To sleep again

New outpatient procedure changes woman’s life
June 7th, 2016

For about a year, Anita Kitt taped her mouth shut each night before going to bed. It was the only thing that she found helped with her sleep apnea — until now.

Kitt was among UCHealth’s first patients to have the FDA-approved Inspire device implanted in her chest, and she is thrilled with the results.

“I’ve got to tell you, this works,” she said.

Anita Kitt, one of UCHealth's first patients to be implanted with an Inspire device to treat her sleep apnea, looks at a CPAP machine, which she used to call, "the monster under my bed."
Anita Kitt, one of UCHealth’s first patients to be implanted with an Inspire device to treat her sleep apnea, looks at a CPAP machine, which she used to call, “the monster under my bed.”

More than 18 million Americans suffer from sleep apnea, a sleep disorder in which breathing repeatedly stops and starts. Besides wreaking havoc on a person’s daily life, there are serious and life-shortening consequences, such as high blood pressure, heart disease and stroke.

“When you don’t sleep well and you’re not rested, the effect on your awake time is pretty profound,” said Dr. Mark Petrun, a UCHealth pulmonologist whose specialties include sleep medicine. “It affects your concentration, alertness, and ability to get things done.”

Obstructive sleep apnea — the most common type of sleep apnea — occurs because the throat muscles intermittently relax and block the airway during sleep. For Kitt, it resulted in fatigue and migraines so horrible that she often vomited.

The most common treatment with a fairly high success rate is the use of a continuous positive airway pressure machine, or CPAP, while a person sleeps. This machine supplies constant and steady air pressure through a hose and mask. Although it’s an effective treatment 90 percent of the time, only 60 percent of people actually wear it more than four hours a night, said Cindy Crosby, manager of UCHealth’s Poudre Valley Hospital Sleep Disorder Center.

Kitt fit into that statistic. The mask made her feel confined, and she would still wake exhausted. She called it “the monster under my bed.” She finally resorted to taping her mouth shut — an alternative that worked because it kept her jaw from dropping and her tongue from closing off her airway — but it wasn’t ideal, Kitt said.

Then she heard about Inspire.

Inspire therapy provides a person relief without a mask or oral appliance, said Dr. Matthew Robertson, an otolaryngologist with Alpine Ear, Nose & Throat. During an outpatient procedure, a small device is implanted in the chest of the patient. From that device, a wire that senses the patient’s natural breathing patterns is directed to a nerve in the tongue and another to the rib cage area. When a patient breathes in, or inspires, an electrical stimulus is delivered to the tongue. That stimulus gives the tongue tone and prevents it from falling backward and obstructing the airway.

The Inspire device is controlled by a small hand-held sleep remote that can turn on the device at night and off in the morning when the person is awake.

Patients must meet certain criteria, as Kitt did, to be considered for Inspire. Kitt suffered from moderate to severe obstructive sleep apnea, which was verified through a sleep study she had done with her primary care provider in Nebraska. She wasn’t benefiting from CPAP, was 22 years of age or older and she was not overweight. Candidates must have a total body mass index of less than 32 because additional fatty tissue in the neck can affect the therapy.

Doctors at PVH’s sleep lab evaluated Kitt’s overall health and performed a physical examination of her airway to make sure Inspire was her best alternative.

“It was a very positive process and experience for me,” Kitt said. “The people at UCHealth’s sleep lab couldn’t have been more attentive. Dr. Robertson was very good about explaining the process and answering my questions.”

Kitt’s Inspire procedure took place Feb. 26. After one month — to allow for full healing of the nerve — the device was turned on. Once she turned it on, Kitt had another full month to get used to it and adjust the level of stimulation. She then returned to the sleep lab, where doctors and technologists were able to determine the optimum setting to treat her sleep apnea. In six months to a year, she’ll  see Petrun again, and he will download the usage data from the device and ensure that her range of settings is still effective for her.

“It works, and that’s the best part,” Kitt said. “I’m breathing now.”

The treatment also is available at UCHealth Metro Denver through Katherine Green, MD.

For more information on Inspire, call 970.408.0581 or go to uchealth.org/maskfree.