He snored! How does a tongue pacemaker work?

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Snoring: No one likes to hear the rattling, the sound of a saw. It occurs as a result of the tongue or uvula and the soft palate falling towards the throat while sleeping and blocking the air flow. In so-called sleep apnea, the air supply is completely cut off, even for a short time. Whoever is affected by it will wake up again and again. Pausing in breathing increases the long-term risk of high blood pressure, stroke, and heart attack.

Lorenz Epprecht, 35, senior doctor at University Hospital Zurich (USZ), says weaker sleep apnea can be treated with splints or corsets, and stronger ones with CPAP masks, which increase the air pressure in the airways. “Effective, but significantly disturbing many patients while they sleep.”

Sometimes surgery is the last resort. Among other things, Epprecht tightens the soft palate. On March 30, he placed a pacemaker in a patient. A premiere for the University Hospital Zurich. The only center in Switzerland that has offered this procedure for a long time is in Liestal BL.

The most important things about the procedure at a glance:

It gives the tongue a slight electric pulse, causing it to move forward slightly, making room at the back of the mouth. This allows the sleeper to breathe freely. The model implanted by Lorenz Epprecht emits impulses with every breath you take. When you exhale, the tongue relaxes again.

No, it can be activated by remote control when you want to sleep. Epprecht says you can feel how the tongue becomes stiff due to the current urges. “Patients get used to it quickly,” he said. With an activated pacemaker, you can only slurp talk, he adds. Police in the US recently arrested a driver who forgot. “The officers thought he was drunk.” Epprecht says that if a patient loses the remote control and their pacemaker is active, they should contact the clinic. Someone can be reached around the clock for all the concerns of pacemaker patients.

The tongue pacemaker is implanted subcutaneously about two inches below the middle of the collarbone. It consists of a stimulation electrode powered by a small generator. A cable runs from it under the chin, where it is connected by a cuff to a nerve that goes to the tongue. Epprecht says that from the outside you can only see the pacemaker in very weak people. However, they rarely experience sleep apnea. “Among other things, because they have very few fatty deposits in their throat and palate that put pressure on the airways.”

It takes between one and a half to two hours, according to Epprecht. The surgery is performed in bed and under general anesthesia. “You’re back in shape after two nights in the hospital.” Health insurance covers implantation in apnea patients. Epprecht says that if a person “only” snores without apnea, they usually have to pay for the procedure themselves, which costs an estimated CHF 30,000. Whether a person is eligible for a pacemaker depends on numerous tests. Candidates spend at least one night in the sleep laboratory at the Zurich Pneumology Clinic.

In most cases, sleep apnea can be stopped with a pacemaker, Epprecht says. Sometimes it makes sense to additionally tighten the soft palate. After eleven years, the pacemaker needs to be replaced, which requires local anesthesia. Epprecht says that a person with a pacemaker in their tongue may still be snoring. “However, in the vast majority of cases, it’s just very weak.”

Source : Blick