WASHINGTON — Loud snoring may do more than irritate your spouse: It can signal sleep apnea, depriving you of enough zzzz’s to trigger a car crash, even a heart attack.
Now scientists are beginning to test if an implanted pacemaker-like device might help certain sufferers, keeping their airways open by zapping the tongue during sleep.
Wait, what does your tongue have to do with a good night’s sleep?
One of the main causes of obstructive sleep apnea is that the tongue and throat muscles relax too much during sleep, enough to temporarily collapse and block breathing for 30 seconds or so at a time. The person jerks awake and gasps, a cycle that can repeat itself 30 or more times an hour, depriving patients of crucial deep sleep.
The idea behind the experimental implant: Stimulate the nerve that controls the base of the tongue with a mild electrical current during sleep, and maybe it will stay toned and in place like it does during the day rather than becoming floppy.
More than 12 million Americans have obstructive sleep apnea, according to the National Institutes of Health. It’s particularly common in people who are overweight and in middle-aged men, but anyone can have it.
Left untreated, sleep apnea is more dangerous than just feeling tired. It stresses the body in ways that increase the risk of high blood pressure, heart attack, stroke and diabetes.
Surgeons sometimes try removing part of the roof of the mouth or other soft tissues to treat apnea by widening airways. But it’s hard to predict when these difficult operations will help, so they’re usually reserved for the most severe cases.
“It got to the point where I’d dread going to bed,” says Rik Krohn, 67, of suburban Minneapolis. Sleep studies showed his apnea was awakening him an average of 35 times an hour. He tried five different CPAP masks unsuccessfully before giving up in frustration, and surgeons turned him away.
Enter hypoglossal nerve stimulation.
With Minneapolis-based Inspire Medical Systems’ treatment option, doctors implant a small pacemaker-like generator under the skin near the collarbone, and snake a wire up under the jaw to that tongue-controlling nerve. A sensor at the diaphragm detects when a patient takes a breath, signaling the implant to zap the nerve. Researchers adjust the power so that the nerve is stimulated just enough to keep the tongue from falling backward during sleep but not to stick out.
“I don’t have any idea while I’m sleeping that it’s on,” said Krohn, who’d given up on apnea treatment until volunteering for an early Inspire study last year. He said he now gets a good night’s sleep. “It’s a game-changer for me.”
These experiments are only now beginning, with a handful of implants performed so far — and while it’s an interesting concept, frustrated patients should try some proven steps first, cautions, Dr. Amy Atkeson of Columbia University Medical Center in New York.
Her advice: Don’t give up on CPAP without first seeing an experienced sleep technician to adjust humidity levels and take other steps that not every CPAP prescriber knows to try.