OhioHealth Doctor Marks Milestone With Inspire Therapy for Sleep Apnea

OhioHealth Doctor Marks Milestone With Inspire Therapy for Sleep Apnea

Key Takeaways:

• OhioHealth Physician Group Clinical ENT/ Otolaryngologist Dr. Christopher Selinsky has performed more than 100 Inspire procedures.
• Inspire offers an alternative for patients who can't tolerate CPAP.
• The device helps keep the airway open during sleep.
• Untreated sleep apnea can raise serious heart health risks.
• OhioHealth patient, Daniel Lee, says Inspire improved his sleep and quality of life.

For people living with obstructive sleep apnea, a good night's sleep can feel out of reach, especially when continuous positive airway pressure (CPAP) therapy isn't an option.

For Daniel Lee, that search for an alternative led him to OhioHealth Physician Group Clinical ENT/ Otolaryngologist Christopher Selinsky, MD, who recently surpassed a major milestone by performing more than 100 Inspire procedures.

"I've now done over 100, probably around 105 at this point," Dr. Selinsky said. "I've refined this and got it down to a bit of an art now. We can do it rather efficiently; I've decreased the incision sizes for patients and recovery time is pretty quick."

Approved by the FDA in 2014, Inspire Therapy is an implantable hypoglossal nerve stimulator designed to treat moderate to severe obstructive sleep apnea.

During sleep, the device sends a small signal to the nerve that controls tongue movement, preventing the tongue from collapsing into the back of the throat and blocking the airway.

"In simple terms, a lot of people develop sleep apnea because their tongue falls into the back of the throat, creating a physical obstruction," Dr. Selinsky explained. "The nerve stimulator sends a small signal to that nerve, lifting the tongue so patients can breathe past that obstruction with each breath throughout the night."

Untreated sleep apnea can repeatedly interrupt breathing throughout the night, causing oxygen levels to drop again and again.

"What happens is through the night, you'll have these apneic events which means you essentially you stop breathing and your oxygen goes down, and that happens multiple times a night," Dr. Selinsky said. For some people, it's 50, 60, 70 times an hour that's happening where you're having an apneic event, or even more than that."

Those repeated drops in oxygen can do more than disrupt sleep; over time, they can put added strain on the heart and increase the risk of serious health complications.

"The long-term consequences of that are higher rates of cardiovascular disease which can lead to heart attacks, stroke, patients tend to have or can get arrythmias in their heart, so you may have heard of atrial fibrillation or AFIB," Dr. Selinsky said. "That leads to being on blood thinners to prevent strokes and so there's other health consequences if this is not treated whether it's surgically or with a more traditional mainstay of therapy is CPAP, but many patients don't tolerate CPAP which then patients land in an ENT office like myself and we're talking about alternative surgical options."

Lee understands those risks firsthand.

After developing chronic nosebleeds, he visited Dr. Selinsky for treatment. During the appointment, the conversation shifted to Lee's atrial fibrillation, or AFib, and the sleep apnea that was likely contributing to it.

"My cardiovascular surgeon made the recommendation to see Dr. Selinsky," Lee said. "While I was there, we started talking about what kind of drives my AFib, which is sleep apnea."

Lee had lived with sleep apnea for years and struggled to tolerate CPAP therapy.

"Sleep apnea is a life-altering problem for a lot of people, and mine is hereditary," Lee said. "The CPAP machine just didn't work for me. I was looking for an alternative, and that's how Dr. Selinsky and I started talking about Inspire."

According to Dr. Selinsky, before surgery, patients undergo a comprehensive evaluation to determine whether Inspire Therapy is the right treatment. One important step is a drug-induced sleep endoscopy, known as a DICE procedure, which allows physicians to evaluate how a patient's airway collapses during sleep.

"We need to make sure patients have the appropriate anatomic findings that Inspire is going to work for them," Dr. Selinsky said.

Once approved, the outpatient procedure is relatively straightforward.

"This is a minor procedure," Dr. Selinsky said. "There are two incisions, one goes up under your jaw that allows us to get to the nerve that makes your tongue move and we need to put a small electrode around that nerve. And then wire gets tunneled through the soft tissue in your neck to the incision in your chest. That's where the battery and the computer go."

Compared to older surgical approaches for sleep apnea, Dr. Selinsky explained that Inspire Therapy offers patients a significantly easier recovery.

"Some of the more traditional surgeries were very painful," he said. "This is a more modern technology that's working better. The surgery is quicker, patients recover better and it's helped a lot of people."

Most patients, while not fully recovered just yet, return to work and normal daily activities within about a week.

"From a surgical standpoint, it's a fairly easy recovery," Dr. Selinsky said.

For Lee, deciding to undergo another surgery was the hardest part.

"I'm a stage 3 colon cancer survivor," he said. "The real challenge was coming to grips with doing one more surgery. The surgery itself was a piece of cake."

The procedure was completed at OhioHealth Doctors Hospital, and Lee said everything happened exactly as expected.

"It was outpatient," Lee said. "It all went exactly as he told me it was going to. Very little pain."

About one month after surgery, the device is activated and carefully adjusted over time to provide the best results.

"You have to be patient getting the implant set on the right settings for you," Lee said. "That takes time. But immediately I could tell it was going to work."

Today, Lee no longer relies on a CPAP machine.

"Push the button, and you get up and go live your life," he said. "Getting good sleep is critical to good health."

Dr. Selinsky said Lee's experience reflects what he hopes for every eligible patient.

"He's done wonderful," Dr. Selinsky said. "It's treating his sleep apnea, changed his quality of life and he doesn't have to wear a CPAP anymore."

Although Inspire has transformed treatment for many patients, Dr. Selinsky emphasizes that not everyone with sleep apnea is a candidate. He encourages anyone interested in alternatives to CPAP to first speak with their sleep medicine physician.

"Just because you have sleep apnea doesn't necessarily mean you're a candidate," Dr. Selinsky said. "Ask your sleep doctor would I potentially be a candidate for this, and if so, getting referred to an ENT doctor like myself to further discuss that."