The Inspire implant made big waves a decade ago when it was the first, and until recently the only, implant that could genuinely reduce sleep apnea events to a level where some patients could stop using PAP therapy.
It was aimed at sleep apnea patients who, for whatever reason, were unable or unwilling to tolerate PAP therapy. The downside to the Inspire implant is it’s location, in the upper chest. It is a bit like having a pacemaker fitted.
However, there is now another option on the scene from Belgian medical tech company Nyxoah.
Nyxoah’s implant, which they have named Genio, appears to be easier to work with due to the implant being placed under the chin… in the submental region.
The implant is only part of the tech though. In order to keep things simple… such as no batteries or changeable parts in the implant… Genio has a second part that attaches to the outside of the implanted ara at sleep time… and it’s this external controller that motors the implant to do it’s stuff.
At a high-level, the physical stuff is similar to the Inspire implant in that it plays with the hypoglossal nerve during sleep to keep the tongue forward and… as a result… prevent the airway closing.
It is this 2-parter that makes the real difference between the two options, potentially giving Genio the upper-hand.
As the Inspire kit is made up of 3 bits of kit (pulse generator, sensing lead and impulse lead) and implants all 3 of them, it is a bigger job than Genio and it comes with future restrictions too.
Although most CT scans are fine, should the patient need a future MRI scan the Inspire implant makes that unlikely, for now at least. Genio, on the other hand, is fully MRI compatible.
It isn’t all one-sided in Genio’s favour though. It looks like it’s horses for courses with Inspire being right for some patients and Genio the top-choice for others.
An easy, yet probably messed-up, comparison would be CPAP versus BiPAP.
Genio currently delivers pulses at a consistent rate, similar (if you allow me to stretch the similarity here) to the constant air pressure supplied by CPAP.
Inspire goes more of a BiPAP route by using it’s sensing lead to assess the patient’s breathing pattern and adjusts stimulation to match.
Inspire also plays around with 2 different muscles (genioglossus and geniohyoid) whereas Genio only addresses the genioglossus, which is easier to get to with its external controller. The game of Top-Trumps doesn’t stop there though, as there’s a mix of nerve stimulation and muscle activity that needs manipulating to keep the tongue from falling back. With this in mind, Genio works on nerves on both sides of the tongue, as opposed to the Inspire impulse lead playing with only one-side.
Due to test groups being too small to tell, there’s currently no evidence to point towards one or other method being more effective than its competitor. All we do know is it won’t be a simple winner takes all. Some patients needs will steer them towards one over the other.
With approval’s in place across Europe and the United States (and Australia expected in the near future) the future looks bright for this next stage anti-Obstructive Sleep Apnea option.
Far from being an Inspire versus Nyxoah Genio story, this should be taken as inspiration (no pun intended) for the future of non-PAP therapy ways to address Obstructive Sleep Apnea. After all, you would be hard pressed to find anyone who actually enjoys wearing a CPAP mask.
Interested in knowing more?... It’s right here: https://www.geniosleep.com/en/
Cheers,
Alan
P.S. I have taken to creating various bits on sleep and sleep apnea. If you would enjoy hearing more and find out where else you can find stuff like this, you can get my weekly Triple Whammy email, which has 3 short topics each week. Some written or recorded by me and others I’ve found out there in the strange world we live in.
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