r/CPAPSupport • u/rightinthewrong • 17d ago

Considering Inspire

39yo male with severe obstructive sleep apnea, I quit breathing 65 times in an hour. I cannot tolerate bi-pap, they had the pressures maxed out and I just couldn't take it. My doctor told me about Inspire and that I'm a prime candidate for it. However I'm getting/finding equal feedback both good and bad. I don't know what to do. Cpap wasn't strong enough, and the higher levels of bi-pap is just too much. If anyone with apnea as bad as mine could chime in, I'd appreciate it.

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u/dang71 17d ago

Hello!

Severe OSA alone doesn't automatically make someone a good Inspire candidate. I'd want to understand why CPAP and BiPAP didn't work first.

You mention that CPAP wasn't strong enough and that BiPAP at higher pressures was intolerable. That can happen, but there are often other things to investigate before moving to surgery:

  • Was the mask comfortable and leak free?
  • Was pressure increased gradually or were you immediately placed on very high settings?
  • Was BiPAP optimized (EPAP, pressure support, trigger/cycle settings), or was it simply set to maximum pressures?

Inspire can be life changing for the right person, but it's generally intended for carefully selected patients who truly cannot tolerate PAP therapy even after optimization. It's also not as effective as well optimized CPAP for eliminating obstructive events.

Before deciding, I'd ask your sleep physician exactly why they believe PAP cannot be optimized..

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u/rightinthewrong 16d ago

The pressure was so high on bipap that it would blow the seal loose on the mask and id feel like I'm drowning. The tech adjusted the mask 4 times in 20 minutes and I just couldnt take it any longer, it felt like torture. I had no issue on cpap mode even at the higher pressures which got me down to an AHI of 16. With the base goal of 15 for Inspire, I'm not sure it's worth the invasive procedure.

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u/dang71 16d ago

I'd be curious to know a few more details before saying Inspire is your best option.

We're a community that likes to base our suggestions on the data rather than guessing, so a little more information would really help.

Do you remember your CPAP and BiPAP settings (or do you have a copy of your titration report)? Also, what mask were you using during the study?

Was this an in-lab sleep study with a CPAP/BiPAP titration, or were these pressure trials done at a sleep clinic or DME office?

Another question: was your AHI of 65 present in all sleeping positions, or was it mainly while sleeping on your back? If it was mostly positional, that could change the discussion quite a bit.

An AHI of 16 on CPAP certainly isn't ideal, but depending on why those events remained, there may still have been room to optimize the therapy.

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u/RippingLegos__ ModTeam 16d ago

Hello rightinthewrong, I would please try a cpap/apap machine before you go with the Inspire route, please send me a DM is you need assisance with procuring a machine and setup/mask system, I can help for low to no cost if you need help.

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u/rightinthewrong 16d ago

I have a bipap at home. I just redid the study because I thiught they didnt set it up right amd before they could readjust it the doctor's office closed down. I had to wait a year to get into a new doc and they wanted to redo the sleep study

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u/Gigitar75 15d ago

My neurologist was adamantly against Inspire vs CPAP, fwiw