Sleeping Soundly Again: How Inspire Therapy Is Changing Lives

For more than 30 years, Jerry Martinez managed his severe sleep apnea with a CPAP machine. When he was first diagnosed in 1991, a sleep study showed he was experiencing 88 breathing interruptions an hour. The CPAP machine helped for many years, but over time, it became harder to tolerate, and real rest became impossible.

Looking for another option, Jerry was referred to Sally Smalley, MD, a board-certified otolaryngologist with AdventHealth Medical Group Ear, Nose & Throat at Calhoun. Together, they explored an approach that would change the way he sleeps and his overall quality of life.

When CPAP Isn’t Enough

Obstructive sleep apnea happens when the tongue relaxes backward during sleep and blocks the airway. When the airway closes, the brain briefly wakes the body to restart breathing.

This cycle can repeat dozens of times each hour, often without the person even realizing it. Over time, untreated sleep apnea can increase the risk of heart disease, stroke, Type 2 diabetes and depression. It can also leave people feeling exhausted, foggy and irritable during the day.

Continuous positive airway pressure, or CPAP, is often the first treatment recommended for obstructive sleep apnea. The device uses a mask and hose to deliver steady air pressure that keeps the airway open during sleep. For many people, it works well and is effective at reducing breathing interruptions and improving sleep quality. For others, it can be difficult to use consistently.

“It is very obtrusive,” Dr. Smalley said. “The mask has straps that go around the head, and the pressure needed to keep the airway open can feel uncomfortable. Many people struggle simply because of the physical challenges of wearing the device.”

Travel, chronic pain or an active lifestyle can also make the equipment hard to manage long term. Dr. Smalley is quick to reassure patients that difficulty with CPAP does not mean they have failed. It simply means the therapy may no longer be the right fit.

For Jerry, the CPAP machine worked for decades, helping him manage his severe sleep apnea. But as he aged and his back and hips began to cause more pain, his nights changed. He started tossing and turning more. The hose would wrap around him as he shifted in bed. More than once, he pulled the machine off the nightstand.

“It got to the point where I just wasn’t tolerating it,” he said. “I would throw the mask off and go back to sleep because I just couldn’t deal with it.”

Without the machine in place, his breathing interruptions returned. Instead of resting, his body was constantly fighting to breathe. For patients like Jerry, that struggle can feel discouraging. But CPAP is not the only option.

A Different Way to Breathe at Night

For patients who cannot tolerate CPAP, Dr. Smalley offers another option called Inspire Therapy. Unlike a mask and hose worn outside the body, the Inspire device is implanted internally. A small battery pack is placed in the chest, similar to a pacemaker. A thin wire connects to a nerve under the tongue.

“The device senses when you take a breath,” Dr. Smalley said. “It then delivers a gentle pulse that moves the tongue forward, which helps keep the airway open.” Unlike a pacemaker, Inspire is not on all the time. Patients turn it on at night with a small handheld remote and turn it off in the morning.

Dr. Smalley’s Careful, Intentional Process

Before surgery is ever scheduled, Dr. Smalley takes time to make sure Inspire is the right solution. The process begins with a detailed exam of the nose, mouth and throat. She looks for anything that may affect breathing and evaluates whether there are other issues that could be addressed to improve the outcome. Patients also undergo a brief, sedated airway evaluation so she can observe how the airway behaves during sleep and confirm the pattern of obstruction.

But for Dr. Smalley, the evaluation is about more than anatomy. “You have to see the patient as a big picture,” she said. “Not just a tiny problem you’re trying to fix.” Weight changes, stress, anxiety, chronic pain and other health concerns can all affect sleep and recovery. That’s why she spends time talking through expectations, limitations and long-term goals.

“Communication is very important,” Dr. Smalley said. “Both sides need to understand what we are trying to accomplish so that we work as a team. At the end of the day, if the patient is not right for this device, then I won’t operate. I want them to be successful.”

For Jerry, that level of honesty built confidence. “Dr. Smalley is very good at explaining the procedure,” he said. “You never go into it without knowing exactly what will happen. Although I was worried at first, she eased my mind.”

Once he was confirmed to be a candidate, the next step was scheduling surgery. The implant procedure is performed under general anesthesia and typically takes about an hour to an hour and a half. Most patients experience only a few days of soreness afterward.

About a month later, once healing is complete, the device is activated. Patients are taught how to use it and return for follow-up visits to adjust the settings. It often takes two or three adjustments to fine-tune the therapy. “We work closely with patients to dial it in and optimize their results,” Dr. Smalley said.

Several months after implantation, patients undergo a follow-up sleep study to objectively measure improvement and see how much their breathing interruptions have decreased. Jerry said the process required patience, but it was worth it.

“It may take a few months to tune it in,” he said. “But once it’s tuned in, it opens up a whole different world.”

Restored Energy, Renewed Life

About a year after receiving the Inspire implant, Jerry said the change is remarkable. His breathing interruptions have dropped dramatically. Instead of waking up exhausted, he feels energized and ready for the day.

“I feel like a different person,” he said. “My energy levels are through the roof.” With better rest came clearer thinking. The mental fog he once lived with began to lift. That clarity helped him better manage his PTSD symptoms and gave him the focus to make other healthy changes.

He has lost weight, stopped drinking and quit smoking.

Advanced Care Close to Home

Inspire procedures are available locally at AdventHealth Gordon and AdventHealth Murray, giving patients in Northwest Georgia access to advanced sleep apnea treatment without traveling far from home.

Dr. Smalley said the smaller, close-to-home setting allows her team to be especially attentive. From the first phone call, staff review eligibility criteria and prepare patients so that appointments are efficient and meaningful.

That personal approach made a lasting impression on Jerry. From the front desk staff to follow-up visits, he said he felt supported at every step. “Dr. Smalley and every person in that office genuinely cares about you as a person, not just a patient,” he said. “You never feel like you’re just another number.”

For Dr. Smalley, that level of support is intentional. “We want patients to feel informed, prepared and confident,” she said. “When someone comes back and tells me they are finally sleeping well, that’s a success. That’s why we do this.”

If you have difficulty navigating sleep apnea, schedule an appointment with Dr. Smalley to find out if Inspire Therapy may be the right fit for you.