The activation, clinical course, and clinical outcome of using an unconventional electrode configuration in a patient newly implanted with Inspire® therapy: a case report

Abstract

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Hypoglossal nerve stimulation therapy via the Inspire® implant is a common alternative to positive airway pressure (PAP) treatment for obstructive sleep apnea (OSA). While hypoglossal nerve stimulation (HGNS) therapy offers a high rate of successful treatment outcomes, the post-activation care pathway, which involves gradual titration of the amplitude to achieve both subjective and objective improvements, can be lengthy, ranging from 3 to 12 months post-activation. Here, we report a case of a 55-year-old man with severe obstructive sleep apnea and a history of hypertension who underwent successful activation and titration of the Inspire® implant to achieve subjective and objective relief within 8 weeks post-implantation and 5 weeks post-activation, using an unconventional starting electrode configuration. This case highlights the need for further exploration of alternative Inspire® activation and management protocols that may lead to improved patient outcomes and higher success rates.

Keywords

• obstructive sleep apnea
• sleep disorders
• hypoglossal nerve stimulation
• Inspire®
• hypoxic burden
• CPAP intolerance