Research & Publications

An Update On Inspire's Upper Airway Stimulation Device (UAS)

Date Posted: Wednesday, February 18th, 2015 by Alan Berger

In April 2014, the Food and Drug Administration (FDA) approved the first implantable device to treat obstructive sleep apnea (OSA).  While continuous positive airway pressure (CPAP) is considered first-line therapy for the treatment of OSA, nearly 50% of patients will become non-compliant over time.  Inspire's implantable system, named Upper Airway Stimulation or UAS, is an alternative to the CPAP mask and includes a small generator, a sensing lead and a stimulation lead. Turned on by a handheld remote, it delivers stimulation to the muscles of the airway, which keeps the airway open during sleep. Patients retain control of their treatment and are able to disable the device while not sleeping.   Inspire therapy is approved to treat patients with moderate to severe OSA who are unable to use CPAP therapy.

The safety and effectiveness of the Inspire device was demonstrated in the STAR trial which I wrote about last October, 2014 in an article titled New Device to Treat OSA Patients Who Can’t Tolerate CPAP’s.  The STAR trial demonstrated a 68% reduction in apnea severity (AHI reduction). Furthermore, the device was proven safe with a less than 1% serious adverse outcome rate. 

While this information was published more than a year ago, new data has demonstrated that the majority of patients implanted with the device are still using it more than 2 years later.  For surgeons, the safety and efficacy of the procedure are encouraging.  However, several other metrics were evaluated in this study, specifically a patient’s daytime fatigue and quality of life measures.  As a surgeon, we often become focused on numbers (AHI or apnea severity) and may discount more subjective issues such as fatigue.  Yet, fatigue and quality of life are paramount to patients.  The STAR trial demonstrated that patients implanted with the Inspire device reported a significant improvement in fatigue and quality of life measures.

Dr. Sesso is the only surgeon in the Delaware Valley to have participated in the STAR trial.  “My experience is that the Inspire device is less invasive than traditional sleep apnea surgery and the effectiveness is very promising.  This procedure may give hope to patients who cannot tolerate CPAP and are at risk for health problems due to their OSA.  I think that a 70% improvement in sleep apnea severity will have major health benefits to severe OSA patients that are currently untreated.”