Obstructive sleep apnea (OSA)  is a sleep disorder in which breathing frequently stops throughout the night. It happens because your upper airway muscles relax and block airflow. Your body is required to wake up to begin breathing again, which can disrupt your sleep. These awakenings are often subconscious, so you wake up tired, but unsure why.

Obstructive sleep apnea can have severe consequences for your health, including increased blood pressure, weight gain, inflammation, increased risk of heart disease, and more. Obstructive sleep apnea can also lead to premature death due to low oxygen and high levels of toxic elements like carbon dioxide, hydrogen, etc.  

Current treatment for OSA is continuous positive airway pressure (CPAP), which is a machine with a mask that is worn over the mouth and nose. The mask is connected to a machine that delivers a continuous flow of pressurized air. This force opens your airways and will help you breathe while sleeping.

CPAP machines used to be quite bulky, but now they are easier to sleep with. However, many people still find them uncomfortable and inconvenient to use. Some may also experience a little bit of claustrophobia while wearing the mask. An alternative to CPAP machines is a sleep apnea implant.

This is a device that opens your airway by changing the placement of your tongue. Most of the time, OSA can be due to your tongue blocking your airway, so by stimulating the nerve responsible for moving your tongue, you may have more space for air to flow and decrease incidences of sleep apnea events, or pauses in breathing while you are sleeping. Continue reading to find out more about how a sleep apnea implant device works.

How does a sleep apnea implant device work?

A sleep apnea implant is a device that can help you breathe during sleep. It is called a hypoglossal nerve stimulator because it stimulates the twelfth cranial nerve, also known as the hypoglossal nerve. This nerve is responsible for the movement of the tongue and can help move your tongue out of the way while you are sleeping.

It is implanted in your upper right chest beneath your skin and has four main parts:  a generator with batteries that produces electrical signals, a breathing center that is implanted in the side of your chest near your ribs which is also connected to the generator, a stimulation electrode cuff that is placed around the hypoglossal nerve and also connected to the generator, and a remote control but it's the external handheld component that can be used to control the strength of the stimulation.

When you breathe, the breathing sensor sends electrical signals to the electrode. The electrode stimulates the hypoglossal nerve, which contracts your tongue muscles and moves your tongue slightly forward. As a result, the airway becomes less narrow, which left air flow through. The remote control can be used to turn the device on and off, pause the stimulation, and change the force of the stimulation.

Are internal sleep apnea stimulators effective?

Upper Airway Stimulation has been used to manage sleep apnea for several decades. Research on the therapy has increased in the last decade. A 2014 study of 126 people with OSA received this type of device, and researchers measured the safety and efficacy of the device over 12 months.

According to the results, the device significantly reduces the severity of OSA, which was determined using overnight studies, self-reported sleep quality, and other skills that are used to report the severity of obstructive sleep apnea. In a 2020 study with 51 people, they found that hypoglossal nerve stimulation can improve OSA.  And finally, a 2021 review notes that this therapy is effective for people who are non-compliant or unable to use CPAP therapy. 

Sleep apnea implant surgery

Implant surgery takes place in an outpatient procedure and is typically completed within 90 to 180 minutes. You will be under general anesthesia, so you will not feel anything during the surgery. Whenever you are asleep, your surgeon will make an incision on the right upper neck and locate the hypoglossal nerve. Your surgeon places the stimulator cuff around the nerve and tests the cuff using the external nerve stimulator.

Then, the surgeon will make another incision on your chest on the same side as your first incision. They implant the generator device in your chest. You will then have a third incision made near your ribs where the breathing center will be placed. All three of these parts will be connected with wires, and an electrical test will be performed to make sure the device triggers the correct tongue movements. Your surgeon closes the incisions with stitches. You will normally go home the same day that you came in.

Potential drawbacks, wrist common side effects

With every surgery, there are going to be potential side effects and risks. A few common risks include swelling at the incision sites, pain, excessive bleeding, infection, and reactions to the anesthesia. Having the device in your chest can also come with its fair share of risks, including blood vessel damage near the end plate, nerve damage or injury, allergic reaction, irritation, swelling, discomfort caused by nerve stimulation, changes in stimulation caused by loose device connections, tongue weakness, and difficulty moving your tongue.

Another drawback is the remote, because if it is replaced or inappropriately handled, it could be difficult to use the device properly. Keeping track of the remote could be one of the most stressful parts for some individuals.

This procedure costs about $30,000, and health insurance providers may cover some or all of the cost. With regular use, the battery of the device will last about 11 years, and the implantation of a new battery will be an additional cost. You may qualify through special programs for financial aid, or ask your doctor or insurance providers if your state or healthcare facility offers any of these financial assistance programs.

Your physician may also accept payment plans, although this will not reduce the initial cost; it may be easier to pay for the procedure over time. This implant is not for everyone. It is primarily for those with obstructive sleep apnea who are unwilling to use a CPAP machine, have tried other treatments without success, and are unable to get tonsils removed.

Surgery should be avoided if you only have central sleep apnea, are pregnant, have upper airway blockage, have a neurological condition, are unable to operate or keep track of the remote, frequently get MRI scans, or have an implanted device that may interact with the sleep apnea device.

If you have more questions about sleep apnea, CPAP machines, and which treatment option is the best for you, then please click the orange button below to take a free online sleep test and speak with one of our sleep health professionals. 

https://www.healthline.com/health/sleep-apnea/sleep-apnea-implant#summary