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Physicians' Clinic of Iowa Neurology & Sleep Medicine specialists and Ear, Nose & Throat surgeons, are partnering to offer Inspire Upper Airway Stimulation (UAS) therapy, a breakthrough obstructive sleep apnea (OSA) treatment option for those who cannot use Continuous Positive Airway Pressure (CPAP) therapy.

Physicians' Clinic of Iowa is one of only a handful of specialty medical groups offering the Inspire system, and the only one in Cedar Rapids.

What is Obstructive Sleep Apnea (OSA)? 

OSA affects 22 million Americans. OSA occurs when soft tissues in the airway collapse during sleep and block the flow of oxygen to the brain. The brain senses a lack of oxygen and wakes the body up just long enough to take a breath, then the body falls back asleep. This cycle repeats throughout the night and causes poor, disruptive sleep. When left untreated, OSA can cause vehicle and workplace accidents, worsening mood and memory, stroke, heart attack, and even death. 

Treatment Options

There are many different sleep apnea treatment options available. Continuous Positive Airway Pressure (CPAP) is the most commonly used treatment for OSA. CPAP uses a mask and hose to blow pressurized air into the airway to keep it open during sleep. This treatment works well for some patients, however studies show about 50% of people who are given a CPAP machine don’t use it. Other treatment options include oral appliances and major anatomy altering surgeries.  

Inspire Therapy

Inspire therapy represents a significant advancement in treating sleep apnea. It is clinically proven to reduce sleep apnea events and also has a high level of patient satisfaction and therapy adherence.

It is a fully implanted system, controlled with a small handheld Inspire sleep remote.

The implanted components are:

  • A small generator
  • A breathing sensor lead
  • A stimulation lead

When activated, Inspire therapy senses breathing patterns and delivers mild stimulation to key airway muscles, which keeps the airway open during sleep.

A patient simply turns the therapy on before bed and off upon waking using the handheld Inspire sleep remote.

Inspire Sleep Therapy Time Line

Inspire therapy is a process. It takes time and commitment to succeed! The average time line from initial consult to success with therapy could be 6 to 9 months.

Steps to Success with Inspire Sleep Therapy

  • Step 1: You will be evaluated by a PCI Ear, Nose and Throat surgeon.
  • Step 2: Drug Induced Sleep Endoscopy (DISE) procedure. Your ENT surgeon will place you under mild anesthesia to mimic your sleep patterns. While you're asleep, he/she inserts a tiny camera into your nose and throat to determine the cause of your apnea.
  • Step 3: Prior Authorization for Inspire placement. Please allow three weeks for insurance approval.
  • Step 4: Outpatient surgery to place the Inspire device.
  • Step 5: One week post-operative check up with ENT.
  • Step 6: 4 to 8 weeks after your surgery, you will have an office appointment with PCI Neurology & Sleep Medicine to activate the Inspire device.
  • Step 7: You will increase the amplitude on your device remote one step every 5-7 days.
  • Step 8: In 5 to 7 weeks, you will have an office appointment with Neurology and Sleep Medicine to increase the amplitude range on your Inspire remote.
  • Step 9: You will increase the amplitude on your device remote one step every 5-7 days.
  • Step 10: In 5 to 7 weeks, you will have an office appointment with Neurology and Sleep Medicine to increase the amplitude range on your Inspire remote.
  • Step 11: Prior authorization for an in-lab sleep study. Please allow three weeks for insurance approval.
  • Step 12: You will have an in-lab Fine Tune sleep study at the Eastern Iowa Sleep Center.
  • Step 13: You will have an appointment with a PCI sleep medicine specialist to discuss the results of your Fine Tune sleep study.

If needed, additional appointments will be added to help you achieve the maximum benefits of using the Inspire system. You will continue to see a sleep medicine specialist every 6 to 12 months to monitor your Inspire therapy.

Frequently Asked Questions

How Does Inspire therapy work?

Inspire therapy works inside your body with your natural breathing process to treat obstructive sleep apnea. It continuously monitors your breathing patterns while you sleep. Based on your unique breathing patterns, the system delivers mild stimulation to key airway muscles which keeps the airway open while you sleep.  The Inspire system is controlled by a small handheld sleep remote, and consists of three components: a small generator, a breathing sensor lead, and a stimulation lead. Simply turn the therapy on at night before bed, and off in the morning when you wake up.

Is Inspire therapy covered by insurance?

Inspire therapy is being reviewed and approved by insurance providers on a case by case basis. The Insurance Team at Inspire Medical Systems, your Inspire trained doctor and you will work as a team to gain insurance approval. 75% of people who submit for insurance approval get it and the procedure is not scheduled until it’s been approved.

How much will I have to pay out of pocket for this procedure?

Every insurance plan is different. Typically, patients can expect to pay the cost of any unmet deductible for the year, along with any required copay or coinsurance fee for a surgery. The Insurance Team at Inspire Medical Systems and your Inspire trained doctor will help you through this process.

Do I need to get approval from my insurance before my first visit?

No, you do not need to have prior approval from your insurance company for the therapy prior to your first clinic visit. Your medical care team will work together to determine if Inspire therapy might be right for you. If you qualify for Inspire therapy, your Inspire trained doctor will work with you, the hospital, and your insurance company for approval.

Is Inspire therapy DOT approved?

The Department of Transportation (DOT) requires commercial drivers to be compliant with their sleep apnea treatment in order to keep their license. Similar to CPAP, an Inspire doctor can print out a usage record of Inspire therapy to show the medical examiner that you are using your prescribed sleep apnea treatment. By proving compliance, there should be no issues renewing your commercial driver's license.

Will Inspire therapy help with snoring?

Data from clinical trials showed that 86% of bed partners reported either no snoring or soft snoring by their partners using Inspire therapy after twelve months.

What does the stimulation feel like?

You should feel a mild sensation from the stimulation. Typically, patients feel a tingling sensation or mild contraction in their tongue muscles. The stimulation should not be painful or uncomfortable and the level is adjustable. Your Inspire therapy-trained doctor will make any adjustments as needed.

How long does the battery in Inspire therapy last?

The battery in Inspire therapy is designed to last for approximately 11 years. The battery cannot be recharged so once the battery runs out, you will need to have it replaced. This is a very common procedure with many implanted devices, including pacemakers.

What does the surgical procedure involve?

The Inspire system is typically implanted during an outpatient procedure. The system is placed under the skin of the neck and chest through three small incisions.

How long is the recovery time after surgery?

Recovery time after surgery will vary from patient to patient, but you can expect some pain and swelling at the small incision sites for a few days after the implant. Most patients return home the same day and take over-the-counter pain medication if needed. You can resume normal, non-strenuous activities within a few days or as directed by your doctor. Most patients have a full recovery within a couple of weeks.

Am I still a candidate for Inspire therapy if I have a pacemaker?

Having a pacemaker does not disqualify you from becoming a candidate for Inspire therapy. The Inspire trained doctor will evaluate your sleep apnea history and overall health, including heart health, before deciding if Inspire is right for you.

Will the Inspire system limit my activities?

Generally, inspire will not limit normal daily activities. However, you should ask your Inspire trained doctor about any activities that are particularly strenuous, like weight lifting, or those that entail a large or unpredictable range of motion in your upper body and/or arms, such as working as a firefighter.

How often should my doctor check the Inspire system?

Generally, the Inspire system should be checked 1 to 2 times a year. However, your Inspire trained doctor may want to see you more or less often, depending on your situation.

What types of medical imaging are compatible with the Inspire system?

All Inspire patients can undergo most imaging technologies across the entire body including CT, ultrasound, and X-ray scans. Depending on the model of your Inspire system, you may be able to undergo MRI on the head and extremities, provided certain conditions and precautions are followed. If you are a current Inspire patient, please visit the "For Inspire Therapy Patients" section of the website to learn if your device allows MRI Conditional scans.

Is it ok to use a microwave oven and common household appliances after my procedure?

Yes, you may use a microwave oven and any common household appliances that do not emit strong magnetic fields. If you have concerns, consult with your Inspire therapy-trained doctor.

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