufferers.
Due to the wide variety of CPAP devices and the lack of a definitive better alternative in medical studies, we advise patients to discuss their options with their physician before choosing a medical device for sleep apnea. It is advisable that physicians consider each patient’s unique background and biological characteristics.