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{"id":556298272841,"title":"Inspire Sleep Apnea Review: Better Than CPAP?","created_at":"2022-03-14T23:13:51-04:00","body_html":"\u003cscript type=\"application\/ld+json\"\u003e\/\/ \u003c![CDATA[\n{\n \"@context\": \"https:\/\/schema.org\",\n \"@type\": \"Article\",\n \"headline\": \"Inspire Sleep Apnea Review: Better Than CPAP?\",\n \"keywords\": \"inspire sleep apnea, inspire sleep apnea review, inspire sleep apnea reviews, inspire for sleep apnea, inspire sleep apnea device, sleep apnea inspire, inspire sleep apnea innovation, inspire sleep apnea treatment, what is inspire for sleep apnea, inspire sleep apnea implant\",\n \"description\": \"Our MD and research team reviews the medical research backing the Inspire device, highlights the side effects, and explains whether we believe it’s truly superior to a CPAP for patients with sleep apnea.\",\n \"url\": \"https:\/\/illuminatelabs.org\/blogs\/health\/inspire-sleep-apnea-review\",\n\"author\": {\n \"@type\": \"Person\",\n \"name\": \"Taylor Graber MD\",\n \"url\": \"https:\/\/illuminatelabs.org\/pages\/taylor-graber\",\n \"sameAs\": \"https:\/\/www.linkedin.com\/in\/taylor-j-graber-md-81351642\/\",\n \"jobTitle\": \"Content Partner\",\n \"knowsAbout\": \"medicine, health, anesthesiology, iv therapy, science, drugs, pharmaceutical, medical research, scientific research, medical journals, entrepreneurship, healthcare, orthopedic surgery, biomedical engineering\",\n \"alumniOf\": {\n \"@type\": \"EducationalOrganization\",\n \"name\": [\n \"University of California San Diego\",\n \"Arizona University\",\n \"University of Arizona College of Medicine\"\n ]\n },\n \"memberOf\": {\n \"@type\": \"Organization\",\n \"name\": \"Illuminate Labs\"\n }\n},\n\"contributor\": {\n \"@type\": \"Person\",\n \"name\": \"Calloway Cook\",\n \"url\": \"https:\/\/illuminatelabs.org\/pages\/calloway-cook\",\n \"sameAs\": \"https:\/\/www.linkedin.com\/in\/calloway-cook\/\",\n \"jobTitle\": \"President\",\n \"knowsAbout\": \"entrepreneurship, dietary supplements, herbal supplements, eCommerce, medical research\",\n \"alumniOf\": {\n \"@type\": \"EducationalOrganization\",\n \"name\": \"S.I. 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We recommend that patients follow their doctor’s guidance in regard to medical devices and sleep apnea.\u003c\/span\u003e\u003c\/i\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan style=\"font-weight: 400;\"\u003e\u003cspan class=\"dc\"\u003eI\u003c\/span\u003enspire is a brand which manufactures the only Food and Drug Administration (FDA)-approved device for treating obstructive sleep apnea. The company claims that their device is a more convenient alternative to Continuous Positive Airway Pressure (CPAP) machines.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan style=\"font-weight: 400;\"\u003eIn this article we’ll review the medical research backing the Inspire device, highlight the side effects, and explain whether we believe it’s truly superior to a CPAP for patients with sleep apnea.\u003c\/span\u003e\u003c\/p\u003e\n\u003ch2 style=\"text-align: center;\"\u003e\u003cb\u003eDoes Inspire Really Work?\u003c\/b\u003e\u003c\/h2\u003e\n\u003cp\u003e\u003cspan style=\"font-weight: 400;\"\u003eInspire has funded several clinical trials published in legitimate medical journals which tested the efficacy of their device.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan style=\"font-weight: 400;\"\u003eThe first medical study, \u003c\/span\u003e\u003ca href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/29582703\/\"\u003e\u003cspan style=\"font-weight: 400;\"\u003epublished\u003c\/span\u003e\u003c\/a\u003e\u003cspan style=\"font-weight: 400;\"\u003e in a leading Otolaryngology journal in 2018, tracked the results of the Inspire device in 126 patients over 5 years. The researchers found that the device caused improvements in sleep apnea metrics such as snoring and daytime sleepiness, as well as self-reported improvements in quality-of-life metrics.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan style=\"font-weight: 400;\"\u003eThese results are relatively weak in our opinion, because the study was not placebo-controlled or even compared to other sleep apnea treatments like the CPAP. It does suggest that the Inspire device is better than nothing, but the more clinically-relevant question is whether the Inspire device is superior to CPAP.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan style=\"font-weight: 400;\"\u003eA more recent \u003c\/span\u003e\u003ca href=\"https:\/\/www.ncbi.nlm.nih.gov\/labs\/pmc\/articles\/PMC6319796\/\"\u003e\u003cspan style=\"font-weight: 400;\"\u003emedical trial\u003c\/span\u003e\u003c\/a\u003e\u003cspan style=\"font-weight: 400;\"\u003e on the Inspire device reported similar results to the previous trial. Patients using the Inspire device reported fewer sleep apnea events, lower daytime sleepiness scores, and improve quality of life.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan style=\"font-weight: 400;\"\u003eThe article’s footnotes detail that many of the study authors received grants, fees and paid travel expenses, among other forms of compensation, for their work on this trial. This adds bias to the process and makes the study results weaker in our opinion.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan style=\"font-weight: 400;\"\u003eOverall we would conclude from the available research that the Inspire device is likely to be effective. Even though we don’t find either of the studies the company funded to be particularly well designed, and there are conflicts of interest, it does seem clear that this device is significantly superior to taking no action on treating sleep apnea.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan style=\"font-weight: 400;\"\u003eSleep apnea is a serious condition which is highly associated with increased mortality and a variety of chronic diseases, so the more innovation in this field, the better for patients.\u003c\/span\u003e\u003c\/p\u003e\n\u003ch2 style=\"text-align: center;\"\u003e\u003cb\u003eHow Does Inspire Work?\u003c\/b\u003e\u003c\/h2\u003e\n\u003cp\u003e\u003cspan style=\"font-weight: 400;\"\u003eThe innovation of the Inspire device involves a technology called hypoglossal nerve stimulation therapy. An implanted medical device sends electrical signals that prevent the tongue from blocking the airway during sleep, which is a common cause of sleep apnea.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan style=\"font-weight: 400;\"\u003eBecause we aren’t consciously in control of our tongues during sleep, there is no way to achieve this naturally.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan style=\"font-weight: 400;\"\u003eThe Inspire device implementation is an outpatient surgery that requires a doctor to cut several small incisions into the patient's skin to insert the device. One incision goes below the collarbone to implant the device. Another goes under the chin where the electrical stimulation is targeted. Inspire notes that some patients require an additional incision on their rib cage.\u003c\/span\u003e\u003c\/p\u003e\n\u003ch2 style=\"text-align: center;\"\u003e\u003cb\u003eInspire Vs. CPAP\u003c\/b\u003e\u003c\/h2\u003e\n\u003cp\u003e\u003cspan style=\"font-weight: 400;\"\u003eBecause the Inspire device and CPAP machines are both proven to be effective for treating sleep apnea, many patients are curious about which is more effective. \u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan style=\"font-weight: 400;\"\u003eUnfortunately, there don’t appear to be any medical studies directly comparing the two treatments for a population of patients with sleep apnea. \u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan style=\"font-weight: 400;\"\u003eThe CPAP is more well-studied than the Inspire, but \u003c\/span\u003e\u003ca href=\"https:\/\/www.ncbi.nlm.nih.gov\/labs\/pmc\/articles\/PMC5436801\/\"\u003e\u003cspan style=\"font-weight: 400;\"\u003emedical data\u003c\/span\u003e\u003c\/a\u003e\u003cspan style=\"font-weight: 400;\"\u003e suggests it may not be as effective for mild-to-moderate sleep apnea as it is for severe sleep apnea. There are also compliance issues. Because it can be frustrating to use a large face mask at night during sleep, many patients who are prescribed a CPAP don’t use it regularly.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan style=\"font-weight: 400;\"\u003eAn \u003c\/span\u003e\u003ca href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/27542595\/\"\u003e\u003cspan style=\"font-weight: 400;\"\u003eextensive medical review\u003c\/span\u003e\u003c\/a\u003e\u003cspan style=\"font-weight: 400;\"\u003e on CPAP adherence found that over 1 in 3 patients don’t use the device regularly. \u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan style=\"font-weight: 400;\"\u003eBecause the causes of sleep apnea are so individualized, we strongly recommend that patients speak with their doctor to determine what the best approach for their unique situation is. There are many different types of CPAP devices, and there doesn’t seem to be clinical evidence suggesting which type is superior or whether the Inspire is superior to the CPAP, so these types of determinations are best left to a medical professional who understands the patient’s history and unique biology.\u003c\/span\u003e\u003c\/p\u003e\n\u003ch2 style=\"text-align: center;\"\u003e\u003cb\u003eMisleading Patient Outcomes Section\u003c\/b\u003e\u003c\/h2\u003e\n\u003cp\u003e\u003cspan style=\"font-weight: 400;\"\u003e\u003cimg src=\"https:\/\/cdn.shopify.com\/s\/files\/1\/0047\/1524\/9737\/files\/Inspire_Sleep_Apnea_Misleading_Claims_480x480.png?v=1647314803\" alt=\"Inspire Sleep Apnea misleading claims\" style=\"display: block; margin-left: auto; margin-right: auto;\"\u003e\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan style=\"font-weight: 400;\"\u003eInspire has a section of their website highlighting patient outcomes. One of the key figures states that “94% of Inspire patients say Inspire is better than CPAP \u0026amp; would recommend Inspire to others.”\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan style=\"font-weight: 400;\"\u003eTheir citation for this claim is a \u003c\/span\u003e\u003ca href=\"https:\/\/www.ncbi.nlm.nih.gov\/labs\/pmc\/articles\/PMC6319796\/\"\u003e\u003cspan style=\"font-weight: 400;\"\u003emedical review\u003c\/span\u003e\u003c\/a\u003e\u003cspan style=\"font-weight: 400;\"\u003e of patients who used Inspire after a documented intolerance to CPAP.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan style=\"font-weight: 400;\"\u003eWe find the claim on Inspire’s site to be extremely misleading and unethical, given that their citation is from a self-selected group of people who \u003c\/span\u003e\u003ci\u003e\u003cspan style=\"font-weight: 400;\"\u003ealready had negative experiences\u003c\/span\u003e\u003c\/i\u003e\u003cspan style=\"font-weight: 400;\"\u003e with CPAP devices.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan style=\"font-weight: 400;\"\u003eInspire’s claim makes it seem as though both CPAP and Inspire were trialed by a group of neutral patients who hadn’t used either device, and the vast majority of them preferred the Inspire, which simply isn’t the case.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan style=\"font-weight: 400;\"\u003eIt’s also worth noting that most of the medical research on sleep apnea seems to suggest hypoglossal nerve stimulation devices like Inspire as an alternative treatment when CPAP intolerance is noted, and not a first-line treatment for sleep apnea.\u003c\/span\u003e\u003c\/p\u003e\n\u003ch2 style=\"text-align: center;\"\u003e\u003cb\u003eInspire Side Effects\u003c\/b\u003e\u003c\/h2\u003e\n\u003cp\u003e\u003cspan style=\"font-weight: 400;\"\u003eThe medical review from the previous section documented adverse events to Inspire. Only 2% of patients experienced an adverse event during the implementation procedure, which is a relatively low number.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan style=\"font-weight: 400;\"\u003eAfter the operation and during normal use, 23% of patients experienced adverse events, with the most common being “stimulation-related discomfort.” None of the side effects were severe or life-threatening.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan style=\"font-weight: 400;\"\u003eWe consider this side effect profile to be similar to that experienced by CPAP patients. Around 30% of CPAP patients \u003c\/span\u003e\u003ca href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/24557772\/\"\u003e\u003cspan style=\"font-weight: 400;\"\u003ehave been documented\u003c\/span\u003e\u003c\/a\u003e\u003cspan style=\"font-weight: 400;\"\u003e in a medical review to experience minor side effects such as a blocked nose, discomforting mask pressure and skin irritation.\u003c\/span\u003e\u003c\/p\u003e\n\u003ch2 style=\"text-align: center;\"\u003e\u003cb\u003eConclusion\u003c\/b\u003e\u003c\/h2\u003e\n\u003cp\u003e\u003cspan style=\"font-weight: 400;\"\u003eThe Inspire device is effective for sleep apnea on average, and seems like a good option for patients who are prescribed a CPAP but don’t stick to a routine of using it. Current medical literature describes the Inspire, and its class of devices, generally as secondary treatments for sleep apnea and not first-line treatments.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan style=\"font-weight: 400;\"\u003eInspire makes marketing claims suggesting that their device is significantly preferred to the CPAP, but we disagree with those claims as they’re cited from a study of patients who already experienced displeasure with the CPAP device.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan style=\"font-weight: 400;\"\u003eInspire Sleep Apnea device has a relatively minor side effect profile, and the benefits seem likely to outweigh the risks for patients with sleep apnea, considering that the condition is associated with significant increases in all-cause mortality.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan style=\"font-weight: 400;\"\u003eWe recommend that patients speak with their doctor about medical devices for sleep apnea, because there are so many different types of CPAP machines, and there isn’t a clearly superior option in medical studies. An individualized approach based on patient history and biology is recommended.\u003c\/span\u003e\u003c\/p\u003e","blog_id":49281925193,"author":"Calloway Cook","user_id":26601750601,"published_at":"2022-03-15T15:24:11-04:00","updated_at":"2022-03-15T15:24:11-04:00","summary_html":"We review the medical research backing the Inspire Sleep Apnea device, highlight the side effects, and explain whether we believe it’s truly superior to a CPAP for patients with sleep apnea.","template_suffix":"","handle":"inspire-sleep-apnea-review","tags":"_related:sleep, _related:sleep-apnea"}

Inspire Sleep Apnea Review: Better Than CPAP?

Inspire Sleep Apnea Review: Better Than CPAP?


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Read our Editorial Guidelines to learn more about what makes our site the premier resource for online health information.


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Disclaimer: None of the information in this article constitutes medical advice, and is just the opinion of the writer(s) and presented for informational purposes only. We recommend that patients follow their doctor’s guidance in regard to medical devices and sleep apnea.

Inspire is a brand which manufactures the only Food and Drug Administration (FDA)-approved device for treating obstructive sleep apnea. The company claims that their device is a more convenient alternative to Continuous Positive Airway Pressure (CPAP) machines.

In this article we’ll review the medical research backing the Inspire device, highlight the side effects, and explain whether we believe it’s truly superior to a CPAP for patients with sleep apnea.

Does Inspire Really Work?

Inspire has funded several clinical trials published in legitimate medical journals which tested the efficacy of their device.

The first medical study, published in a leading Otolaryngology journal in 2018, tracked the results of the Inspire device in 126 patients over 5 years. The researchers found that the device caused improvements in sleep apnea metrics such as snoring and daytime sleepiness, as well as self-reported improvements in quality-of-life metrics.

These results are relatively weak in our opinion, because the study was not placebo-controlled or even compared to other sleep apnea treatments like the CPAP. It does suggest that the Inspire device is better than nothing, but the more clinically-relevant question is whether the Inspire device is superior to CPAP.

A more recent medical trial on the Inspire device reported similar results to the previous trial. Patients using the Inspire device reported fewer sleep apnea events, lower daytime sleepiness scores, and improve quality of life.

The article’s footnotes detail that many of the study authors received grants, fees and paid travel expenses, among other forms of compensation, for their work on this trial. This adds bias to the process and makes the study results weaker in our opinion.

Overall we would conclude from the available research that the Inspire device is likely to be effective. Even though we don’t find either of the studies the company funded to be particularly well designed, and there are conflicts of interest, it does seem clear that this device is significantly superior to taking no action on treating sleep apnea.

Sleep apnea is a serious condition which is highly associated with increased mortality and a variety of chronic diseases, so the more innovation in this field, the better for patients.

How Does Inspire Work?

The innovation of the Inspire device involves a technology called hypoglossal nerve stimulation therapy. An implanted medical device sends electrical signals that prevent the tongue from blocking the airway during sleep, which is a common cause of sleep apnea.

Because we aren’t consciously in control of our tongues during sleep, there is no way to achieve this naturally.

The Inspire device implementation is an outpatient surgery that requires a doctor to cut several small incisions into the patient's skin to insert the device. One incision goes below the collarbone to implant the device. Another goes under the chin where the electrical stimulation is targeted. Inspire notes that some patients require an additional incision on their rib cage.

Inspire Vs. CPAP

Because the Inspire device and CPAP machines are both proven to be effective for treating sleep apnea, many patients are curious about which is more effective. 

Unfortunately, there don’t appear to be any medical studies directly comparing the two treatments for a population of patients with sleep apnea. 

The CPAP is more well-studied than the Inspire, but medical data suggests it may not be as effective for mild-to-moderate sleep apnea as it is for severe sleep apnea. There are also compliance issues. Because it can be frustrating to use a large face mask at night during sleep, many patients who are prescribed a CPAP don’t use it regularly.

An extensive medical review on CPAP adherence found that over 1 in 3 patients don’t use the device regularly. 

Because the causes of sleep apnea are so individualized, we strongly recommend that patients speak with their doctor to determine what the best approach for their unique situation is. There are many different types of CPAP devices, and there doesn’t seem to be clinical evidence suggesting which type is superior or whether the Inspire is superior to the CPAP, so these types of determinations are best left to a medical professional who understands the patient’s history and unique biology.

Misleading Patient Outcomes Section

Inspire Sleep Apnea misleading claims

Inspire has a section of their website highlighting patient outcomes. One of the key figures states that “94% of Inspire patients say Inspire is better than CPAP & would recommend Inspire to others.”

Their citation for this claim is a medical review of patients who used Inspire after a documented intolerance to CPAP.

We find the claim on Inspire’s site to be extremely misleading and unethical, given that their citation is from a self-selected group of people who already had negative experiences with CPAP devices.

Inspire’s claim makes it seem as though both CPAP and Inspire were trialed by a group of neutral patients who hadn’t used either device, and the vast majority of them preferred the Inspire, which simply isn’t the case.

It’s also worth noting that most of the medical research on sleep apnea seems to suggest hypoglossal nerve stimulation devices like Inspire as an alternative treatment when CPAP intolerance is noted, and not a first-line treatment for sleep apnea.

Inspire Side Effects

The medical review from the previous section documented adverse events to Inspire. Only 2% of patients experienced an adverse event during the implementation procedure, which is a relatively low number.

After the operation and during normal use, 23% of patients experienced adverse events, with the most common being “stimulation-related discomfort.” None of the side effects were severe or life-threatening.

We consider this side effect profile to be similar to that experienced by CPAP patients. Around 30% of CPAP patients have been documented in a medical review to experience minor side effects such as a blocked nose, discomforting mask pressure and skin irritation.

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Conclusion

The Inspire device is effective for sleep apnea on average, and seems like a good option for patients who are prescribed a CPAP but don’t stick to a routine of using it. Current medical literature describes the Inspire, and its class of devices, generally as secondary treatments for sleep apnea and not first-line treatments.

Inspire makes marketing claims suggesting that their device is significantly preferred to the CPAP, but we disagree with those claims as they’re cited from a study of patients who already experienced displeasure with the CPAP device.

Inspire Sleep Apnea device has a relatively minor side effect profile, and the benefits seem likely to outweigh the risks for patients with sleep apnea, considering that the condition is associated with significant increases in all-cause mortality.

We recommend that patients speak with their doctor about medical devices for sleep apnea, because there are so many different types of CPAP machines, and there isn’t a clearly superior option in medical studies. An individualized approach based on patient history and biology is recommended.





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