Inspire Upper Airway Stimulation (UAS) System

Reviewed by: HU Medical Review Board | Last reviewed: February 2023

The Inspire® Upper Airway Stimulation (UAS) system is approved to treat moderate to severe obstructive sleep apnea (OSA), the most common type of sleep apnea. The device is an implantable nerve stimulator. It is approved for use in some people who have not had success with continuous positive airway pressure machines (CPAP).1-3

What is the Inspire device?

Inspire is a small device similar to a pacemaker. It is implanted into the chest wall in a same-day, outpatient surgery. To place the device, 1 small incision is made under the chin, and another is made below the collarbone.1-3

The device includes a small machine that creates an electrical pulse to stimulate a nerve in your tongue. This causes the tongue to move forward at night as you breathe. This keeps your airway open.1-3

The device is turned on and off by a handheld remote control. The Inspire battery lasts about 11 years.3

How does Inspire work?

About 4 weeks after surgery, you will have a follow-up appointment with your doctor. During this appointment, your doctor will turn on and program the device. Your doctor will also make a number of small adjustments to the device to make sure it is working and find the right settings for your body. You will also be given instructions on how to use the device at home.1-3

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When you get ready for bed each night, you click the remote control to turn the device on. As you sleep, the device monitors your breathing. Every time you breathe, Inspire opens your airway by stimulating the hypoglossal nerve. This nerve causes the genioglossus muscle in the back of your tongue to move forward. This is the muscle that blocks the throat during sleep in some people with obstructive sleep apnea.1-3

Inspire lets you sleep without a mask or hose, but it does take some time to get used to the way it feels. Your doctor will need to check your device and see how it is working for you after it is turned on. The first follow-up sleep study is about 90 days after the device is activated. Inspire recommends that you have a follow-up every 6 to 12 months after you have reached a therapeutic level.3

Who qualifies for an Inspire device?

Inspire is intended for people who are unable to use or get consistent benefits from CPAP. A doctor trained in the Inspire procedure will help determine if this requirement has been met. You must also have had a sleep study to document the severity of your sleep apnea. You will likely need a new sleep study if your last one was more than 2 years old, based on your insurance requirements. You must also:1,3

  • Be age 18 or older
  • Have moderate to severe obstructive sleep apnea with an apnea-hypopnea index (AHI) between 15 and 65
  • Have a body mass index (BMI) below 35 kg/m2 (though most insurances require a BMI below 32 kg/m2 for coverage)
  • Have a throat structure that allows Inspire to work

Adults with mild sleep apnea, children, people with a BMI over 35, or certain throat conditions do not qualify for Inspire. People with certain health conditions are not good candidates for Inspire, including those with:1

  • Neuromuscular disease
  • Hypoglossal nerve palsy
  • Severe heart or lung diseases
  • Some mental health issues
  • Other uncontrolled sleep disorders

In early 2023, Inspire was approved for children with Down syndrome who are ages 13 to 18, are unable to tolerate CPAP, and have an AHI between 10 and 50.4

Inspire model 3028 is eligible for MRI scans provided specific conditions are followed. Talk to your doctor before undergoing an MRI. Other imaging tests may be a better option for you.3

What are the possible side effects?

Possible side effects after Inspire implantation include:1,2

  • Temporary pain where the device has been placed
  • Temporary tongue or lower lip weakness
  • Tongue soreness
  • Pain at the incision sites

Tongue soreness tends to get better over time or when your doctor adjusts the device. You may be prescribed over-the-counter pain relievers after surgery to take care of any soreness.1,2

Long-term side effects are rare but may include:2

  • Device malfunction and damage
  • Implant exposure and migration
  • Infection
  • Scarring

These are not all the possible side effects of the Inspire UAS system. Talk to your doctor about what to expect with the device. You also should call your doctor if you have any changes that concern you after Inspire implantation.

Other things to know

You will likely need a follow-up sleep lab test (polysomnography) about 90 days after Inspire was activated to track how well your obstructive sleep apnea is controlled and make any adjustments to your settings.1,2

Insurance companies and Medicare/Medicaid often cover the cost of Inspire. Contact your insurance company to learn more about coverage and requirements.2

Before beginning treatment for OSA, tell your doctor about all your health conditions and any other drugs, vitamins, or supplements you are taking. This includes over-the-counter drugs.

For more information, read the full Inspire UAS system patient manual.