Sleep apnea affects 3 million people in France. This respiratory syndrome increases the risk of heart disease and can cause drowsiness in everyday life. In a recent press release, the US Medicines Agency (FDA) announced market authorization for an implant specially designed to treat sleep apnea. Created by Inspire Medical Systems, an American company based in Minneapolis in the United States, this implant works like a pacemaker, by electrically stimulating a nerve.
“Obstructive Sleep Apnea Syndrome” or OSAS is a sleep disorder characterized by short stops in respiratory flow (apnea) or decreased respiratory flow (hypopnea). These apneas lead to a deterioration in the quality of sleep which ultimately affects the lives of patients and those around them. Thus, each year, many road accidents are counted as a result of drowsiness caused by OSA.
A respiratory “pacemaker”
The causes of this syndrome are various, but most of the time, it is due to an obstruction of the airways (nose, mouth, pharynx, larynx). Often, OSA is caused by excessive relaxation of the tongue and muscles in the throat which then blocks the sleeper’s breathing and wakes him up.
This is why scientists had the idea of creating an implant that electrically stimulates the hypoglossal nerve (which controls the tongue) in order to project it forward and free the space necessary for good air circulation. The implant is placed under the collarbone, and is activated at bedtime using a small remote control. It is connected to two electrodes: one, implanted under the skin at the level of the neck, in contact with the hypoglossal nerve and the other at the level of the thorax. At the start of inspiration, the chest electrode sends a signal to the tongue electrode, which activates to free the airways.
Treatment already available in France
A published study in January 2014 in the review New England Journal of Medicine reported a 68% decrease in sleep apnea symptoms in patients fitted with this device. If it is now authorized in the United States, the only French establishment to offer it is the sleep clinic of the Bordeaux University Hospital, which benefits from a medical agreement for European use.
However, not all people with OSA are eligible for the device. Indeed, the patient must suffer from a moderate to severe syndrome, that is to say more than 20 apneas per hour, and not respond to the usual treatments.
The most effective treatment to treat sleep apnea so far has been continuous positive airway pressure (CPAP) at night. During the night, pressurized air is blown through a mask placed on the nose, thus preventing any obstruction during each inspiratory and expiratory phase.
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