Inspire Sleep Apnea Therapy: Is it worth it?
Continuous positive airway pressure (CPAP) therapy is the frontline treatment for obstructive sleep apnea (OSA), but it isn’t the right fit for everyone. Many people struggle with the discomfort of masks, hoses, or simply cannot tolerate CPAP long-term. For those patients, Inspire sleep apnea therapy offers a surgical, FDA-approved alternative.
Inspire is an implantable device designed specifically for moderate to severe OSA patients who cannot use CPAP effectively. This article will explain how Inspire works, who qualifies, its success rates, and key considerations—including costs—so you can make an informed decision about whether it’s worth it.
What Is Inspire Sleep Apnea Therapy?
Inspire sleep apnea therapy is a surgically implanted device that treats OSA by stimulating the hypoglossal nerve, which controls tongue movement and other airway muscles. By delivering mild electrical pulses in sync with your breathing, Inspire keeps the airway open during sleep, preventing the collapse that causes apneas. The device is FDA approved for certain adults with moderate to severe OSA and teens with Down syndrome with severe OSA who can’t tolerate CPAP.
The Inspire device is implanted under the skin in the chest with leads connecting to the hypoglossal nerve and near the diaphragm. Patients activate the device each night with a handheld remote, and can adjust the stimulation strength as needed.
How Effective Is Inspire Therapy?
Clinical studies and real-world data show that Inspire is highly effective for its intended population.
- Success rates for Inspire therapy are reported at around 72–75% at one and five years post-implantation, with significant reductions in apnea-hypopnea index (AHI) and improvements in daytime sleepiness scores.
- One study found a median AHI reduction from 33 to 10 at 12 months.
- Another study found an oxygen desaturation index (ODI) reduction of 70% at 12 months.
- 90% of bed partners reported soft snoring or no snoring.
While Inspire improves symptoms, it may not completely eliminate OSA for all patients.
Additionally, outcomes have been shown to be better in patients who meet certain criteria (e.g., lower BMI, female sex, no complex comorbidities).
What Are the Pros and Cons of Inspire Therapy?
Like most treatment options, there are several pros and cons to consider before starting Inspire therapy for sleep apnea.
Pros
- No external mask, hose, or machine required—making it more comfortable and less intrusive than CPAP.
- Silent and discreet.
- Simple nightly use with a remote control.
- Convenient for travel and daily use.
- Customizable stimulation levels for personalized comfort.
- High therapy adherence rates and long-term effectiveness.
- Covered by many insurance plans for eligible patients.
- Significant improvements in sleep quality, daytime alertness, and quality of life for both patients and their partners.
Cons
- Requires a surgical procedure, with associated risks such as infection, discomfort, or device-related complications.
- Not suitable for all OSA patients—only those with moderate to severe OSA who cannot tolerate CPAP and meet specific anatomical criteria.
- Some patients may experience side effects like tongue discomfort or swallowing issues, though serious adverse events are rare (about 6%).
- Device and procedure are costly, and not all insurance plans may cover the full expense.
- Battery replacement surgery may be needed after several years.
- High upfront cost ($30,000–$40,000 before insurance).
- May not fully resolve sleep apnea symptoms for everyone.
What Does Inspire Sleep Apnea Therapy Cost?
The total cost of Inspire therapy—including the device, surgical implantation, and follow-up care—can range from $30,000 to $40,000 or more without insurance coverage. Most major insurance companies, including Medicare, cover Inspire for eligible patients, but out-of-pocket costs will depend on your specific plan and deductible. Pre-authorization may be required before your insurance plan will cover Inspire. Ongoing device management costs include battery replacement and follow-up appointments.
Related questions
- Ozempic Mounjaro Wegovy & Zepbound: Weight Loss Compared
- Do Ozempic, Wegovy, Mounjaro & Zepbound cause hair loss?
- Can you get tirzepatide from a compounding pharmacy?
Who Is a Good Candidate for Inspire Therapy?
Not everyone is a good fit for Inspire therapy. Ideal candidates for Inspire therapy must meet certain criteria.
Adults
- Diagnosed with moderate to severe OSA (AHI between 15 and 100).
- Cannot tolerate positive airway pressure therapy, or not getting a consistent benefit.
- Body Mass Index (BMI) under 40.
- No complete concentric collapse at the soft palate, as determined by a drug-induced sleep endoscopy (DISE).
- No significant comorbidities that would increase surgical risk.
Teens with Down syndrome
- Diagnosed with severe OSA (AHI 10-50).
- Cannot tolerate positive airway pressure therapy, or not getting a consistent benefit.
- Continue to have symptoms despite adenotonsillectomy.
A thorough evaluation by a sleep specialist is required to determine eligibility.
Inspire Therapy Compared to CPAP and Other Alternatives
Choosing between Inspire Sleep Apnea Therapy and traditional treatments like CPAP, oral appliances, or other implants depends on individual medical history, insurance, and sleep study results. Inspire offers mask-free sleep and high adherence, but it comes with surgical risks and higher upfront costs ($30,000–$40,000). CPAP remains the most widely recommended initial treatment for moderate to severe sleep apnea and is covered by most insurance plans. Remede (phrenic nerve stimulation) is another implant-based alternative (for central sleep apnea), and oral appliances may be effective for patients with mild sleep apnea or anatomical limitations.
| Treatment | Pros | Cons | Typical Cost |
|---|---|---|---|
| CPAP | Non-surgical, effective, widely covered by insurance | Mask discomfort, adherence issues | $500–$1,000+ |
| Inspire Implant | No mask needed, high satisfaction, long-term adherence | Surgical risks, high cost, device recall risk | $30,000–$50,000 |
| Oral Appliance | Comfortable, travel-friendly, non-invasive | Only effective for mild cases, fit and durability issues | $1,500–$3,000 |
| Remede Implant | Option for central sleep apnea, no mask | Newer therapy, expensive, limited long-term data | $35,000–$45,000 |
Inspire Device Recall and Safety Alerts
Recently, there have been safety advisories and device recalls relating to Inspire Sleep Apnea Implants. In July 2024, the FDA announced a recall for select Inspire models due to the risk of unintended electrical shocks and technical malfunctions. At the time, no injuries were reported. All potential candidates should ask healthcare providers about device model safety, recall status, and how to access updates or repairs. Patients can check the FDA Medical Devices database for current safety notices and recommendations, which also detail how to report device-related issues.
Conclusion
Inspire sleep apnea therapy is a breakthrough for adults with moderate to severe OSA and teens with Down syndrome and severe OSA who cannot tolerate CPAP. It offers a mask-free, highly effective alternative with sustained benefits and high patient satisfaction. However, it is only suitable for a specific subset of patients and involves surgical risks and significant costs. For those who qualify, Inspire can dramatically improve sleep quality and overall health, making it a worthwhile option to consider after other treatments have failed. Talk to your doctor to find out if Inspire therapy is right for you.
References
- American Academy of Sleep Medicine. 2024. FDA approves next-generation Inspire V therapy system. Accessed on May 28, 2025 at https://aasm.org/fda-approves-next-generation-inspire-v-therapy-system/
- Bestourous, D. E., et. al. 2020. Adverse events associated with the Inspire implantable hypoglossal nerve stimulator: A MAUDE database review. American journal of otolaryngology, 41(6), 102616. https://doi.org/10.1016/j.amjoto.2020.102616
- Costantino, A., et. al. 2020. Hypoglossal nerve stimulation long-term clinical outcomes: a systematic review and meta-analysis. Sleep & breathing = Schlaf & Atmung, 24(2), 399–411. https://doi.org/10.1007/s11325-019-01923-2
- Epstein, L. J., et. al. 2009. Clinical Guideline for the Evaluation, Management and Long-term Care of Obstructive Sleep Apnea in Adults. In: Journal of Clinical Sleep Medicine. Accessed on May 28, 2025 at https://aasm.org/resources/clinicalguidelines/osa_adults.pdf
- Inspire. Accessed on May 28, 2025 at https://www.inspiresleep.com/en-us/
- National Council on Aging. 2024. Inspire Sleep Apnea Device Review 2025. Accessed on May 28, 2025 at https://www.ncoa.org/adviser/sleep/inspire-sleep-apnea-device-review/
- Patel, R. (2025, March 18). Comparing Inspire® and remedē®: Which one is appropriate for your sleep condition? Sleepless in Arizona. Accessed on August 25, 2025 at https://sleeplessinarizona.com/comparing-inspire-and-remede-which-one-is-appropriate-for-your-sleep-condition/
- Sleep Foundation. (n.d.). How much do CPAP machines cost? Accessed on August 25, 2025 from https://www.sleepfoundation.org/cpap/how-much-do-cpap-machines-cost
- Strollo, P. J., Jr, Soose, R. J., Maurer, J. T., de Vries, N., Cornelius, J., Froymovich, O., Hanson, R. D., Padhya, T. A., Steward, D. L., Gillespie, M. B., Woodson, B. T., Van de Heyning, P. H., Goetting, M. G., Vanderveken, O. M., Feldman, N., Knaack, L., Strohl, K. P., & STAR Trial Group (2014). Upper-airway stimulation for obstructive sleep apnea. The New England journal of medicine, 370(2), 139–149. https://doi.org/10.1056/NEJMoa1308659
- Thaler, E., et. al. 2020. Results of the ADHERE upper airway stimulation registry and predictors of therapy efficacy. The Laryngoscope, 130(5), 1333–1338. https://doi.org/10.1002/lary.28286
- TMJ & Sleep Solutions of Alabama. (2024, August 15). What's the cost of oral appliance for sleep apnea? https://tmjandsleepsolutions.com/2024/08/15/whats-the-cost-of-oral-appliance-for-sleep-apnea/
- United States Food and Drug Administration. 2023. Inspire Upper Airway Stimulation – P130008/S090. Accessed on May 28, 2025 at https://www.fda.gov/medical-devices/recently-approved-devices/inspire-upper-airway-stimulation-p130008s090
- U.S. Food and Drug Administration. (2024, June 21). Implantable Hypoglossal Nerve Stimulator Device Removal: Inspire Medical Systems, Inc. Removes Inspire IV Implantable Pulse Generator due to Manufacturing Defect That Can Result in System Malfunctions. Accessed on August 25, 2025 at https://www.fda.gov/medical-devices/medical-device-recalls/implantable-hypoglossal-nerve-stimulator-device-removal-inspire-medical-systems-inc-removes-inspire
Read next
Is Zepbound covered by insurance?
To find out if Zepbound is covered by your insurance, call and ask about your formulary drug benefits and copay or check the website. Your plan phone number is located on the back of your insurance card. Eli Lilly also offers a $25 copay savings card for patients with commercial insurance. Continue reading
What happens when you stop taking Zepbound?
If you stop using Zepbound for weight loss or obstructive sleep apnea (OSA), you will most likely regain much of the weight you have lost or you may lose the beneficial effects for OSA over time. The improvement in apnea in people with OSA is most likely related to body weight reduction with Zepbound. Continue reading
How does Zepbound help treat sleep apnea?
Zepbound (tirzepatide) can treat obstructive sleep apnea (OSA) in patients with obesity by lowering the number of times during sleep that breathing stops (apnea) or becomes significantly reduced (hypopnea). This may help improve symptoms like reduced sleep quality and daytime sleepiness. Patients with OSA also lost an average 45 to 50 pounds during treatment. Continue reading
See also:
Related medical questions
- How do I know if I have sleep apnea? The warning signs
- Is sleep apnea the hidden cause of your high blood pressure?
- Can sleep apnea kill you? Understanding the real risks?
- Can tonsils cause sleep apnea and should they be removed?
- Atrial Fibrillation: The most Commonly Occurring Heartbeat Problem
- How do I control my sleep apnea?
Related support groups
- Sleep Apnea (22 questions, 103 members)