Inside Sleep with The Snoring Doctor Issue #3

Hello!

Welcome back to Inside Sleep with The Snoring Doctor! I hope you’re well-rested and ready to read. This month marked a special milestone for the team at Texas Sinus and Snoring. Recently, I completed my 200th Inspire Implant.

Around four years ago, I was the first surgeon to perform the Inspire procedure in Texas successfully. Since then, Texas Sinus and Snoring has become a leader in sinus and snoring solutions in Houston, and I’m very proud of the work we’ve done.

Now, I’ve also come across some fascinating stories in sleep apnea research and technology that I’m excited to share in this issue. First, I’ll look at some research breaking down a concerning rise in mortality rates among sleep apnea and heart failure patients. Then, I’ll break down key differences between the Inspire Implant and a prospective challenger, the Genio implant. 

Finally, we’ll wrap up with a sleep myth or fact, my sleep clip of the month, and I’ll shine the spotlight on this month’s snoring and sleep apnea treatment segment. So, sip your coffee this morning and dive in.

Catching Up On Sleep: A Current Events Roundup

Mortality burden related to heart failure with sleep apnea increasing in US

Recent data presented at the CHEST Annual Meeting showed that over the past two decades, there has been a significant increase in mortality related to sleep apnea, particularly when it coexists with heart failure. I’ve often talked about the impacts of sleep apnea on the heart, and this data clarifies that point even further. 

The data describes the increasing prevalence of sleep apnea as a comorbidity among individuals with heart failure in the United States. Approximately half of patients with heart failure are affected by sleep apnea, which further increases their risk of mortality. 

While the mortality rates for heart failure have remained steady—even decreasing slightly— over the same time period, the statistics for sleep apnea-related mortality and combined heart failure and sleep apnea-related mortality have seen a substantial and worrying rise. The study found that men, the elderly, and Black individuals are at a higher risk for sleep apnea-related mortality. 

Now, if you’ve followed my social media accounts, you may have read my sleep apnea story. I’ve experienced first-hand the dangerous effects of sleep apnea on the heart; it’s why I’m so passionate about treating this condition. 

These findings further underscore the importance of recognizing and addressing sleep apnea as a serious health concern, especially for high-risk populations. It also emphasizes the need for early diagnosis and treatment of sleep apnea in patients with heart failure to potentially improve outcomes.

At Texas Sinus and Snoring, we’re committed to providing the highest quality care for individuals affected by sleep apnea and snoring. We encourage you to seek medical attention if you suspect you or a loved one may be at risk. Early intervention can make a significant difference in improving health, well-being, and longevity.

Genio, a new upper-airway stimulator implant, makes waves. How does it compare to Inspire?

As we all know by now, I’m a major proponent of the Inspire Implant. It’s an upper-airway stimulator that can be implanted in a patient’s chest in a simple outpatient procedure. After just two incisions and a couple of hours, my patients’ sleep apnea conditions are—95-98% of the time—dramatically improved or cured. 

It’s a miraculous piece of technology that could change the lives of millions suffering from sleep apnea. For many, it’s just nice not to be tied to their CPAP machine anymore. We know this upper-airway stimulator works for snoring and sleep apnea, so naturally, Inspire has some competition entering the market. 

The Genio is an upper-airway stimulator that’s currently undergoing clinical trials at Vanderbilt University. Like Inspire, Genio works by stimulating the tongue nerves with gentle pulses during sleep. These pulses move the tongue forward, preventing the collapse of the airway and typically reduce snoring.

One key difference I’m seeing between Genio and Inspire is the procedure and placement of the technology. Genio is implanted through a single incision under the chin, where the device stays. Inspire, on the other hand, requires one incision in the chest—where the device sits—and one under the chin for the stimulators. Both procedures appear to be minimally invasive with fast recoveries. 

One interesting potential advantage of Genio is that it doesn't require an implanted power source, eliminating the need for future battery changes. Instead, the stimulator is activated by an external battery patch, which the user wears on their chin at night. Inspire’s internal battery is designed to last over a decade, and it’s activated via remote control. 

The Genio team is confident their device will be available to the public in the next 12 to 18 months, pending successful trials and approvals. They’ve been available in Europe since 2019. For the time being, I still believe that the Inspire Implant is the most effective sleep apnea treatment on the market, and I’ll continue to use it with my patients. 

But it’s certainly exciting to see developments in this space as these companies push toward the best possible sleep apnea treatments.

Sleep Mythbusting

The Truth: For the first time in this newsletter—this is a FACT! Now, a causal link could be up for debate, but an overactive bladder is marked by symptoms like nocturia. Nocturia is that sudden, powerful urge to get up and urinate, often leading to awakenings at night. 

Around 50% of people with obstructive sleep apnea (OSA) experience nocturia as well. Sleep apnea impacts a hormone in the body called atrial natriuretic peptide (ANP), which leads to increased production of urine while sleeping. 

To be extra clear, the fact here is not that one of these conditions causes the other, but rather that they have a relationship that can exacerbate each other’s symptoms. If you have sleep apnea, you’re already struggling with disordered sleep, but add OAB to that, and you have a recipe for a bad night’s sleep.

Sleep Clip of the Month

Sleep apnea occurs from a progressive weakening of the tongue and throat. As you age, the ability of your airway to handle a full stream of air decreases. Learn more in the clip below!

Snoring and Sleep Apnea Treatment Spotlight

SomnoGuard® Oral Appliances

Oral appliances—also called mandibular advancement devices—are another solution for snoring and sleep apnea that we like to use with patients when appropriate. The SomnoGuard oral appliance is made of a thermoplastic material, which is heated in a hot water bath, softening the material and allowing for a custom fit for the patient.

These devices work by pulling the lower jaw and tongue forward to open up the upper airways. The vibration of the soft palate and uvula (which is what causes the snoring sound) is typically reduced and sometimes prevented entirely. 

I’m a huge fan of these devices in the right circumstances. They’re portable, adjustable, clinically proven to be effective for snoring and sleep apnea, and they can be used in combination with other solutions.  

How to further connect with The Snoring Doctor:

If you’d like to hear the latest sleep news, you’re in the right place.

To join in on the conversation, you can follow me on LinkedIn and Instagram.

If you’re ready to get treatment for your snoring and sleep apnea, reach out here to request an appointment.

Sweet dreams and happy breathing,

Dr. Ben Cilento, “The Snoring Doctor”

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