Implants May Help Patients with Sleep Apnea, Severe Snoring

Researchers at the University of Cincinnati are evaluating the effectiveness of palatal implants in providing relief for patients with obstructive sleep apnea (OSA) and socially disruptive snoring.

The implant, called the Pillar palatal implant system, is a minimally invasive treatment involving significantly less pain than traditional surgeries used to treat OSA, says David Steward, MD, associate professor of otolaryngology at UC.

“Sleep apnea can cause physical and emotional issues for patients,” says Dr. Steward. “Patients with untreated sleep apnea stop breathing frequently while sleeping, which causes interrupted sleep and daytime fatigue. Sleep apnea can also contribute to heart disease, high blood pressure, memory impairment, impotence, stroke, and up to a seven fold increased risk of traffic accidents. Bed-partners of those with sleep apnea can suffer from sleep deprivation because of their partner's snores and gasps for breath.”

OSA is usually caused by the soft tissue in the rear of the throat (uvula) collapsing which blocks air flow to the trachea. Each time the breathing stops the body wakes itself to resume breathing, which significantly reduces sleep quality.

Traditional treatment options for OSA include continuous positive airway pressure (CPAP) and a surgical technique called uvulopalatopharyngoplasty (UPPP).

CPAP involves a mask that is fitted to a patient’s face and worn during sleeping. It provides continuous pressure to keep the airway open. UPPP includes cutting away the uvula and soft palate. The surgery requires hospitalization and leaves patients in pain for up to two weeks.

The Pillar procedure involves implanting three small polyester braids into the soft palate to stiffen and support the palate to prevent tissue vibration (snoring) and obstruction of the airway during sleep. The implants, which have been cleared by the Food and Drug Administration (FDA), are inserted into the palate using a needle delivery system under local anesthesia. The procedure takes less than five minutes and is performed during one office visit.

“Tissue is not removed or damaged during this procedure, so patient discomfort is minimal,” says Dr. Steward. “Short-term results from previous studies show that most patients experience an improvement within four to six weeks and most report a noticeable reduction in snoring. The inserts are designed to be permanent, but can be removed and replaced if necessary.”

Although the treatment and diagnosis of sleep apnea is traditionally reimbursed by insurance companies, currently most insurers do not cover the Pillar procedure.

According to the National Institutes of Health (NIH), more than 12 million Americans have OSA and it is more common in men. NIH estimates that one out of 25 middle-aged men and one out of 50 middle-aged women have sleep apnea.

For more information on the study, call Christine Canter or Colleen Eigel at (513) 558-1719. The study is funded in part by Restore Medical, which holds the patent for the technique. Dr. Steward has no financial interest in the company.