First UK patients describe receiving the technology which could spell the end for the uncomfortable masks some sufferers have to wear
Sleep apnoea sufferers have been fitted with an app-controlled device that zaps the nerves in the tongue to help them breathe overnight.
The first UK patients have described receiving the technology which could spell the end for the uncomfortable masks some sufferers have to wear.
The three-hour procedure to fit the Genio Nyxoah implant was carried out by medics at University College London Hospitals NHS Foundation Trust (UCLH) earlier this month. It is the first centre in the UK to offer devices which stimulate the hypoglossal nerve, which controls the muscles in the tongue, and can be an alternative to continuous positive airway pressure (Cpap) machines.
Consultant sleep surgeon Ryan Chin Taw Cheong, described the implants which have been fitted to 22 people in the UK as a “pacemaker for the tongue” and “the best treatment for sleep apnoea on the planet”.
Sleep apnoea causes breathing to repeatedly stop during sleep and is thought to impact about eight million people in the UK. The most common form – obstructive sleep apnoea – happens when the walls of the throat relax and narrow or close, with symptoms including choking noises, loud snoring and waking up a lot. Cpap machines are the first line of treatment for sleep apnoea and involve patients wearing a mask that blows pressurised air into the nose and throat while they sleep. However, it can be uncomfortable.
Surgeons make a 6cm incision below the chin and use a microscope to pinpoint the nerves that make the tongue protrude and patients are fitted with the Genio Nyxoah nerve stimulator. It is controlled by an external chip that is stuck to the chin using an adhesive patch before the patient goes to sleep. During the day, the patch can be removed and the chip recharged, while patients are able to adjust the level of stimulation and monitor their sleep on a smartphone app.
One recipient, Natalie Boller, a 63-year-old mother of six from East Sussex who has suffered from sleep apnoea for a decade, said she went under the knife after trying “everything”. She said: “I tried the Cpap machine for a whole year but I just found it impossible to get comfortable. Everything I’ve tried has failed. They implanted it under the muscle, it’s a very delicate surgery. They didn’t damage any nerves, I can still wiggle my tongue and swallow. I’m glad I went through with it and now I’m looking forward to the next step of having it activated.”
Mrs Boller will meet with doctors to have the implant activated in the coming weeks and said she is looking forward to being more active, including hiking, cycling and looking after her two grandchildren. “I would like to be as active as possible but I’ve been prevented from doing this because I’m always tired,” she added.
Another alternative being offered at the hospital is the Inspire implant which involves two incisions, one below the jaw and one in the chest, with the device fitted in the chest with a lead connecting the stimulator to one side of the nerve, usually the right. Once it has been activated, patients can control the strength of the stimulation using a remote control, starting off low and going up one level per week.
Olivia Rushton, 48, of Northamptonshire, had the operation in June, with the device activated a month later. Prior to having Inspire, her breathing would pause for 10 seconds or more about 65 times per hour each night. Anything over 30 is considered severe sleep apnoea. Early results showed Ms Rushton’s breathing is now only stopping about 25 times per hour, a reduction of 62%.
Olivia said: “It’s been a steady progress of improvement. This is only halfway through the journey. They’re going to have me back in for another sleep study early next year.”
Patients eligible for the implants must have moderate to very severe sleep apnoea, a body mass index of below 35, and must have tried using a Cpap machine.
Mr Cheong said: “We’re hoping to be able to be really driving this field forward to be able to offer these treatment options. So when a patient comes to our clinics, they are confident and they are assured that they will be able to access the best treatment for sleep apnoea on the planet.”