Around 22 million Americans have sleep apnea. It happens when the brain has trouble controlling breathing. For more information, please visit. You are age 18 or above. The risks and cost of the surgery and the possibility that I might still have to be on CPAP are not worth it.". If a patient falls outside the coverage criteria of their insurance, a team of insurance specialists at Inspire will assist in gaining approvals. For a list of covered benefits, please refer to your Evidence of Coverage or Summary Plan Description. These include: You can also try oral breathing devices or nasal devices. You're right. Medicines include some types of sleeping pills, opioids, and sedatives. You are unable to use or get consistent benefit from CPAP. It should not be painful or uncomfortable. I talked with my doctor, and we agreed that surgery might be a good option to treat my sleep apnea. Several oral devices have been tested to help treat people with sleep apnea or snoring. Oral breathing devices or other types of devices that you wear while you sleep have not worked for you. A tracheostomy nearly always cures sleep apnea. Kaiser Permanente is not responsible for the content or policies of external websites. To learn more about Healthwise, visit Healthwise.org. The main side effect of tracheostomy is that you have a hole in your throat where the breathing tube sits. For some, sleeping with a CPAP machine is impossible. Do you have enough support and advice from others to make a choice? Decrease daytime sleepiness. 1995-2023 Healthwise, Incorporated. Instead, use lifestyle changes to try to improve sleep. Oral or nasal breathing devices may also help. It's important to treat sleep apnea, because it makes you more likely to have high blood pressure, depression, irregular heart rhythms, heart failure, coronary artery disease, and stroke. Healthwise, Incorporated disclaims any warranty or liability for your use of this information. Your doctor may ask you or your bed partner about your snoring and sleep behavior and how tired you feel during the day. Almost all people who have sleep apnea snore. Medicines to avoid include sleeping pills, opioids, and sedatives. The Medicare program will cover those who require the use of Inspire. This may prevent a buildup of fluid and swelling of the tissues in the nose and throat at night. or If other members of your family have sleep apnea, you are more likely to have it than someone who doesn't have a family history of it. Health plan provider Humana Inc will provide coverage for Inspire Medical Systems Inc's Inspire upper airway stimulation therapy for obstructive sleep apnea, effective August 27. The risks and cost of the surgery and the possibility that I might still have to be on CPAP are not worth it. Decision Points focus on key medical care decisions that are important to many health problems. Neighbor islands : 8 a.m. to 5 p.m. Monday through Friday, 5 p.m. to 8 a.m. next day; Weekends and holidays, 24 hoursOahu: 808-432-7700Neighbor islands: 1-800-467-3011. Have personality changes, anxiety, and depression. Radiofrequency ablation for sleep apnea can cause: Damage to tissue near the area being treated. If you have sleep apnea, you may wear a mask that is connected to a continuous positive airway pressure (CPAP) machine. You are unable to use or get consistent benefit from CPAP. I'm willing to try surgery to get better. Inspire is the most effective alternative to CPAP., Having an effective alternative sleep apnea treatment is important in our field of sleep medicine., Inspire offers a way to stimulate the bodys own physiology to provide a more natural way to keep the airway open during sleep., Ryan Nord, MD - VCU Health, Department of Otolaryngology, Suzanne Stevens, MD - The University of Kansas Health System, Department of Neurology, Bruce Corser, MD - Sleep Management Institute, Asim Roy, MD - Ohio Sleep Medicine Institute, Gerard J. Meskill, MD - Comprehensive Sleep Medicine Associates, Inspire Medical Systems, Inc. 2023. Talk to your doctor or pharmacist about your options. Your use of this information means that you agree to the Terms of Use and Privacy Policy. Check what you need to do before you make this decision. Think about what matters most to you in this decision, and show how you feel about the following statements. CPAP Machine. 1. What are the Operating Hours of the Sleep Lab at South Sacramento Kaiser Permanente? Obesity is the factor most likely to lead to sleep apnea. Changing the position of the lower jaw enlarges the airway and decreases the chance that it will collapse when you inhale. I have been using CPAP. Kaiser Permanente health plans around the country: Kaiser Foundation Health Plan, Inc., in Northern and Southern California and Hawaii Kaiser Foundation Health Plan of Colorado Kaiser Foundation Health Plan of Georgia, Inc., Nine Piedmont Center, 3495 Piedmont Road NE, Atlanta, GA 30305, 404-364-7000 Kaiser Foundation Health Plan of the Mid-Atlantic States, Inc., in Maryland, Virginia, and Washington, D.C., 2101 E. Jefferson St., Rockville, MD 20852 Kaiser Foundation Health Plan of the Northwest, 500 NE Multnomah St., Suite 100, Portland, OR 97232 Kaiser Foundation Health Plan of Washington or Kaiser Foundation Health Plan of Washington Options, Inc.,1300 SW 27thSt., Renton, WA 98057, Selecting these linkswill take you away from KP.org. Lead to other problems, such as high blood pressure and heart disease. You sometimes fall asleep at the wrong times, such as while you are talking or eating. You can go back to your usual activities. If these things don't help, you might try a different type of machine. Your use of this information means that you agree to the Terms of Use and Privacy Policy. Healthwise, Healthwise for every health decision, and the Healthwise logo are trademarks of Healthwise, Incorporated. You may not need to use CPAP after surgery. While youre asleep, a camera records how your airway opens and closes, The whole exam only takes about 20 minutes, and when youre done, youll find out if Inspire is right for you, Inspire is placed under the skin, in a same-day, outpatient procedure that takes about two hours, Most patients take over-the-counter pain medication and resume non-strenuous activities within a few days, You can resume more strenuous activities within a couple of weeks, Inspire sends mild stimulation to the motor nerve that controls your tongue, moving it out of the way. However, as an example, the pricing page states that a person with traditional Medicare should expect to pay a maximum of $1,400 out of pocket if the procedure is done in hospital. Central sleep apnea is caused by a problem with how the brain signals the breathing muscles. Central sleep apnea is less common. Delivered on weekdays. This is a limited benefit. Conditions such as periodic limb movement disorder. Bone deformities or enlarged tissues block your airways. Enter X266 in the search box to learn more about "Learning About CPAP for Sleep Apnea". Conditions such as periodic limb movement disorder. Taking certain medicines or drinking alcohol before bed. The Inspire systemis the latest in obstructive sleep apnea treatment. This causes a little back-pressure in the airways that may help keep them open. For recommended treatments, please consult with your health care provider. How sure do you feel right now about your decision? Here's how it works and who should use it. Sleep studies you do at home can be done with portable equipment. It reduces the chance of developing long-term. It really isn't that much of a bother for me to use. BCBS of Kansas City, March 1, 2019 . 4. That eliminates an incision and, according to Inspire, reduces the procedure time by 20%. What else do you need to make your decision. This is repeated muscle twitching of the feet, arms, or legs during sleep. This may happen many times during a night. 2006-2023 Healthwise, Incorporated. This most often occurs because your airways are blocked or partly blocked. If your sleep apnea doesn't improve with treatment, you may have more tests to find out what's causing it. You may also hear this called BiPAP. There are risks associated with the surgery and the device itself, including tongue abrasion and discomfort (more on that below). Despite seeming like a minor annoyance that might keep your partner up at night, there are several serious side effects of sleep apnea if left untreated, including high blood pressure, strokes and heart issues. It's important to treat sleep apnea, because it makes you more likely to have other serious problems. Sleep apnea is often treated using continuous positive airway pressure, or CPAP, machines. "I have been using continuous positive airway pressure (CPAP) to treat my sleep apnea for over a year. To diagnose sleep apnea, the doctor will gather information about your child's symptoms and general health. Go to https://www.healthwise.net/patientEd. Sleep Apnea: How Is It Treated? | Kaiser Permanente or CPAP side effects may include nosebleeds, a sore throat, and headaches. As of March 2021, the need for the second lead to the ribs is no longer necessary. There are three main types of sleep apnea: Inspire is only for treating obstructive sleep apnea; it will not treat central sleep apnea. Your doctor will probably have you try lifestyle changes and CPAP (continuous positive airway pressure) first. Surgery is a first choice only if the sleep apnea is caused by a blockage that is easily fixed. Does Medicare Cover Sleep Apnea | MedicareFAQ Sleep apnea is often treated with a CPAP machine or other machine that prevents your airways from closing during sleep. That's right. Your doctor may suggest a sleep study. Nerve stimulation. A sleep study may take place in your home. What will the scars look like after I have healed from the Inspire procedure? Use this Prior Authorization Guide to assist you in determining if your patient meets criteria.. Blocked or narrowed airways in your nose, mouth, or throat can cause sleep apnea. Le pedimos disculpas por cualquier inconveniente y agradecemos su paciencia. My doctor said that even if I have the surgery, I still might have to use CPAP. Feeling unrefreshed or tired after a night's sleep. Sleep apnea occurs when you often stop breathing for 10 seconds or longer during sleep. They may be helpful as you make important health decisions. Problems with nighttime behaviors. Get in touch with an Inspire Advisor. They check for how often you stop breathing or have too little air flowing into your lungs during sleep. Follow the directions for cleaning the machine. According to Inspire, the stimulation is subtle and is designed to not wake you up, meaning it shouldn't be painful or uncomfortable. The risks of maxillo-mandibular advancement are: Changes in appearance and in how the teeth meet. Your throat muscles and tongue relax during sleep and partially or completely block the airways in your nose, mouth, or throat. Phone 844-756-9744 844-756-9744; Chat; Email The Inspire device is placed during a minor surgical procedure, but you can usually go home the same day. Show which way you are leaning right now. For a list of covered benefits, please refer to your Evidence of Coverage or Summary Plan Description. 1. Your doctor will probably have you try lifestyle changes and. Most sleep apnea patients who meet eligibility requirements for Inspire have access to insurance coverage. Healthwise, Incorporated disclaims any warranty or liability for your use of this information. 2011-2023 Healthwise, Incorporated. We apologize for the inconvenience and thank you for your patience. Your airway can become blocked when your throat muscles and tongue relax during sleep. These will record things like brain activity, eye movement, oxygen levels, and snoring. For recommended treatments, please consult with your health care provider. These include sleepwalking, night terrors, bed-wetting, and REM behavior disorders (RBD). Some lifestyle changes can help sleep apnea. But it leaves a hole in your throat where the breathing tube sits. Here are some things you can try: Talk to your doctor if you're still having problems. You have moderate to severe obstructive sleep apnea. Inspire Sleep Apnea Review | Better Than CPAP? - Illuminate Labs Read and follow all instructions on the label. Kaiser Permanente health plans around the country: Kaiser Foundation Health Plan, Inc., in Northern and Southern California and Hawaii Kaiser Foundation Health Plan of Colorado Kaiser Foundation Health Plan of Georgia, Inc., Nine Piedmont Center, 3495 Piedmont Road NE, Atlanta, GA 30305, 404-364-7000 Kaiser Foundation Health Plan of the Mid-Atlantic States, Inc., in Maryland, Virginia, and Washington, D.C., 2101 E. Jefferson St., Rockville, MD 20852 Kaiser Foundation Health Plan of the Northwest, 500 NE Multnomah St., Suite 100, Portland, OR 97232 Kaiser Foundation Health Plan of Washington or Kaiser Foundation Health Plan of Washington Options, Inc.,1300 SW 27thSt., Renton, WA 98057, Selecting these linkswill take you away from KP.org.
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