New implant helps patients with sleep apnea

SAN FRANCISCO

For Peter, falling into bed rarely meant falling asleep -- at least not for long.

"I had terrible, terrible, terrible sleep. I thought it was insomnia. I tossed and turned. I took prescription meds," he said.

He was suffering from sleep apnea, but it wasn't until he enrolled in a study at UCSF, that he learned just how severe his condition was.

"The results were pretty dramatic in the sense that I wasn't really getting any R.E.M. sleep at all," Peter said.

He turned to Eric Kezirian, M.D. and his research team, ultimately becoming just the second patient in the country to be implanted with a device known as Apnex.

"It's effectively a tongue pacemaker. It's a device that's placed inside your body, it is turned on during sleep," said Kezirian.

First it helps to understand a common cause of sleep apnea. A patient's tongue relaxes backward as they sleep, blocking the airway. Then the resulting gasp for air wakes them up.

To counteract the effect, the implanted system uses a neurostimulator that produces an electronic pulse. One set of leads connects to the rib cage to gauge the rhythm of the patient's breathing. The other set then delivers electricity to the nerve that controls the tongue.

"So this system is designed to deliver stimulation to the nerve to help move the tongue forward during sleep, so it doesn't block breathing during sleep," said Kezirian.

Images taken with fluoroscopy show the device stimulating Peter's tongue. Once it's in sync, he says he rarely notices it while he's sleeping. A portable controller can pause it at any time.

"In the evening when I'm ready to go to sleep, I just press the play button and I hold it up to my chest and in the morning I just press the stop button," Peter said.

The implantable Apnex is an alternative to a popular sleep apnea device called the CPAP. The mechanical breathing machine does help many patients sleep, but others find the mask uncomfortable and not always effective. Kezirian said early results with Apnex are promising.

"It could certainly benefit a wide range of patients," said Kezirian.

For Peter, the device came at the perfect time because shortly after the surgery, he became a new dad - a time of life when sleep is more valuable than ever.

"I can't imagine having gone through some of these months, just having such poor quality sleep," he said.

UCSF plans to begin recruiting for a second phase of the trial this summer. If you're interested in learning more about the trial and the technology click on the following link: http://www.sleep-doctor.com/

Written and produced by Tim Didion

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