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If you have sleep apnea, waking up tired may be your norm. Even if you wear a CPAP every night, you might not get the good night’s rest you need. Thankfully, there’s a different option available.

Positive airway pressure (PAP)—CPAP and BiPAP therapy—is the most common treatment for sleep apnea. It pushes pressurized air through a mask to keep your airway open so you can sleep better. But it doesn’t work well for everyone.

“For years, countless patients who have been intolerant of CPAP or BiPAP therapy have had few options for treatment,” said Dr. Michael Vick, an otolaryngologist with Wellstar. “What we have done in the past has been painful and unpredictable.”

Fortunately, if you don’t respond to PAP therapy, there’s good news. Wellstar is a multidisciplinary Center of Excellence for Inspire Implants—the first with the designation in Georgia and the second in the country. This hypoglossal nerve stimulator can reduce sleep apnea without the bulky mask.

What is sleep apnea?

Sleep apnea is a sleeping disorder. It causes you to stop breathing off and on while you’re asleep. It can happen when something blocks your airway (obstructive sleep apnea) or if your brain doesn’t send the right signals to the muscles that control your breathing (central sleep apnea). Either way, your body doesn’t get enough oxygen.

To kickstart your breathing, your body triggers a survival reflex. The jolt wakes you up just enough for you to start breathing again. But it also breaks your sleep cycle, meaning you’re tired the next day. And without proper treatment, you can develop high blood pressure or other heart problems that can be life-threatening.

How is sleep apnea diagnosed?

You may have sleep apnea if you snore, wake up frequently at night or stop breathing when you sleep. An at-home or overnight in-clinic sleep test can diagnose you accurately.

At-home tests use a finger monitor to measure and record your airflow, blood oxygen level, breathing pattern and heart rate. We may suggest an in-clinic test called a polysomnogram if we think you have central sleep apnea. This test uses electrodes placed around your body to evaluate your arm and leg movements, blood oxygen level, brain activity, breathing, and heart and lung activity while you sleep.

Common treatments for sleep apnea

Oral appliances can treat mild sleep apnea, and surgery can address treatment-resistant sleep apnea. But two types of PAP therapy have long been the most common treatments for most people with moderate-to-severe sleep apnea:

• Continuous PAP (CPAP): A machine delivers constant air pressure through a mask to keep your airway open during sleep.
• Bilevel PAP (BiPAP): A similar machine uses a mask to deliver higher air pressure when you inhale and lower air pressure when you exhale.

More advanced sleep apnea treatment

PAP therapy is uncomfortable for many people. If it doesn’t work for you, an Inspire Implant can reduce your sleep apnea without the mask. The two-piece implant involves a sensor in your chest and a receiver that wraps around the hypoglossal nerve that controls your tongue.

Our ear, nose and throat (ENT) specialists partner with lung and sleep medicine experts to place the device. They perform a minimally invasive procedure that requires two small incisions. This outpatient surgery requires minimal recovery time.

Once in place, the implant works simply. When turned on at night, the sensor sends a signal to the receiver that gently stiffens your tongue and palate with each breath, so your airway does not become blocked—all without waking you.

According to Dr. Vick, Inspire has been a breakthrough for many patients who cannot tolerate CPAP or BiPAP therapy. While success rates can vary depending on individual health factors such as body mass index (BMI), Inspire generally delivers higher satisfaction, fewer complications and a more comfortable recovery than previous surgical options.

“With Inspire, we have a successful and convenient treatment option with a high patient satisfaction rate. While it is a surgically placed device, there is far less risk of complications and downtime than anything we have previously offered,” he said. “If you cannot tolerate PAP therapy, you should consider Inspire.”

Learn more about Inspire at Wellstar and find an ENT who’s right for you.

Having or witnessing a seizure can be frightening. But clinicians have made remarkable advances in diagnosing the causes and preventing future seizures with medications and surgery.

“Seizures often seem scarier to bystanders than to patients,” said Dr. Thomas Holmes, a Wellstar neurologist. “Most patients don’t even remember them.”

Epilepsy is more common than many realize—about 1 in 26 people will be diagnosed in their lifetime. On WSB’s The Weekly Check-Up, Dr. Holmes explained how epilepsy is diagnosed, why not all seizures mean epilepsy and what treatments are available.

As director of neurodiagnostics at Wellstar, Dr. Holmes helped Wellstar Kennestone Regional Medical Center earn Level 3 Adult Epilepsy Center accreditation, recognizing its advanced care for patients with hard-to-treat seizures.

Diagnosing epilepsy

According to Dr. Holmes, a seizure happens when there's an “abnormal firing of neurons in the brain.” This electrical disturbance can cause a range of symptoms—some more visible than others. A person having a seizure may briefly lose consciousness, and other signs can include:

• Trouble breathing or temporarily stopping breathing
• Sudden falls without warning
• Jerking movements or a sudden loss of muscle control
• Loss of bladder or bowel control
• Not responding to sounds or voices for a few moments
• Staring spells, sometimes with rapid blinking

It’s important to know that not all seizures are caused by epilepsy. Other conditions like stroke, brain injuries, infections or tumors can also trigger them. That’s why gathering details from someone who witnessed the seizure—like a family member—can be helpful for doctors trying to make an accurate diagnosis.

When someone experiences a seizure, the first step is usually brain imaging. An MRI is often ordered to look for structural causes, and an EEG, which records the brain’s electrical activity, can help detect abnormal patterns. In some cases, patients may be asked to wear a portable EEG at home for several days to capture activity that doesn’t happen regularly. Both MRIs and EEGs are safe and painless.

For more advanced monitoring, Wellstar offers inpatient epilepsy monitoring units (EMUs) at Wellstar Kennestone, Wellstar MCG Health and Wellstar North Fulton Medical Centers. These specialized units provide around-the-clock observation and are among the few in Georgia offering this level of epilepsy care.

Medications and surgery for seizures and epilepsy

For most people with epilepsy, medication is the first and most effective treatment option. How long someone needs to stay on medication depends on several factors, including what’s causing the seizures and what clinicians find during ongoing monitoring.

Sometimes a seizure is triggered by a specific event, like a head injury. In those cases, Dr. Holmes explained, long-term medication may not be necessary. But if tests reveal a structural issue in the brain—like an area of damage—it usually means a higher risk of future seizures and longer-term treatment is often recommended.

“You don’t necessarily need to be on medication for life, even if you have epilepsy,” said Dr. Holmes. Patients are regularly monitored, treatment plans are highly personalized and care plans are revisited to ensure the best outcomes possible.

“If someone has been seizure-free for two to three years, has a normal EEG and no visible brain lesion, we’ll often discuss tapering off medication if the patient is open to it,” he said.

Some people may struggle with seizure control despite medication. About 10% of patients don’t respond well to drugs—but there are additional treatments available.

Wellstar’s EMUs can help determine where in the brain seizures are starting. In some cases, surgery to remove a small area of brain tissue can significantly reduce or even stop seizures. According to Dr. Holmes, this approach is successful in nearly 70% of cases.

Other advanced options include laser surgery or a responsive neurostimulation—when a small device is implanted in the brain to detect abnormal activity and deliver a pulse to stop a seizure before it starts.

Looking ahead, Dr. Holmes is optimistic. “There are going to be many options that are not drug-related,” he said. “Less invasive procedures are on the rise, and we’re learning more about the genetic causes of epilepsy—especially in children. Research and clinical trials may even lead us to gene therapies in the near future.”

Epilepsy care is evolving rapidly, and for many patients, that means more control, fewer side effects, and real hope for the future.

Epilepsy and Seizures Program at Wellstar

Our Epilepsy and Seizures Program is one of only a few such programs in Georgia. It provides comprehensive care to help children and adults manage seizures. The program also offers a streamlined pathway to determine if a patient is a candidate for advanced treatments, including minimally invasive surgery and deep brain stimulation.

Wellstar Children's Hospital of Georgia and Wellstar MCG Health in Augusta are Level 4 Comprehensive Epilepsy Centers, the highest designation by the National Association of Epilepsy Centers. Wellstar Kennestone is a Level 3 Adult Epilepsy Center.

Learn more about the Epilepsy and Seizures Program and Wellstar providers.