Breathe easy: A new implantable device to treat sleep apnea wraps around the tongue's large hypoglossal nerve, stimulating it in six different places to keep the tongue muscle toned and less likely to fall back and obstruct a person's airway as he sleeps. It's powered by a small rechargeable generator and computer, about the size of a Zippo lighter, implanted in the patient's chest.
ImThera Medical
An implant stimulates the tongue to treat the disorder.
Unlike most researchers, the engineers at ImThera Medical just might consider it a compliment if someone called their product a "snooze." The experimental device is designed to treat sleep apnea, a breathing disorder that can disrupt sleep and trigger serious complications, including an increased risk for heart disease and stroke, as well as daytime sleepiness so severe that sufferers often fall asleep at the wheel. The implant, which wraps around a nerve connected to the tongue, is now being tested in a small clinical trial in Europe.
Sleep apnea is one of the most common kinks to the breathing process. It affects as much as 4 percent of the U.S. population, and occurs when something--usually a blockage, such as the tongue--stops a person's breathing multiple times throughout the night. The resulting oxygen deprivation and sleep loss leads to fatigue in the short-term, but it can also cause serious long-term health problems.
The gold standard for sleep apnea treatment is a CPAP (Continuous Positive Airway Pressure) machine, which keeps the airway open by forcing air through a mask and down a person's throat. But the device is loud and uncomfortable, and roughly half of CPAP users can't tolerate it. Alternative therapies include everything from a device that changes the relative positions of the upper and lower jaw, to actually breaking the jaw and repositioning it, to something as invasive as cutting out a portion of the patient's soft palate to increase the airway opening.
ImThera's device takes a different tack, one that hasn't yet been broadly explored. The neurostimulator wraps around the tongue's large hypoglossal nerve, and delivers electric pulses to the nerve in up to six different spots. "The goal is to open the airway by not allowing the tongue to collapse," says Marcelo Lima, the company's president. It does that by creating muscle tone in the muscles on the side of and beneath the tongue--muscles that flatten, stiffen, and pull the tongue forward, preventing it from relaxing and falling back to block the airway. Power comes from a rechargeable pulse generator, about the size of a Zippo lighter, which is implanted beneath the skin above the pectoral muscle in the chest, and is connected to the stimulator with a small power wire that snakes up to the throat.
Lima first tested the device using external power on two hospitalized patients in Brazil. The results were so promising that the refined device is already the center of a small clinical trial of 12 patients in Europe; a larger trial is scheduled to begin in the U.S. in mid-2010.
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mitcheisenstein
1 Comment
cpap compliance
the first time i was given a cpap i tried it for one night and didnt use the machine again for a year until i switched from a psychiatrist administering the pulmonary sleep studies, to a pulmonologist administering and treating me. so for one thing, i dont reccomend using a psychiatrist to do the sleep study even though it falls into their perview. in fact, i didnt even know that the dr was a psychiatrist. I dont think they have the knowledge of airways to do the job. sure they know the eeg and brainwave pattern, but when it comes to practical airway obstruction management, i would go to a pulmonologist first, and only if they are board certified. too many medical fields are able to capitalized on by those whose experience just happens to touch on the involved organs.
secondly, the sleep apnea machines and the masks that come with them are sources of multiple problems. positioning during sleep affects the way the mask sits and its seal on the face. the pressure that can be tolerated, and how that pressure is delivered to provide positive airway pressure is not the same at home as it is in the sleep study. there is no way to measure what is happening at home. the sleep study is not representative of what happens during regular use. i found, the hard way, that i had to adjust the cpap pressure myself to find the right pressure to give me what i needed. and also, i shifted to a full face mask from a nasal mask. but even then, the full face mask would ride up above my mouth and then the seal gets broken, the mouth opens up and suction is created which nullifies the cpap and even worse, creates a kind of venturi effect, drying out the mouth and making it almost impossible to breathe. i created a device that locks the cpap mask to my chin, like a chin strap on a football helmet, and anchors the mask to the proper position.
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neurosine
1 Comment
Re: cpap compliance
After finding through sleep studies that I was not breathing for up to 30 seconds, multiple times during the night, and getting very little deep sleep, I rented a CPAP machine, and made and effort to use it, but immediately determined to take some steps to get off the thing. I lost some weight and that helped a great deal. I am now sleeping though, sometimes a whole day, with short breaks. The monitoring systems used seemed not only esoteric, but a bit outdated. A headphone was used for the throat mic, for example. I thought that there must be a more sophisticated way to do this using less expensive methods, and I'm glad someone has envisioned a way to do this using emerging tech in a convergent fashion. Now I just have to get involved, y'know...so I can live longer.
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