A Patient with Severe Obstructive Sleep Apnea Benefits from Hypoglossal Nerve Stimulation
Jim Pollard was diagnosed with obstructive sleep apnea (OSA) 15 years ago, after his cardiologist ordered a sleep study. When he was fitted with a continuous positive airway pressure (CPAP) machine, he discovered that he is among the 50% of people with sleep apnea who are unable to tolerate the mask. OSA increases the risk of heart attack, stroke, and high blood pressure, as well as car and work-related accidents due to lack of good sleep.
“I couldn’t fall asleep and would take off the mask after an hour or so,” Pollard says. “I tried for many years but it never really worked for me.”
After failing CPAP, he used a mouth appliance for several years. “It was much better, but my mouth got sore after about an hour. Still, it was usable.”
In December 2022, he underwent a sleep study to confirm his eligibility for hypoglossal nerve stimulation using Inspire® therapy. To qualify, patients must be age 18 or older, have moderate to severe OSA with an apnea-hypopnea index (AHI) from 15 to 65 on a diagnostic sleep study, not be significantly obese, be unable to use or get significant benefit from CPAP or BPAP machines, and not have a complete blockage of the upper airway.
He was referred to Ron Karni, MD, chief of the Division of Head and Neck Surgical Oncology and an associate professor who holds joint appointments in the Department of Otorhinolaryngology and the Division of Hematology/Oncology at McGovern Medical School at UTHealth Houston, by another member of his otorhinolaryngology practice. Dr. Karni implanted Pollard’s Inspire device in April 2023 in a day surgery that lasted less than an hour.
About three months after the device was implanted and activated, he returned to the sleep lab for a study while using it. A sleep technologist worked with an Inspire technologist to adjust the stimulation to the optimal level.
“It’s a highly effective alternative for the right patient, and our results have been outstanding,” says Dr. Karni, who sees patients referred from sleep medicine specialists around Houston. “With Mr. Pollard, we had a grand slam. His preimplant AHI, which counts the number of times he stopped breathing or airflow is blocked during sleep, was 54.1. During his Inspire Fine Tune polysomnogram in November, his AHI was 0.”
“I’m sleeping longer – pretty close to nine hours a night – and I’m less tired when I wake up,” says Pollard, who is 70. “The biggest advantage besides effectiveness is ease of use. It has dramatically improved my quality of life.”