Inspire Therapy (Hypoglossal Nerve Stimulation)
An implanted device that stimulates the hypoglossal nerve to prevent airway collapse during sleep, offering a CPAP alternative for selected patients with obstructive sleep apnea.
What is Inspire Therapy (Hypoglossal Nerve Stimulation)?
Inspire therapy is an FDA-approved implantable device for treating obstructive sleep apnea in patients who cannot use CPAP. The system includes a small generator implanted in the chest, a sensing lead that monitors breathing, and a stimulation lead connected to the hypoglossal nerve that controls tongue movement. When activated at bedtime with a remote, the device detects breathing patterns and stimulates the tongue to move forward, keeping the airway open during sleep.
How It Works
The implanted device monitors breathing through a sensing lead. During inhalation, it delivers mild stimulation to the hypoglossal nerve, causing the tongue and other airway muscles to stiffen and move forward. This proactive muscle activation prevents the airway collapse that causes obstructive apneas. The patient controls activation using a handheld remote.
Who Is It For?
Inspire is approved for patients with moderate to severe OSA (AHI 15-65) who cannot use or have failed CPAP therapy, are not significantly obese (BMI ≤35 in most cases), are age 18 or older, and have specific airway collapse patterns confirmed by drug-induced sleep endoscopy (DISE). Concentric collapse at the soft palate (complete concentric palatal collapse) is a contraindication.
Benefits
Effective CPAP Alternative
For appropriate candidates, Inspire significantly reduces AHI and improves sleep quality and daytime function.
No Mask or Machine
Inspire works from inside the body—no mask, hoses, or bedside equipment required.
High Patient Satisfaction
Studies show high satisfaction rates among Inspire users compared to their previous CPAP experience.
Consistent Use
Once implanted and activated, patients tend to use Inspire consistently because it's easy to turn on.
Proven Results
Clinical studies demonstrate significant, sustained reduction in apnea events over multiple years.
Side Effects & Considerations
Most side effects are minor and can often be resolved with simple adjustments.
Surgical Procedure Required
Implantation requires outpatient surgery with associated surgical risks (infection, bleeding, nerve injury).
Tongue Discomfort
Stimulation causes sensation in the tongue, which most patients adapt to but some find uncomfortable.
Device-Related Issues
Like any implant, there's potential for device malfunction, lead issues, or need for replacement/revision.
MRI Limitations
Inspire is MRI-conditional, meaning MRI scans require specific protocols and may not be possible in all situations.
Not for Everyone
Strict criteria limit eligibility. Many patients interested in Inspire don't qualify based on BMI, AHI, or anatomy.
Variations & Types
Inspire Upper Airway Stimulation System
The currently FDA-approved device, with sensing lead, stimulation lead, and implantable pulse generator.
Evolving Technology
Next-generation devices with different features are in development and may expand treatment options.
Tips for Success
Get Proper Evaluation
Complete evaluation including sleep study and drug-induced sleep endoscopy is required to determine if you're a candidate.
Choose an Experienced Center
Select an implanting center with significant experience. Surgical experience affects outcomes.
Understand the Timeline
The device isn't activated immediately after surgery. Expect a month for healing before activation and titration begin.
Be Patient with Titration
Finding optimal settings takes time. Multiple visits may be needed to optimize stimulation levels.
Use It Every Night
Inspire only works when activated. Turn it on every night at bedtime for full benefit.
Follow Up for Outcome Verification
A follow-up sleep study after titration confirms the device is effectively controlling your OSA.
Additional Resources
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