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Does A Pacemaker Help Sleep Apnea

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What Is Inspire Sleep

Implantable device may help some sleep apnea sufferers

Inspire Sleep is a small device that is placed inside the throat and used during sleep to open your airway, helping you to inhale. The device is placed under the skin of your neck and chest during a short, minimally invasive procedure in an outpatient setting. It is the only FDA approved device for treating sleep apnea from within your body, which means it is safe, practical, and effective.

Keep reading to find out what are inspire sleep pros and cons.

Continuous Positive Airway Pressure

In patients with heart failure, the inspiratory muscles generate greater force per breath and systolic intra-thoracic pressure contributes more to left ventricular transmural pressure than in healthy subjects. By increasing intra-thoracic pressure in patients with heart failure, CPAP unloads inspiratory muscles and reduces left ventricular afterload without compromising cardiac index . Finally, as previously mentioned, CPAP reduces the concentrations of nocturnal urinary and daytime plasma norepinephrine in heart failure patients presenting with CSA-CSR . Thus, these promising results represent a plausible background from which to set randomised trials assessing the role of CPAP on CSA-CSR and heart failure prognosis in the long term.

A post hoc analysis of the CANPAP trial reported a comparative evaluation of patients with AHI < 15 at 3 month patients with AHI 15 at 3 month and patients not receiving CPAP . Heart transplantation-free survival rate was significantly better in the suppressed CSA-CSR group compared to controls , while no difference in the outcome rate was observed between the unsuppressed CSA-CSR group and controls. Of note, the adherence to treatment did not differ between the two subgroups on CPAP treatment, suggesting a possible lack of efficacy or that effective and prompt treatment could be important in this clinically fragile group of heart failure patients .

How To Know If You Have Sleep Apnea

The signs and symptoms of different types of sleep apnea can overlap, making it hard to ascertain which kind you have sometimes. Your physician will be able to tell you what kind of sleep apnea you have after running some tests, but the most frequent symptoms and signs of central and obstructive sleep apneas come with:

  • Loud snoring during sleep
  • Short periods where you dont breathe during sleep that you dont remember that your partner or family member brings your attention to
  • Gasping for air during sleep
  • Waking up with a dry mouth
  • Morning headache

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C How To Try Them Out

Ready to try out one of the new CPAP alternatives?

Here are some things that can help move the process along:

Do your homework Educate yourself about the various options so that youre ready to discuss pros and cons with a doctor.

Schedule a doctor appointment A sleep specialist will play an important role in helping you figure out which treatments are worth trying, getting the prescription, and qualifying for insurance.

Work with your sleep specialist As you try out a new treatment, they may be able make adjustments so that it works better for you.

Some of the latest sleep apnea devices may not yet be available. If youre interested in something thats still under development, talk to your doctor and the manufacturer about trying it out as a participant in a clinical trial.

What Are The Types Of Sleep Apnea

Have trouble sleeping? Here is a new implant to ease sleep ...

There are three main sleep apnea types.

  • Obstructive sleep apnea this is the most common type of sleep apnea, which occurs when the muscle tissue supporting your tongue and throat relax, obstructing your airway.
  • Central sleep apnea less common, this type of sleep apnea is attributed to the brain not sending adequate breathing signals to the muscles that control your breathing.
  • Complex sleep apnea syndrome occurs when both the obstructive and central sleep apnea exist at the same time and is also known as treatment-emergent central sleep apnea.

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Positive Airway Pressure Devices

Positive airway pressure machines, used with a variety of breathing masks, are the most widely used treatment for moderate and severe sleep apnea.

The mask, worn snugly over the nose, or sometimes nose and mouth, during sleep, supplies pressurized air that flows continuously or intermittently into the sleepers throat. The increased air pressure prevents the sleepers airway from collapsing.

The pressurized air is supplied through a flexible tube from one of several types of machines: CPAP , BiPAP , VPAP , and so on. Studies of the effect of PAP therapy show that people with sleep apnea who consistently use their machines feel better and, as a result of the reduction of apnea and hypopnea episodes during sleep, encounter fewer complications of the disease. Theres more information about PAP therapy here.

Although PAP devices are not used to treat snoring alone, they do eliminate snoring in addition to treating obstructive sleep apnea.

What Are The Symptoms Of Central Sleep Apnea

Only a licensed physician can properly diagnose central sleep apnea. If you believe you have symptoms related to central sleep apnea, make an appointment with your doctor so that you can discuss proper diagnosis and, if needed, potential treatment options. CSA and OSA share a number of symptoms, which can make diagnosing which type of sleep apnea a patient has difficult. The more common symptoms include:

  • Difficulty staying asleep

Also, many individuals with central sleep apnea report what they refer to as forgetting to breathe while awake.

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What Will The Scars Look Like After I Have Healed From The Inspire Procedure

The visibility of the scars will depend on your skin tone and individual healing process. There are two or three incisions made to place the device. Each patient will have one incision under the chin and one below the collarbone. Some patients will also have one on the side of the rib cage.

James Morales

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Cons Of Inspire Sleep Therapy

New implant designed to help sleep apnea and snoring, replace CPAP

Invasive

Unlike the other sleep apnea treatments, the Inspire gadget is embedded under the skin of your neck and chest, so it will need an invasive medical process. You may also experience low-level discomfort after it is implanted. However, although requiring an invasive implantation procedure, the invasiveness is minimal, as it requires only three tiny entry points.

Battery Replacement

Although the battery life of the Inspire device is incredible, lasting up to 10 years, the battery will still require an invasive procedure under local anesthesia when it starts to run out.

MRI support

Some versions of the Inspire device are not compatible with MRI scans. That means that you may not be able to get an MRI scan for other potential health issues due to a high risk of bodily harm to the tissue surrounding the device. However, the most recent version of the Inspire the Inspire 3028 is made to be entirely compatible with MRI scans provided that your doctor follows specific guidelines, which means you can attend your health checkups undisturbed.

Price

Even though CPAP machines and similar machines range from $1,900 to $4,500, the Inspire implantation device alone, without the cost of the implantation, costs over $20,000.

Luckily, there are more than 100 health insurance companies that provide subsidies for Inspire implantation, while several Medicare contractors have recently announced that Medicare will be covering Inspire costs in the states covered by the contractors.

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Sdb And Coronary Heart Disease

Patients with OSA may also present with major cardiovascular risk factors, such as hypertension, diabetes mellitus, dyslipidaemia and obesity or overweight that all can affect cardiac structure and function . Thus, OSA and these risk factors may explain the increased prevalence of CAD in patients with OSA .

What Is A Tongue Pacemaker

Simply put, the tongue pacemaker is a device that intervenes when there is a danger of complications from sleep apnea, like stopping to breathe altogether.

If you are suffering from obstructive sleep apnea there are many treatment available. The most widely used one is your doctor prescribing an oxygen mask you wear at night to aid your breathing. Or he or she may recommend your tonsils to be removed or the entire throat to be tightened with a laser. However, not all approaches are successful.

So, most recently, the tongue nerve pacemaker has become available as a new option for patients suffering from OSA.

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The End Result Was Life

Everything is going well, Layton says. I use a remote to turn the device on, go to bed, and a half-hour later it kicks in. Im asleep before that happens.

He adds that as the device does its job throughout the night, he stays sound asleep. As a result, he feels better, has no problems waking up, and most importantly, I have no more tears in my eyes or pain in my stomach, Layton says.

Today, the grandfather of three enjoys the simple pleasures of life again sports, listening to music and spending time with his family.

I even look better than I did when I used the CPAP machine, Layton jokes. But seriously, this is the best thing that has ever happened to me.

With locations in Drexel Hill, Glen Mills and Ridley Park, Crozer Healths sleep centers offer a full complement of therapies to treat all types of sleep disorders including studies to calibrate and determine the effectiveness of an implanted Inspire device.

To find out more or for a referral to a sleep specialist, call 1-888-SLEEP-03 or visit crozerkeystone.org/Sleep.

Basic Mechanisms Linking Osa And Cardiovascular Diseases

New implanted device can help ease sleep apnea symptoms.

OSA is associated with the development of various cardiovascular diseases and this association now represents a significant public health burden . The identification of the mechanisms underlying the cardiovascular disease processes is of major importance and, despite significant effort being made, the process remains incompletely understood. Clinical studies using OSA populations have often been limited by inadequate control for frequent comorbid conditions, in particular obesity, pre-existing cardiovascular disease or medications. Moreover, OSA is a complex and heterogeneous disease and differences in morphology and length of the nocturnal airflow cessations and associated oxygen desaturations, which are not captured by the traditional OSA severity marker, as well as differences in duration of the disease prior to diagnosis are major contributors for the large variability observed between studies results, including differences in response to short-term continuous positive airway pressure therapy. Cell culture and animal models have been developed to overcome some of these hurdles. These models allow single components of the disease to be studied precisely controlling the triggering events in both severity and duration, and providing genetic homogeneous populations. Thus, in vitro and animal studies have greatly contributed to our current knowledge.

Main mechanisms linking obstructive sleep apnoea , intermittent hypoxia and cardiovascular diseases.

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Cardiac Pacemaker Therapy In Sleep Apnea

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Central Sleep Apnea Treatments

  • Treating the medical condition that is also causing central sleep apnea. Congestive heart failure or the aftermath of a stroke can interfere with night-time breathing and lead to CSA. The solution here is simple: Treat the heart failure or the stroke and the apnea will likely subside.
  • Cutting back or eliminating the use of opiods. Studies have proved that more powerful pain medications such as morphine, codeine and oxycodone can cause central sleep apnea. Reducing the dosage or not taking them altogether can help, but discussing this option with your doctor and with a sleep specialist is important. Pain medications do just thathelp with pain, and trying to fix the apnea might not be worth additional suffering when you are awake.
  • Continuous positive airway pressure . More commonly associated with obstructive sleep apnea , a CPAP device can also help CSA sufferers, particularly those who are recovering from heart failure. With this treatment, the patient wears a mask that continuously delivers a constant pressure of air to the lungs, thus countering any inclination the body might have to pause breathing.
  • Bilevel positive airway pressure . This is another treatment used for OSA sufferers that can be effective for central sleep apnea patients. Similar to a CPAP mask, a BPAP device adjusts the amount of air delivered to the lungs depending on whether the patient is inhaling or exhaling.
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    Obesity Age Didnt Explain Link

    Sleep apnea is characterized by repeated interruptions of breathing during sleep, which leads to excessive daytime sleepiness and other health problems.

    Obesity and age are both major risk factors for heart disease and sleep apnea, but they did not explain the excess of sleep breathing problems among the pacemaker recipients in the study, Levy says.

    The patients in the study who were found to have sleep apnea also had less daytime sleepiness than is generally reported for the condition.

    There was no relationship with symptoms in this population, which may explain why the disorder remains undiagnosed in so many heart patients, Levy says.

    He recommends that all heart patients who are candidates for pacemakers be evaluated for sleep apnea before they have the devices implanted, and that patients who have sleep apnea receive treatment for the condition.

    In the absence of lifestyle changes, such as weight loss, continuous positive airway pressure remains the most effective treatment for sleep apnea. Patients wear a mask during sleep, which delivers pressurized air to the lungs.

    Most Popular Sleep Apnea Treatments

    Dr. Douglas Borg on Sleep Apnea and Atrial Fibrillation (AFib)

    For those diagnosed with obstructive sleep apnea, there are several treatment options available from which to chose. Here, we will discuss the most popular treatment options available. These options include CPAP, sleep apnea dental devices, weight loss, and sleep apnea surgery. We will also explore some of the newer treatment options for sleep apnea that are less well known.

    Sleep apnea is a medical condition that involves brief pauses in breathing while you are sleeping. Although the pauses usually only last a few seconds, the condition can have several adverse effects on the body.

    There are a few different types of sleep apnea with obstructive sleep apnea being the most common. Obstructive sleep apnea occurs when the airway becomes blocked. The blockage can develop if the muscles in the back of the throat or the soft fatty tissues relax during sleep.

    If you have sleep apnea, the pauses in breathing disrupt how deep you sleep. Your quality of sleep is diminished, which can often lead to daytime fatigue and sleepiness. But thats not all. Sleep apnea is associated with an increased risk of certain medical conditions. According to the National Heart, Lung and Blood Institute, people with sleep apnea have an increased risk of a stroke, heart attack and diabetes.

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    What Is Sleep Apnea

    Obstructive sleep apnea is a condition that causes the muscles in the back of your throat to relax temporarily, causing your tongue and soft palate to constrict your airflow, and resulting in obstruction of sleep. People who suffer from apnea can wheeze and have difficulties breathing periodically through the night.

    Most people who have sleep apnea are aware that while it may not be a dangerous condition in the short run, it carries a lot of dangers in the long run. Leaving sleep apnea untreated can result in restricted oxygen flow to the brain, heart, and other vital organs, potentially hindering their function throughout the years. Sleep apnea patients are more likely to have strokes, brain damage, heart attacks, as well as diabetes type 2.

    Patient Selection Pacemaker Implantation And Follow

    We enrolled all consecutive adult patients in whom a pacemaker had been implanted from October 2013 to October 2015 at the Santa Maria della Stella Hospital in Orvieto, Italy. Patients were required to have standard indications for dual-chamber pacing. Patients with evidence of systolic dysfunction or a prior diagnosis of heart failure were excluded from the analysis. The study was approved by the Local Ethics Committee and informed consent was obtained from all patients. Devices and pacing leads were implanted by means of standard techniques. Atrial leads were routinely implanted in the right atrial appendage and ventricular leads in the right apex. Baseline evaluation included demographics and medical history, clinical examination, 12-lead electrocardiogram, and echocardiographic evaluation. Optimization of pacing parameters and pharmacological treatments was based on clinical evaluation by the attending physicians. During follow-up, patients returned for regular clinic visits every 3 months. At each scheduled or unscheduled visit, the pacemaker was interrogated and stored data were retrieved.

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    Sleep Apnea Common But Undiagnosed Among Pacemaker Patients

    Date:
    American Heart Association
    Summary:
    Almost 60 percent of pacemaker patients had undiagnosed sleep apnea — possibly contributing to their heart disease — researchers reported in a small study in Circulation: Journal of the American Heart Association.

    Almost 60 percent of pacemaker patients had undiagnosed sleep apnea — possibly contributing to their heart disease — researchers reported in a small study in Circulation: Journal of the American Heart Association.

    Moreover, more than 21 percent of the patients had severe sleep apnea, characterized by 30 or more periods of interrupted breathing each hour during sleep, said Patrick Lévy, M.D., Ph.D., senior author of the study and a professor physiology at Grenoble University in Grenoble, France.

    “Because of the excessive prevalence of undiagnosed sleep apnea we found, it could be recommended that all patients referred for a pacemaker should first be screened for sleep apnea. Sleep apnea is known to increase risk of cardiovascular disease,” Lévy said.

    In the study, researchers investigated the prevalence and consequences of undiagnosed sleep apnea in pacemaker patients. Ninety-eight French, British and Belgian pacemaker patients who were undiagnosed with sleep apnea underwent laboratory monitoring of their sleep.

    Thirty-six had sinus node disease, in which a heart chamber pumps too fast or too slow.

    Abnormally slow heart rhythms are common among patients with obstructive sleep apnea.

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