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Implantable device cuts sleep apnea episodes, Pitt, UPMC researchers say

| Wednesday, Jan. 8, 2014, 5:03 p.m.
Andrew Russell | Tribune-Review
Retired nurse Kathy Gaberson, shown at her home in Forest Hills, is among some 18 million Americans who suffer from obstructive sleep apnea, a condition that causes people to stop breathing up to hundreds of times a night. Kathy used a bulky CPAP machine like the one shown for years to sleep but found relief when she participated in a UPMC trial for a small implantable pace-maker device.
Andrew Russell | Tribune-Review
A patient holds a device used to treat sleep apnea. Highmark Health is diversifying its for-profit operations with a first-of-its-kind retail store focused on sleep apnea and other sleep problems.
James Knox | Tribune-Review
UPMC Mercy's Dr. Ryan Soose shows a device to combat sleep apnea on Wednesday, January 8, 2014, at the hospital in Uptown.
James Knox | Tribune-Review
The device to combat sleep apnea is made by Inspire Medical Systems, a Minneapolis company that funded the sleep study at 22 medical centers in the United States and Europe.

For retired nurse Kathy Gaberson, surgery was a small price to pay for a good night's sleep.

She slept so little that she experienced memory problems, and she once fell asleep while driving. But Gaberson's sleep quickly improved when doctors at UPMC Mercy implanted a device in her chest considered a novel treatment for sleep apnea.

“The surgery made a huge difference in my quality of life,” said Gaberson, 67, of Forest Hills. “My short-term memory has improved dramatically.”

The pacemaker-like device reduced by 70 percent the severity of sleep apnea episodes in 126 patients who used it for a year, according to a study published on Wednesday in the New Journal of Medicine by researchers at the University of Pittsburgh School of Medicine and the UPMC Sleep Medicine Center.

Doctors say the device could benefit as many as 18 million Americans who suffer from obstructive sleep apnea.

“This is very neat and very revolutionary,” said Dr. Ryan Soose, director of UPMC's Division of Sleep Surgery.

Soose performed Gaberson's surgery about two years ago. Twelve other patients received the implant at UPMC Mercy, said Soose, a consultant to Inspire Medical Systems, the Minneapolis company that developed the device and funded the study at 22 medical centers in the United States and Europe.

The Food and Drug Administration is scheduled to review the device for commercial release next month. If approved, it could become a valuable addition to treatments for sleep apnea, Soose said.

Diagnoses of obstructive sleep apnea, first documented in the 1960s, are on the rise in the United States. Many believe that is related in part to the growing epidemic of obesity, a condition linked to the disorder.

Doctors believe many cases go undiagnosed. A 2006 study estimated that untreated sleep apnea may be responsible for $3.4 billion a year in additional medical costs in the United States.

The cost of treatment adds up quickly, even when limited to medical devices. The latest annual data available showed that Highmark, which insures about 4 million Pennsylvanians, paid claims for sleep-apnea equipment for 72,890 members at a cost of $60 million.

Diagnoses of the disorder, often explored because of excessive snoring, typically follow a one- or two-night stay in a hospital or freestanding sleep clinic. Treatment includes recommendations for changing sleeping positions, weight loss, mouth guards, using a continuous positive airway pressure device, or CPAP, and upper airway surgery to remove tissue.

Dr. William Kohler, a spokesman for the American Academy of Sleep Medicine, said the implant shows promise as an alternative treatment. “But there are other, less invasive treatments for those who can tolerate it. The CPAP still does a better job of controlling the apnea,” he said.

CPAP, a scuba-like mask tethered to a machine that regulates air flow and keeps airways open, was developed in 1985 by Phillips Respironics in Murrysville. It remains the most popular treatment but has some drawbacks.

“As many as half of the patients who have been prescribed CPAP are unable to use it regularly, largely due to discomfort with the mask and/or the lack of desire to be tethered to a machine,” said Dr. Patrick Strollo, the study's lead author and medical director of the UPMC Sleep Medicine Center.

That was the case with Al Friedl, a retired Kent State University professor and another of Soose's patients in the Inspire surgical trials.

Friedl, 82, who has had sleep apnea for two decades, could not tolerate the machine and fared only minimally better with a nighttime mouth guard.

“The change with this has been remarkable,” he said. “There was a time when I couldn't remember the last time I slept a full night. Now, I think back, and I'm trying to remember when was the last time I didn't sleep at night.”

Debra Erdley is a Trib Total Media staff writer. Reach her at 412-320-7996 or derdley@tribweb.com.

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