remedē^® or Inspire^®: Which sleep apnea implant is right for you? 

Are you still struggling with your CPAP machine? You’re not alone.

If you’re like many people living with sleep apnea, you’ve tried traditional treatments like CPAP, BiPAP or ASV for years—and are still looking for an effective treatment.

Fortunately, there are now FDA-approved therapies specially designed to treat sleep apnea without masks or medications: implantable devices like the remedē System and Inspire^® therapy.

It’s exciting to know that there are more options available to treat your sleep apnea, but how do you know which one is right for you?

Let’s answer sleep apnea patients’ most common questions—so that you can make an informed decision when talking to your sleep specialist about what’s right for you.

First, a quick overview of sleep apnea

Untreated sleep apnea can lead to serious health concerns including chronic fatigue, depression, Type 2 diabetes, stroke, heart attack, and a shortened lifespan.¹

Most people associate “sleep apnea” with a sleep disorder called obstructive sleep apnea (OSA). But there’s another serious kind of sleep apnea called central sleep apnea (CSA).

Although symptoms of OSA and CSA are similar, they have different causes—and therefore require different treatments:

• In OSA, breathing is obstructed by a narrowing or blockage of the airway often caused by a person’s anatomy, or by relaxation of the chest and neck muscles during sleep.
• In CSA, the brain does not properly signal the body to stimulate a regular breathing pattern.² CSA is less common than OSA, but it’s just as serious.

Because CSA is not caused by an airway blockage, positive airway pressure (PAP) may not adequately treat CSA or its symptoms.

What are remedē and Inspire?

The remedē System and Inspire therapy are both implantable devices designed to treat sleep apnea. However, they treat different disorders:

• The remedē System treats CSA 
• Inspire therapy treats OSA 

Who are these devices for?

The remedē System is FDA-approved for adults with moderate to severe CSA. There is no need to have tried other therapies like CPAP, BiPAP or ASV to be eligible for remedē.

Inspire is FDA-approved for adults with moderate to severe OSA who struggle with CPAP therapy.

How do they work?

Both remedē and Inspire are small devices called neurostimulators that are implanted in the chest. When activated, the devices deliver gentle pulses to stimulate the body and restore a more natural breathing pattern.

There are slight differences between the two therapies:

• The remedē System sends pulses through a small wire, or lead, to the phrenic nerve, which stimulates the diaphragm—pulling air into the lungs and restoring restful sleep. 
• Inspire therapy sends pulses to the hypoglossal nerve, which keeps the tongue and airway muscles from blocking the airway. 

Additionally, the remedē System turns on automatically each night and therapy is customized to your needs with the help of your sleep specialist. Inspire therapy activates and is operated by a remote control.

Are there side effects or risks? 

While both therapies are generally safe, there are risks associated with any surgically implanted device. 

• remedē: Risks related to the implant procedure can include movement of the lead, pain, swelling, and infection. Fortunately, none of these risks have been associated with any long-term injury or harm. Once the therapy is turned on, some people may experience discomfort from stimulation and/or from the presence of the device. The majority of these events resolve on their own or by adjusting the therapy settings. The remedē System may not work for everyone. 
• Inspire: Risks related to the implant procedure can include pain, swelling, temporary tongue weakness, and infection. These types of events are generally expected with any kind of surgery, and almost all of them are resolved on their own or with medication within a period of weeks or months. In rare cases tongue paresis and atrophy were observed. Once the therapy is turned on, some patients may experience discomfort from stimulation, tongue abrasion, mouth dryness, and discomfort from the presence of the device. The majority of these events are resolved either on their own, with medication, or by adjusting the therapy settings. Inspire therapy may not work for everyone. 

Are there eligibility requirements or contraindications?

• remedē is for people with moderate to severe CSA. People with an active infection will not be able to receive remedē until the infection has resolved.
• Inspire is recommended for patients with OSA and less than 25% CSA who are unable to tolerate positive airway pressure (PAP) therapy. It is not suitable for individuals with complete airway collapse or people with a body mass index (BMI) exceeding the recommended threshold. This threshold can be discussed with your provider.

Can I get an MRI if I have an implantable sleep apnea therapy? 

• The remedē System is approved for MRI scans under specific conditions.
• Certain Inspire therapy models are compatible with MRI scans, while others are not.

What if I have OSA and CSA? Can I have both devices?

Individuals who have complex or mixed apnea (both OSA and CSA) may benefit from more than one kind of treatment. While it is possible to have both the remedē System and Inspire therapy, consult with your doctor to determine the best treatment path for you.

Ready to take the next step?

If you think an implantable device is the right treatment option for your CSA or OSA, don’t be afraid to start the conversation with your physician or sleep specialist—after all, only you and a trusted healthcare professional can make the decision that’s best for you.

1. Franklin K.A., Lindberg E. Obstructive sleep apnea is a common disorder in the population-a review on the epidemiology of sleep apnea. 7(8):1311-1322. 
2. Costanzo M.R., Khayat R., Ponikowski P., et al. Mechanisms and clinical consequences of untreated central sleep apnea in heart failure. J Am Coll Cardiol. 2015; 65:72–84.