Patients suffering from a prevalent sleep disorder are using a device controlled by an app. This device stimulates the nerves in the tongue to assist in breathing during sleep.
The technology, which is a first in Britain, could spell the end for uncomfortable machinery which some people need to sleep at night.
Sleep apnoea causes breathing to repeatedly stop during sleep and is thought to impact about eight million people in the UK.
The most typical form of this condition is obstructive sleep apnoea, which occurs when the throat walls relax and narrow or close, leading to symptoms such as choking sounds, loud snoring, and frequent awakenings.
Recently, healthcare professionals at University College London Hospitals NHS Foundation Trust (UCLH) conducted a three-hour procedure to implant the Genio Nyxoah device in patients with this disorder.
One of the two patients, Natalie Boller, 63, was feeling better within days and will return to the clinic to have the device activated in the coming weeks.
She said she is looking forward to being more active, something her tiredness has prevented.
It comes as UCLH became the first centre in the UK to offer sleep apnoea patients a choice of nerve stimulators – the Genio Nyxoah or the Inspire implant.
Natalie Boller, 63, was feeling better within days and will return to the clinic to have the tongue-zapping device activated in the coming weeks
She said she is looking forward to being more active, something her tiredness has prevented
Both devices stimulate the hypoglossal nerve, which controls the muscles in the tongue, and can be an alternative to continuous positive airway pressure (Cpap) machines.
Cpap machines are the first line of treatment for sleep apnoea and involve patients wearing a mask that blows pressurised air into the nose and throat while they sleep. However, it can be uncomfortable.
Consultant ENT and sleep surgeon, Ryan Chin Taw Cheong said: ‘I’m very optimistic about the way things are moving, and I’m hoping that we will be able to make this technology and make this implant more available for the right patients.’
During her operation, surgeons made a 6cm incision below Mrs Boller’s chin and used a microscope to pinpoint the nerves that make the tongue protrude.
The stimulator is controlled by an external chip that is stuck to the chin using an adhesive patch before the patient goes to sleep.
During the day, the patch can be removed and the chip recharged, while patients are able to adjust the level of stimulation and monitor their sleep on a smartphone app.
Mrs Boller, a mother of six from East Sussex, has suffered from sleep apnoea for a decade and said she has tried ‘everything’ to alleviate her symptoms, including a Cpap machine.
‘I tried it for a whole year but I just found it impossible to get comfortable,’ she said.
During her operation, surgeons made a 6cm incision below Mrs Boller’s chin and used a microscope to pinpoint the nerves that make the tongue protrude
‘I’ve had sleep apnoea for 10 years now and everything I’ve tried has failed. I was very hopeful about the surgery.’
After the operation, Mrs Boller recovered at home and despite some tiredness, felt better within a few days.
She added: ‘They implanted it under the muscle, it’s a very delicate surgery. They didn’t damage any nerves, I can still wiggle my tongue and swallow.
‘I’m glad I went through with it and now I’m looking forward to the next step of having it activated.’
Mrs Boller will meet with doctors to have the implant activated in the coming weeks and said she is looking forward to being more active, including hiking, cycling and looking after her two grandchildren.
‘I would like to be as active as possible but I’ve been prevented from doing this because I’m always tired,’ she added.
Mrs Boller’s surgery comes as the first woman in the UK to be fitted with the Inspire implant received her first results.
Mr Cheong describes the Inspire implant as a ‘pacemaker for the tongue’ and said that only about 22 people in the UK have been fitted with it so far.
‘I would like to be as active as possible but I’ve been prevented from doing this because I’m always tired’, Mrs Boller said
The surgery is slightly different and involves two incisions, one below the jaw and one in the chest, with the device fitted in the chest with a lead connecting the stimulator to one side of the nerve, usually the right.
Once it has been activated, patients can control the strength of the stimulation using a remote control, starting off low and going up one level per week.
Olivia Rushton, 48, of Northamptonshire, had the operation in June, with the device activated a month later.
Prior to having Inspire, her breathing would pause for 10 seconds or more about 65 times per hour each night. Anything over 30 is considered severe sleep apnoea.
Early results showed Ms Rushton’s breathing is now only stopping about 25 times per hour, a reduction of 62%.
She said: ‘It’s been a steady progress of improvement.
‘This is only halfway through the journey. They’re going to have me back in for another sleep study early next year.’
Ms Rushton said she was initially ‘terrified’ of having the operation as it was her first ever surgery, but added: ‘It was actually a very quick recovery.’
Olivia Rushton, 48, of Northamptonshire, had the operation in June, with the device activated a month later
Prior to having Inspire, her breathing would pause for 10 seconds or more about 65 times per hour each night. Anything over 30 is considered severe sleep apnoea
Mr Cheong also hailed the recovery time as ‘incredible’ compared to other sleep surgeries, which can involve reconstructing the palate and cutting out parts of the tongue.
‘Patients would be usually in pain for about four to six weeks, with potential changes to the swallow, changes to speech, changes to the sensation at the back of the throat,’ he added.
‘And with these implants, I’m seeing patients like Olivia and Natalie within literally 24-48 hours, and they’re pain-free, with no complications.
‘Up and about, able to swallow, speak normally. And it is incredible. We’ve not been able to do something like this with our practice up until now.’
Patients eligible for the implants must have moderate to very severe sleep apnoea, a body mass index of below 35, and must have tried using a Cpap machine.
Mr Cheong added: ‘We’re hoping to be able to be really driving this field forward to be able to offer these treatment options.
‘So when a patient comes to our clinics, they are confident and they are assured that they will be able to access the best treatment for sleep apnoea on the planet.’
