I need help making a decision

[Bernadine]

So, I have sleep apnea. I do use a cpap, but I hate it. I’ve used it consistently for a year or so, but I’ve never gotten used to it. It wakes me up when I roll around and makes it harder for me to fall asleep.

I’m considering getting the Inspire device, which is an implant that helps in 70% of people. The Dr would need to make a 4 inch incision along my jaw line for the device and another 4 inch incision in my collarbone for the battery. The battery needs replaced every 10 years.

I am so torn. I HATE everything about the cpap. But do I really want something implanted in my body? Not to mention the scars from the incisions?

I’ll take any help you have!

[bex1973]

If what is supposed to help you makes you so uncomfortable that you can't sleep then it's really not doing anything for you. H has had one for years and wears it and isn't super bothered by it but at times it does cause issues and he's considering getting Inspire as well.

Honestly if the choice is no quality of sleep or small scars (that would hopefully fade) I'd choose the scars. I do get the hesitation to implant something but I kind of feel like these have been around long enough to get the kinks worked out.


All that to say I'd choose Inspire

[pixy0stix]

I'd play around with different types of masks/hoses before going the Inspire route.

I'm also not a big fan of the cpap and I started looking at Inspire and the potential risks made it not worth it for me. That being said, it's relatively safe: pubmed.ncbi.nlm.nih.gov/32645535/

My main objection is that I'll probably eventually have other things implanted, like an artificial heart valve, and I don't need more things that will eventually need more surgical upkeep.

[pinkdutchtulips]

Following bc the other night J noticed when I wasn't snoring, I wasn't breathing. I'm getting booked as soon as I can for a sleep study but the idea of a CPAP machine ... so not appealing. 

My dad and younger brother are already on CPAP machines. Why does getting older have to suck so much?

[Bernadine]

Oct 15, 2024 15:13:54 GMT -5 pixy0stix said:

I'd play around with different types of masks/hoses before going the Inspire route.

I'm also not a big fan of the cpap and I started looking at Inspire and the potential risks made it not worth it for me. That being said, it's relatively safe: pubmed.ncbi.nlm.nih.gov/32645535/

My main objection is that I'll probably eventually have other things implanted, like an artificial heart valve, and I don't need more things that will eventually need more surgical upkeep.

Your first point is a good idea. I’ve tried both the masks that cover mouth and nose and just the nose and prefer the one that covers both.

[waverly]

Have you spoken to the sleep doctor about it? Surgeon? Maybe get a second opinion to help you decide?

[Bernadine]

Oct 15, 2024 15:24:19 GMT -5 waverly said:

Have you spoken to the sleep doctor about it? Surgeon? Maybe get a second opinion to help you decide?

I did meet with a doctor who would perform the surgery. I need an updated sleep study, which I’ll be doing this weekend. He seemed to think it was a good idea.

[protozoa]

My dad got it because he was not open at all to using a CPAP and his experience makes it a no for me (I am diagnosed with OSA and have a CPAP that I don't use, however I got sinus surgery which lessened my symptoms). He had huge bruising and swelling after the surgery (lasted a few months) and still had a big lump around 6 months later. If he doesn't fall asleep quickly enough it starts zapping his tongue. He's a 77 year old man with a lifetime of accumulated sleep issues, and he is not good with tech, so your experience would probably be different but I would definitely do a lot of research into peoples' experiences before moving forward.  

[Deleted]

My sleep doctor explained that the data for Inspire isn’t great. Basically it reduces apnea events by up to about 50%. Meaning some people get less benefit from that, and a few get slightly more. For many people, like my husband, he has so many apnea events that event 50% would still be considered “severe” apnea. But 50% is still better than nothing, if you’re not wearing your CPAP. Some people really like inspire, and some don’t. I’m honestly not sure my husband would risk a surgery and implantable device for the chance of cutting his apnea events in half. My sleep study is in 2 weeks, so I guess we’ll see if I have apnea and how bad.

[bittybomb]

My father in law got the inspire after years of the cpap and not having good sleep with it. He got his a few years ago and has loved it ever since. He has offered no complaints and talks it up every tome someone mentions snoring. lol

[sofamonkey]

They also have oral appliances as treatment. I’d explore several options before that type of surgery.

Also, I have a love/hate relationship with my cpap. I found that putting the hose through an upper part of the bed frame helps. That way, it’s freely moving still, but I don’t roll over it and it doesn’t tug. Not sure if that makes sense. Lol I tried.

[skidunks]

I would check into the option of a dental appliance that moves your lower jaw forward (they’re called mandibular advancement devices or MAD) before doing surgery. The doctors I work for have been doing them for years and they really help a lot of people without having to continue with a CPap. I have one patient that has Inspire and she likes it but from what I understand, the device shocks your tongue to move it out of your airway. That sounds like a great night’s sleep…

[starburst604]

One more thing you may or may not know already is before it can be implanted, you have to go under anesthesia in the OR to have some kind of testing done to make sure you’re a good candidate. I just had a meeting with an Inspire rep a couple of weeks ago because our doctors are interested in becoming implanters so that’s why I know this, but I can’t remember the name of this exploratory procedure and exactly what happens.

I’ll also second that a sleep appliance for the mouth can be a great alternative and is often covered by insurance after failure to tolerate cpap.

[lostrn]

Oct 15, 2024 21:37:16 GMT -5 starburst604 said:

One more thing you may or may not know already is before it can be implanted, you have to go under anesthesia in the OR to have some kind of testing done to make sure you’re a good candidate. I just had a meeting with an Inspire rep a couple of weeks ago because our doctors are interested in becoming implanters so that’s why I know this, but I can’t remember the name of this exploratory procedure and exactly what happens.

I’ll also second that a sleep appliance for the mouth can be a great alternative and is often covered by insurance after failure to tolerate crap.

That procedure is a drug induced sleep endoscopy. I know a very broad overview that is looking for the behavior/movements of the upper airway during sleep.

[starburst604]

Oct 15, 2024 21:46:27 GMT -5 lostrn said:

Oct 15, 2024 21:37:16 GMT -5 starburst604 said:

One more thing you may or may not know already is before it can be implanted, you have to go under anesthesia in the OR to have some kind of testing done to make sure you’re a good candidate. I just had a meeting with an Inspire rep a couple of weeks ago because our doctors are interested in becoming implanters so that’s why I know this, but I can’t remember the name of this exploratory procedure and exactly what happens.

I’ll also second that a sleep appliance for the mouth can be a great alternative and is often covered by insurance after failure to tolerate crap.

That procedure is a drug induced sleep endoscopy. I know a very broad overview that is looking for the behavior/movements of the upper airway during sleep.

Yes that was it! I have some more information about it at work but not handy.

[somersault72]

My mom has the Inspire. She didn't seek it out but needed a new CPAP and that's where she ended up. Her doctor told her a low percentage of patients have horrible ear pain after getting it placed and she unfortunately was one of those people. She also had an issue with her incision post op. All that being said, that was all temporary and she really likes it. It was placed December 2022, so she's had it almost 2 years.

[jane6672]

Oct 15, 2024 21:31:45 GMT -5 skidunks said:

I would check into the option of a dental appliance that moves your lower jaw forward (they’re called mandibular advancement devices or MAD) before doing surgery. The doctors I work for have been doing them for years and they really help a lot of people without having to continue with a CPap. I have one patient that has Inspire and she likes it but from what I understand, the device shocks your tongue to move it out of your airway. That sounds like a great night’s sleep…

My husband has one of these and has found it quite effective. (I’m sure it depends on the type and severity of the issue causing sleep symptoms for an individual).

He was on the cusp of getting a CPAP - meaning, his sleep study showed apnea events but not quuuuite enough that insurance was willing to pay for a CPAP. After some back and forth they agreed to cover this device. He’s sleeping better, I’m sleeping better, his blood pressure improved, etc. if he’s very tired or has had alcohol, he still snores but it’s an huge overall improvement. I required him to get his sleep issues sorted before we got married, ha.

He’s had to go in to the office avg. 2x a year for adjustment or fixes with it.

[picksthemusic]

DH has a CPAP and puts up with it. For the most part, he can't sleep without it and when he does, it's not great. I did the research for the implant and I am super skeptical about it and not sure it would be worth it or effective enough to take the place of a CPAP. Like PP have said, exploring different mask options would be my first preference for sure.

Have you met with an ENT to see if it could be your adenoids or tonsils that need to be removed? DD had her tonsils/adenoids out because they were blocking her airway and she was snoring and mouth breathing all night and now she doesn't.

[twinmomma]

Definitely try out other masks and hoses. I've found that the hose that comes out the top of my head is a thousand times better than the one that comes out the front of the mask. I also have a cpap hose holder from Amazon that keeps the bulk of the hose up out of the way so I can roll around with no issues. That made a huge difference in my comfort because I move a lot in my sleep.

My MIL travels a lot and has the oral device to bring with her and keeps the cpap machine at home since it's a pain to lug around for international travel. She says the oral device is fine, but she knows it's not as good as the actual machine. But that could be an alternative to try out too!

[lilac05]

I think taking a deeper look into CPAP options would be my first step. There are so many options now!

When you meet with your the surgeon, keep in mind that their recommendation may be biased. They will see if you'll be a good candidate (healthy enough for the surgery, likely to benefit at least some from the surgery) for THEIR solution to apnea, but they're not necessarily going to look at other options to see if something else might be better.

[doggielover]

I have sleep apnea as well and my dr doesn't recommend it. Have you considered the mouth guard version of it? If your episodes per night are not super high it might be an option.

[holly116]

Oct 16, 2024 11:01:42 GMT -5 picksthemusic said:

DH has a CPAP and puts up with it. For the most part, he can't sleep without it and when he does, it's not great. I did the research for the implant and I am super skeptical about it and not sure it would be worth it or effective enough to take the place of a CPAP. Like PP have said, exploring different mask options would be my first preference for sure.

Have you met with an ENT to see if it could be your adenoids or tonsils that need to be removed? DD had her tonsils/adenoids out because they were blocking her airway and she was snoring and mouth breathing all night and now she doesn't.

This.  DH had obstructive sleep apnea and had Uvulopalatopharyngoplasty (UPPP surgery) a decade ago and hasn't needed a CPAP since.