Device helps sleep apnea in Down syndrome teens, Silver Cross doctor says

During the pause of elective surgeries in the early days of the COVID-19 pandemic, a board-certified otolaryngologist at Silver Cross Hospital in New Lenox looked into Inspire Therapy.

Dr. Rajeev Mehta said in 2022 that Inspire Therapy is a small implantable device that delivers a mild electrical stimulation to the tongue to keep the airways open during sleep in adults ages 18 and older who meet certain criteria.

[ Silver Cross Hospital in New Lenox offers implant treatment for sleep apnea ]

Now the device is helping another group of patients.

The U.S. Food and Drug Administration approved the Inspire implant for teens with Down syndrome in 2023. Down syndrome teens “are particularly prone to tongue collapse leading to sleep apnea,” according to a news release from Silver Cross.

“Those with Down syndrome have breathing difficulty due to multiple areas in the throat,” Dr. Saied Ghadersohi, director of the Complex Sleep Program at Ann & Robert H. Lurie Children’s Hospital of Chicago, said in the release. “As they grow into their teens, the problem becomes even worse, with the base of the tongue being larger than normal and collapsing the throat. This leads to breathing issues during sleep.”

On March 14, Ghadersohi implanted the device into a Down syndrome patient at Lurie Children’s Hospital, according to the release. Ghadersohi also sees Down syndrome patients from birth to early adulthood at Lurie’s Silver Cross Hospital location in New Lenox.

According to the Down’s Syndrome Association publication, “Managing sleep issues in children,” children with Down’s syndrome are more prone to obstructive sleep apnea due to “floppy muscles in the throat, enlarged tonsils and adenoids and a smaller upper airway.”

Other contributing factors include facial structure differences, low muscle tone, narrow airway in the nose and throat, obesity and poor coordination of airway movements, according to the National Down Syndrome Society.

Studies suggest that 53 to 76% of children with Down syndrome have sleep apnea compared to 1-4% of the general population, according to the National Down Syndrome Society.

“Those with Down syndrome have breathing difficulty due to multiple areas in the throat. As they grow into their teens, the problem becomes even worse, with the base of the tongue being larger than normal and collapsing the throat. This leads to breathing issues during sleep.”

—  Dr. Saied Ghadersohi, director of the Complex Sleep Program at Ann & Robert H. Lurie Children’s Hospital of Chicago

Very disturbed sleep in children can lead to behavior issues, according to the Down’s Syndrome Association publication.

“A better night’s sleep, as for anyone, can be a game-changer in their lives,” Ghadersohi said in the release.

The Inspire device system is implanted during a 1½-hour surgery. The device delivers a mild electrical stimulation to the tongue muscles to keep the airways open during sleep. Patients turn the device off and on with a small handheld remote. The device starts working in 30 minutes, giving the user time to fall asleep, Mehta said.

“Every time they inhale, a little electrical impulse goes throughs the nerves that move the tongue,” Mehta said in 2022. “Patients tell me it feels like a 9-volt battery on the tongue, a little bit of a tingle. That’s why we titrate (measure) the level, to see the ideal level they can tolerate and cure the sleep apnea.”

As with adults, the Inspire implant is not a first-line treatment for sleep apnea. Teens must try CPAP first and be unable to tolerate it, according to the release.

In addition, teens with Down syndrome must be age 13 or older, diagnosed with severe obstructive sleep apnea and still experiencing sleep apnea, despite removing of their adenoids and tonsils, according to the Inspire website.

“The key to success is forming a partnership with the patient and their families,” Ghadersohi said in the release. “This procedure really has a chance to be life changing for Down syndrome patients and families.”

For more information about the Inspire implant procedure, call Emily White, pediatric registered nurse in otolaryngology at Lurie’s, at 312-227-7830.