TGH offers new surgical relief from sleep apnea

Tampa General is one of the first hospitals in the nation and the first in Florida to offer a new “sleep pacemaker” solution to patients who suffer from severe sleep apnea.

Clinical trials were held at 22 hospitals nationwide – including TGH, the primary teaching hospital for USF Health – with results published in the New England Journal of Medicine. 

Dr. Tapan Padhya, professor and vice chair of Otolaryngology, Head and Neck Surgery at the USF Health Morsani College of Medicine, was the chief investigator for Tampa General’s trials and co-authored the "sleep pacemaker" study results.

The technology in the implant is “similar to a cardiac pacemaker, re-applied for sleep apnea patients,” says Dr. Padhya. 

Sleep apnea occurs as the result of muscles in the tongue and throat relaxing, which makes breathing more difficult. As people with the condition sleep, oxygen supply runs low, which in turn causes them to wake up to take a breath, often accompanied by a snoring or gasping noise.

The disorder has typically been treated with the CPAP (Continuous Positive Airway Pressure) machine, which involves wearing a mask over the nose, and occasionally mouth, while sleeping. The mask can keep airways open by pumping pressurized air into the mouth, but for many people, it can be difficult to sleep with.

Enter the "sleep pacemaker" neurostimulation device, developed by Minnesota-based Inspire Medical Systems, which is meant to help sleep apnea patients for whom other treatments were ineffective.

Here’s how it works: an implant described as half the size of an iPhone is placed under a patient’s collarbone. It can deliver a small electrical stimulus to the base of the tongue when the patient takes a breath. 

Patients with the Inspire device can activate it with a remote control before sleeping.

“It will gently push the tongue out to help the air flow," Dr. Padhya says. "You have an open airway. You don’t have that struggle to breathe.”

Most telling, says Padhya, is the fact that there are clinical trial patients still using the device several years after the surgical procedure.

Millions of people suffer from severe sleep apnea, a disorder that causes shallow breathing while sleeping, disrupting rest periods and leading to daytime fatigue and other health issues including insomnia, behavioral changes and disruption to executive functions like decision-making, reaction time, memory, and learning.

Because other factors can cause some of these effects, people with sleep apnea can sometimes be unaware that they suffer from the condition. However, if untreated, the disorder increases the risk of heart attack, stroke, high blood pressure and other health problems.