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Sleep Apnea Treatment Implant 2017-01-13T20:11:04+00:00

Sleep Apnea Treatment Center

Innovative Upper Airway Stimulation

sleep-apneaA restful night’s sleep is a critical element of general health. The well-rested mind and body function more efficiently. This is often taken for granted until something interferes with sleep quality. Obstructive sleep apnea (OSA) is a serious condition where the quality of sleep is threatened by cessation of breathing. When this occurs in adults, it is due to the relaxation of throat and tongue muscles during sleep, which results in a collapse of the airway. In children, often large tonsils and adenoids become obstructive when throat muscle relaxation occurs during sleep. Once breathing is obstructed, there is less oxygen supplied to the body and brain.

The normal sleep cycle is then interrupted when the body wakes itself to restore oxygenation. These awakenings, although sometimes brief, result in decreased sleep efficiency, which can cause poor cognitive performance, excessive daytime fatigue, and other detrimental symptoms. Major health issues such as high blood pressure and stroke may also occur. At the Osborne Head and Neck Institute, the quality of your sleep is of vital importance to us. Our cutting-edge approach to sleep medicine has resulted in the implementation of specialized treatment options to address sleep apnea. These non-surgical and surgical techniques have resulted in remarkable improvements to the quality of life and health of our patients, often resulting in complete resolution of obstructive sleep apnea.

What is Obstructive Sleep Apnea (OSA)?

Obstructive Sleep Apnea (OSA) is a condition marked by the disruption of breathing during sleep. Most commonly, OSA occurs when the throat and tongue muscles relax during sleep. In certain individuals, this relaxation results in obstruction of the airway and decreased airflow.

Obstructive Sleep Apnea (OSA) is a condition marked by the disruption of breathing during sleep. Most commonly, OSA occurs when the throat and tongue muscles relax during sleep. In certain individuals, this relaxation results in obstruction of the airway and decreased airflow.

When airflow is reduced, oxygen levels in the bloodstream decrease. The brain senses the decrease in oxygen and wakes the body from sleep in order to relieve the obstruction and open the airway. While this achieves the goal of improving oxygenation, the normal sleep cycle has been disturbed for that period of time. Further, falling back asleep results in recurrence of obstruction and loss of oxygen. This cycle of obstruction and awakening repeats throughout the night, causing significant disruption of sleep.

Common symptoms of OSA include daytime sleepiness, difficulty concentrating, irritability, decreased school/work performance, and difficulty concentrating. Lack of oxygenation also strains the heart, brain, and other organs, and, over time, may result in heart attack, stroke, weight gain, high blood pressure, or heart failure.

Osborne Head & Neck Institute Sleep Surgery Center

Osborne Head & Neck Institute Sleep Surgery Center

What are the current treatment options for OSA?

Treatment options for OSA vary from patient to patient. For some patients, conservative measures result in total resolution of sleep apnea. However, other patients require more advanced techniques.

Upper Airway Stimulation

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Nasal Procedures

nasal treatment options
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Pediatric Procedures

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Treatment options for OSA vary from patient to patient. For some patients, conservative measures result in total resolution of sleep apnea. However, other patients require more advanced techniques. Options include:

  • Lifestyle modifications – Conservative measures that may be implemented include losing weight, exercising regularly, and decreasing alcohol consumption before sleep. If this is not possible or does not succeed, CPAP may be recommended.
  • CPAP – Continuous Positive Airway Pressure (CPAP) may be used during sleep. This machine comes with a mask that is fitted over the nose or mouth, and delivers air pressure to prevent airway collapse. While this is often successful, some people find it difficult to adhere to this treatment.
  • Oral appliances – For those people with OSA due to tongue collapse during sleep, an oral appliance may be prescribed. By moving the jaw forward, the tongue moves forward and obstruction may be prevented.
  • Surgical options – If the above options are not successful, surgical options may be considered. There is a large spectrum of available treatments, including tonsil surgery, nasal surgery, and palatal surgery, which may alleviate obstruction. These procedures typically are uncomfortable but have some success at relieving OSA.
  • Upper Airway Stimulation Therapy – This cutting-edge procedure has been recently developed and has shown remarkable success at conservative treatment of sleep apnea. This fully implanted system senses breathing patterns and coordinates mild stimulating impulses to key airway muscles, preventing them from collapsing.

Our Team of Expert Physicians

At the Osborne Head and Neck Institute, we believe that optimal patient care occurs when everyone focuses on their area of expertise. We have assembled a team that includes sub-specialty trained care providers in all disciplines pertaining to the care of the sleep apnea patient. Our care team includes:

dr-ryan-osborne1

Ryan Osborne, MD – fellowship-trained Head and Neck Surgeon. Dr. Osborne has undergone specific education and training to be certified to implant the Inspire device. Utilizing upper airway stimulation surgery, Dr. Osborne can successfully eliminate sleep apnea in many patients.

hamilton

Jason Hamilton, MD -Facial Plastic and Reconstructive Surgeon. Nasal surgery is often an important adjunct for optimal care of the sleep apnea and snoring patient. Dr. Hamilton has extensive expertise in procedures that improve nasal obstruction in the sleep patient.

zandifar

Hootan Zandifar, MD – Facial Plastic and Reconstructive Surgeon. Dr. Zandifar is a specialist in cranio-facial reconstructive surgery. His expertise is focused on augmenting the facial skeleton to improve breathing for sleep apnea patients

moris

Moris Aynechi DMD, MD – Oral and Maxillofacial Surgeon. Dr. Aynechi has developed and refined advanced techniques for mandibular and maxillary surgery, resulting in improved or resolved sleep disordered breathing as well as facial cosmetic improvement.

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Belinda Mantle, MD – fellowship trained Pediatric Otolaryngologist. Dr. Mantle’s focus on the care of the pediatric patient enables her to optimize medical management of pediatric sleep apnea. Her surgical expertise results in conservative and unparalleled care of the pediatric patient.

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Reena Gupta, MD – fellowship-trained Laryngologist. Dr. Gupta has extensive training in the airway and in airway procedures. This expertise is applied to the diagnostic testing and surgical management of the sleep apnea patient.

What is Upper Airway Stimulation Therapy?

Upper Airway Stimulation Therapy is an advanced, fully implanted system, which delivers small impulses to key airway muscles during sleep to keep them activated and prevent collapse. This device functions with three components: a small generator, a breathing sensor, and a stimulation lead.

Ryan F. Osborne, M.D., F.A.C.S.
INSPIRE ®
 CERTIFIED SLEEP IMPLANT SURGEON

Director – Head and Neck Surgery
Osborne Head and Neck Institute

certifiedInspire (UAS) therapy is an advanced, fully implanted system, which delivers small impulses to key airway muscles during sleep to keep them activated and prevent collapse. This device functions with three components: a small generator, a breathing sensor, and a stimulation lead.

The therapy is activated nightly by the patient and deactivated upon awakening, allowing the patient to retain full control of the device.

This unique approach to the treatment of OSA has resulted in resolution of OSA in those patients who do not want CPAP and would like an alternative to traditional airway surgery.

Full implementation of the Inspire device requires a certified implant surgeon and a sleep medicine physician. Dr Osborne was one of the first surgeons in the United States to be certified to implant the Inspire device.

Dr. Osborne will work collaboratively with you and your local sleep physician to determine if upper airway stimulation (Inspire) therapy is an appropriate therapy for you.

98%

REDUCTION OF EPISODES OF SLEEP APNEA

SIGNIFICANT IMPROVEMENTS OF QUALITY OF LIFE AND DAYTIME FUNCTIONING

85%

OF BED PARTNERS REPORTED NO OR SOFT SNORING

FAVORABLE SAFETY PROFILE WITH A SERIOUS ADVERSE EVENT RATE LESS THAN 2%

Obstructive sleep apnea and upper airway stimulation therapy explained.

obstructive sleep apnea

Upper Airway Stimulation

Upper airway stimulation therapy senses your breathing cycle and delivers gentle impulses to key airway muscles to prevent airway obstruction. UAS therapy consists of a small generator, a sensing lead, and a stimulation lead.

Inspire Upper Airway Stimulation therapy patient testimonial.

obstructive sleep apnea treatment

Upper Airway Stimulation Programmable Implant

UAS therapy is an effective treatment for obstructive sleep apnea patients. UAS therapy is gentle but can be further fine-tuned by the patient via remote control to his/her preference.

Frequently Asked Questions

Is Inspire a safe treatment? Yes Inspire is tested and safe. Inspire is FDA approved for the treatment of moderate-severe obstructive sleep apnea.

Are there some basic criteria to qualify for the Inspire device?

Yes:

  1. Body-Mass Index (BMI) of 32 or less
  2. Unable to tolerate CPAP
  3. Sleep Study documented moderate-severe apnea
  4. Completion of a DISE procedure

How does in Inspire (UAS) therapy work?

UAS therapy is a fully implanted system controlled by the patient. Before bed, the patient simply turns the therapy on. The system consists of three fully implanted components: a small generator, a breathing sensor lead, and a stimulation lead. When activated, UAS therapy continuously monitors breathing during sleep and delivers mild stimulation to key airway muscles, keeping the airway open. There is no mask or oral appliance.

Will UAS therapy address snoring?

Yes, data has shown that 85% of bed partners reported either no snoring or soft snoring for their partners using Inspire therapy. T

What does stimulation feel like?

The stimulation should not be painful or uncomfortable. Patients report only a mild sensation from the stimulation. Patients sometimes feel a tingling sensation or mild contraction of the tongue muscles

What does the surgical procedure involve?

The Inspire therapy system is implanted while the patient is under general anesthesia. It is an outpatient procedure. No hospital stay is required.

Incisions are made for the insertion and connection of the sensing lead, the stimulation lead, and the pulse generator.

How often does the system need to be checked by my doctor?

Generally, the system should be checked 1-2 times a year. However, you will be advised of your follow up needs based on your particular situation.

Will this system limit my activities?

Generally no, activities are not limited by the UAS therapy system.

However, during your consultation with Dr Osborne you can discuss your specific questions regarding physical activity.

How is the recovery after surgery?

There is usually some pain and swelling at the incision sites for a few days after surgery. Certain patients require an overnight hospital stay; however, many are able to go home on the same day as the procedure. Within a few days of the procedure, normal non-strenuous activities are often safe to perform. A week after surgery, we will perform an examination to ensure proper healing is taking place. Most patients have a full recovery within a few weeks.

Becoming Our Patient

Treatment of Obstructive Sleep Apnea (OSA) is highly complex and individualized. Optimized treatment that is unique to each patient’s case is best determined by comprehensive assessment from a specialized team of trained practitioners. At the Osborne Head and Neck Institute, we have made it a priority to stay on the forefront of sleep medicine and surgery. This has allowed us to offer the most diverse and custom treatment plans for patients suffering from OSA. The one-size-fits-all approach does not work well in sleep medicine. We will assess your individual anatomic, social, and medical concerns and ensure that the treatment option selected addresses your particular needs.We understand that it is often inconvenient, time-consuming and expensive for patients to fly to our Los Angeles office for a consultation, and then fly back again a few weeks later for surgery. We have designed a program to facilitate your experience that will allow you to determine the best options available to you from the comfort of your home.

Contact Us Now For Your Free Phone Consultation

The first step is to call or e-mail our patient care consultant, and request a preliminary Phone or In-Office Consultation with one of our specialist regarding your septal perforation.

Send Records/Photos/Exam

Please provide all relevant clinical information. This may include prior doctor/ dental notes, x-rays or CT scan reports, sleep study tests, CPAP titration studies, and general medical information.  Profile, oblique, and frontal photos may be helpful for patients considering orthognathic (jaw) surgery or nasal surgery. Medical records can be sent by mail or e-mailed (preferred) directly to office by you the patient. This is especially important for patients who have had previous treatment and/or surgery.

MedicalCaseObtain an Evaluation

Our sleep specialist team will review your history, physical exam findings, all reports, films and photographs before your consultation. It is very important that we have all your information prior to your consultation. This is especially important in complex cases.   If you are having difficulty obtaining your records from your prior surgeon or institution contact us and we can facilitate and/or expedite the process for you. We will need you to sign a release of medical records to our office prior to us contacting your physician or hospital. After reviewing all your information the physicians at Osborne Head and Neck Institute will then discuss all your treatment options including any adjunctive procedures. Together you will come up with a customized treatment plan. Finally, our Patient Coordinator will discuss pre-operative care, costs, recovery, local accommodations and any questions related to your procedure(s).

ClipboardPatient Forms

Our patient care coordinator will provide you with the specific forms you need to fill out before your visit. For more information, please contact our patient coordinator at (310) 657-0123.

CalendarSchedule Your Procedure

Once you have decided to proceed, we will reserve your surgery date.

CreateWriteRead, Initial, Sign

Shortly after your surgery is scheduled, you will receive a packet in the mail containing pre-operative instructions and procedure consents. These documents must be read carefully and all instructions followed closely. All contents must be signed and initialed. The entire pre-operative packet must be brought with you to your pre-operative office visit. If you have any questions at this time, please do not hesitate to call or email the office for clarification.

Surgery Disclosure Policy

At the Osborne Head & Neck Institute, all of our board certified physicians perform all surgeries from start to finish. Although we conducted clinical research studies and contribute a significant amount to journals and publications we are not a surgical-training center. This simply means that a board certified surgeon, performs ever aspect of your evaluation and treatment from beginning to end. We do not allow residents, fellows, or other trainees to perform any portion of your surgery.

Embassy / Visa Information

For travel outside the U.S. please contact your perspective Bureau of Consular Affairs for assistance on obtaining a travel visa. Please allow ample time approximately 2-4 weeks prior to your procedure for paperwork to be processed by the U.S. State Department and your government consulate. Please call if you need assistance with this process or click the link here: TRAVEL.STATE.GOV.

Fly in for Surgery

Our local international airport is LAX. We are located approximately 20 minutes from LAX. You MUST arrive one to two days prior to your surgery date. At a designated time during this period you will meet with the doctor(s) and have an in-depth consultation discussing all procedures. All consents should be signed and dated for the pre operative appointment. If you have any questions, please do not hesitate to call or e-mail our office. Nearby airports:
  LAX  |  BURBANK  |  ONTARIO  |  ORANGE COUNTY

Hotels

These hotels are located close to our office and are the most convenient for appointments, surgery, and follow-up. We have also had positive feedback about these locations from our patients.

Lodging Information

Travel Stipend Available* *A travel stipend is provided to assist patients from out of town. Travel stipends assist out of town patients with ancillary costs directly associated with their surgery. Stipends may cover part or all of the cost of airfare, ground transportation, and/or lodging, and are available only to surgical patients. Travel stipends are granted by a committee on a rolling basis. Resources are limited annually and provided through the foundation. Please ask Noelia Fedi (surgical coordinator) if you would like to be considered.
*Stipends provided through a generous grant by the Division of Head and Neck Surgery (OHNI). Administered by the Osborne Head and Neck Cancer Foundation.

Recovery

We advise all patients that fly-in for surgery to spend at least the first night after their procedure in a local hotel or after-care facility, thus ensuring convenience for any required medical attention. In the days that follow we will see you post-operatively and, depending upon the procedures that have been performed, you may return home within after 3-7 days after arrival in Los Angeles. In the event that you require any medical attention after returning home, we will refer you to a local physician for a check-up. Your health and safety remain our number one priority. We look forward to meeting you and assisting in your care.

Patient Resources

Contact Osborne Head & Neck Institute

Cedars Sinai Medical Towers
8631 W 3rd St Suite 945E
Los Angeles, CA 90048
310-657-0123

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