Friday, June 11, 2021

Inspire

I suspect you’ve seen some of the recent ads for Inspire, a new treatment for obstructive sleep apnea.

An Inspire TV ad. 

https://www.youtube.com/watch?v=bn5-ydF4_QQ 

How does Inspire work? It uses electrical stimulation, like Russ Hobbie and I discuss in Chapter 7 of Intermediate Physics for Medicine and Biology.

7.10 Electrical Stimulation

The information that has been developed in this chapter can also be used to understand some of the features of stimulating electrodes. These may be used for electromyographic studies; for stimulating muscles to contract called functional electrical stimulation (Peckham and Knutson 2005); for a cochlear implant to partially restore hearing (Zeng et al.2008); deep brain stimulation for Parkinson’s disease (Perlmutterand Mink 2006); for cardiac pacing (Moses andMullin 2007); and even for defibrillation (Dosdall et al.2009).

Like the cardiac pacemaker, the Inspire device is implanted in the upper chest. Instead of monitoring the electrocardiogram, the device monitors breathing; instead of stimulating the heart, it stimulates the hypoglossal nerve controlling muscles in the tongue.

A patient with obstructive sleep apnea has their airway blocked while sleeping, causing the body to crave oxygen. This results in a brief reawakening as the person opens their airway for better airflow. Once oxygen is restored, the patient goes back to sleep. Then, the entire process starts again, so sleep is frequently and repeatedly interrupted.

One way to treat obstructive sleep apnea is using continuous positive airway pressure (CPAP), which requires wearing a mask attached by a hose to a pump. Some people can’t or won’t tolerate CPAP, and it’s hard to imagine that anyone likes it.

When Inspire detects that you’re taking a breath it stimulates the tongue to contract, opening the airway. You only need it when sleeping, so it has a button you can push to turn it on before bed and turn it off when you wake up.

Inspire is yet one more example of how physics can be applied to medicine, and in particular how electrical stimulation can be used to treat patients. I’m into it. 

Dr. Ryan Soose explains the Stimulation Therapy for Apnea Reduction (STAR) clinical trial.

https://www.youtube.com/watch?v=AvQoxv7iDP4

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