Sleep apnea implants are now available in the Lehigh Valley. Why One Patient Says ‘It Was The Best Thing I’ve Ever Had’ – The Morning Call

For about 25 years, Laura Bairro woke up several times each night gasping for breath.

Biro, 58, was diagnosed with sleep apnea in her early 30s, but it wasn’t until about two years ago that she finally found a cure that helped her sleep better.

She underwent surgery at St. Luke’s University Health Network to implant a device known as Inspire, the first neurostimulation device approved by the U.S. Food and Drug Administration in 2014, but recently became available locally. became.

“Even just better sleep makes a big difference. It just makes you feel better,” Beiro said. “I feel much more energized. Honestly, day and night.

Although sleep apnea is underdiagnosed, it is estimated that about 26% of men aged 30 to 70 years and 11% of women in the same age group have it. It can also occur in some young people, including children. Some characteristics, medical conditions, and lifestyle factors predispose to sleep apnea.

There are two forms of sleep apnea. The most common is obstructive sleep apnea, which occurs when the muscles in the back of the throat relax too much, making breathing difficult. Less common is central sleep apnea, which occurs in people whose brain periodically stops telling the body to breathe during sleep. You may have both types of sleep apnea.

Untreated sleep apnea is associated with many health problems, including daytime fatigue, high blood pressure, heart problems, type 2 diabetes, nonalcoholic liver scarring, and abnormal cholesterol levels. Studies have shown that people with severe sleep apnea have an increased risk of death.

Continuous positive pressure (CPAP) machines have been the most common method of treating obstructive and central sleep apnea for decades, but there are other treatments available. For apnea patients, CPAP machines are very effective when used correctly. However, they are noisy, bulky, require the use of breathing tubes and masks during sleep, and must be worn properly on the face.

For 20 years, Bairro of Bethlehem Township has tried intermittently to get his CPAP machine working for him, with little success. She tried to lose weight, but her condition did not improve.

But since she got her Inspire implant, her sleep apnea has virtually disappeared. As long as you remember to turn on the implant using the remote control, you are guaranteed a good night’s sleep and all the health benefits that come with it.

“You pick up the remote, put it on your chest, press a button, and it’s on. Then it goes to sleep for 30 minutes and you can go to sleep,” Baylo says. “After 30 minutes, the switch is on and the back of my tongue is pulled a little bit. I’ve never woken up. People ask me that all the time, but it’s never woken me up.” It’s very subtle.”

The Inspire works similarly to a pacemaker, but instead of keeping your heart pumping, it keeps your airway unobstructed.

Dr. Jarrod Keeler, Chief of Surgery at the St. Luke’s Allentown Campus, performed the first surgery in the Lehigh Valley in September 2020. The Lehigh Valley Health Network plans to begin offering implants in March.

The surgery is minimally invasive and takes only about 60 to 90 minutes to complete, Keeler said. This includes him making two incisions. One near the intersection of the jaw and neck, where the stimulator is placed, and another on her chest, where her Inspire impulse generator and respiration sensor are placed. An impulse generator is smaller than a wallet or smartphone and resembles a pacemaker in appearance.

Keeler said patients are discharged from the hospital the same day they undergo surgery and only have a few days at home to rest before returning to normal life. The patient then has to wait about a month before activating her Inspire device, so the patient’s body has time to fully heal.

A CPAP machine combats sleep apnea by continuously pumping air into the mouth through a tube and mask, preventing the tongue, uvula, and soft palate from moving too far into the airway. so as not to impede breathing.

The maintenance requirements of the device are also not high. The implant battery lasts for about 10 years. Keeler said the surgery to replace the battery takes about 30 minutes.

Dr. Joseph Schellenberg, a pulmonologist at LVHN, said the health problems associated with sleep apnea aren’t just the result of a lack of sleep. provokes a stress response.

“It’s like I’m sitting next to you shaking you,” Schellenberg said.

Immediate effects on the body from the occurrence of sleep apnea can include fluctuations in blood pressure and increased production of cortisol, which, if left unchecked, can lead to other long-term problems. There is a possibility

Baylo said he had health problems before getting the implant. Her cardiologist told her that her untreated sleep apnea was causing the lower chambers of her heart to stop closing completely, and she also developed high blood pressure, which caused I started taking her medicine. She said it was her cardiologist who recommended looking into her inspiration.

By then, Beiro had given up on having his CPAP machine work for him.

“It looked okay at first, but it didn’t last long,” says Baylo. “Either I woke up in the middle of the night with my mask on the floor without my knowledge, or it fell out of my mouth. I’m a mouth breather, so the mask pops out and the air gets through. .”

Keeler says about 30% of people with sleep apnea, like Beiro, have a poor or no tolerance for CPAP machines.

Some people face the problem of not being able to get used to wearing a breathing mask while sleeping, not being able to find one that fits their face properly, or not being able to stop the mask from coming off during sleep.

For others, a CPAP machine keeps them breathing through the night, but the sound wakes them up. If a sleep apnea sufferer has a spouse or long-term partner, it may mean that they must sleep in separate rooms so that their loved ones can’t hear the noisy machinery.

Keeler said several patients have told them that using CPAP machines has made them less confident about pursuing new romantic opportunities.

“They don’t have to wear that stigma when they go out on a date or into a new relationship,” Keeler said.

Keeler said having the Inspire treatment available is a huge benefit and ultimately provides people like Baylo with a better alternative.

However, Schellenberg said the Inspire won’t replace CPAP machines for all sleep apnea sufferers.

“It’s certainly exciting to have something to offer, but it’s certainly a select group of patients and certainly not a treatment for all patients,” Schellenberg said.

At this time, only individuals over the age of 18, with moderate to severe sleep apnea, and not significantly overweight are eligible for treatment. Patients should also be examined and evaluated prior to surgery. Keeler said the weight limit and severity of sleep apnea is largely an insurance issue, but Inspire Medical Systems is looking to expand the list of people who can get implants.

Implant procedures are elective and not completely risk-free. The most common side effects associated with device implantation are minor and include temporary soreness at the incision site or tongue and dry or uncomfortable mouth. According to the Mayo Clinic, less than 2% of his patients with implants experienced severe side effects after surgery. The most common type was infection, a potential risk of any surgery. Other serious side effects included neuropraxia, the mildest form of serious nerve damage, as well as bruising and fluid buildup. was included.

Baylo says the surgery and implants have had no side effects and have brought nothing but positive things to her life.

“It was the best thing ever. It’s very easy for me—it fixed it, literally fixed it,” Beiro said. agreed that they believed treatment for sleep apnea was to blame.”

Wake-up call reporter Leif Greiss at 610-679-4028 or lgreiss@mcall.com.