How to get an INSPIRE Implant on the NHS?

Implant surgery for snoring & sleep apnoea is now available on the NHS. I go through the eligibility criteria so you know if you can get one.
I appreciate that during this video I keep saying 'free on the NHS' which upsets some people because it is paid via taxation. Please understand that I mean that the NHS is free at the point of care. You do not have to pay anything extra for these treatments.
I also do not get any benefits (financial or otherwise) from performing this operation on the NHS. I gain nothing from making this video promoting it (apart from the advertising from youtube money which is about £4 in total before tax).
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** DISCLAIMER: Please be advised that the information presented in this video is not intended to serve as a substitute for professional medical advice, diagnosis, or treatment. It is essential to understand that all content, including text, graphics, images, and information, provided in this video, is for general information purposes only. You will need to consult with your doctor or health professional before making any medical decisions based on the contents of this video. **

[@ngaikaituck8229]

I had an Inspire device implanted in Singapore 6 months ago. I have been using CPAP for the past 7 years but not really compliant to using every night. My surgeon was great and did DISE and sleep test and ensured my suitability for this implant. My AHI has improved after the implant and after using the Inspire therapy, and via a recent sleep study, I was found to have very low AHI. So I would give a thumbs up for this implant. This procedure is costly but thank God that it’s 100% covered by my insurance.

[@BridgetmarieSouthin]

Mr Veer, it would be really helpful to hear from patients who have had this procedure.

[@VikVeerENTSurgeon]

perhaps one day I will have a patient who will be willing to go on camera to describe their experience. I don't like asking as I feel like I am pushing them into it. hope you understand. there are comments in some of my videos of people who have had the device implanted in America. there have been about 60,000 implanted so far.

[@MSjackiesaunders]

He is a specialized physician. He really should be addressed as Dr.

[@VikVeerENTSurgeon]

thank you, but in the UK surgeons revert back to Mr from Dr. either is fine, I'm not hung up on it. thank you both though.

[@jobovens6949]

Great Vik....you are the best and most honoust doctor i know ......

[@baba-sm1fm]

This video was incredibly helpful to me because I am in the midst of getting scheduled for a consultation for an oral appliance ( I failed the C-pap 4 years ago). The only sleep test I had done was an at home sleep study, which confirmed mild sleep apnea. However the sleep doctor does not know if the obstruction is caused just by the tongue or the tongue and the side walls collapsing. I do know that I snore, so some obstruction is there for sure. After watching this video I am confused that the doctor would send me out for the appliance without knowing for sure the origin of my problem. I read that the appliance can be costly but there are also many draw backs like TMJ and changes in dental occlusion that can really mess you up.

[@jarviafoxter8198]

Thank for posting more fantastic content Vik! Legend

[@VikVeerENTSurgeon]

My pleasure.

[@goodtimesbeatz6718]

Any treatment for empty nose syndrome I heard about stem cells does it help people?

[@VikVeerENTSurgeon]

I have not seen any studies that show benefit in ENS. they might help those who have atrophic rhinitis.

[@goodtimesbeatz6718]

@@VikVeerENTSurgeon Ok thanks 💯

[@oaken8]

I asked my GP for referral to a sleep clinic here in SW Wales. 2 months on I asked if there was progress to be told it would be 18 months minimum to get an initial consultation, if I was lucky, through NHS. Are they really that inundated/underfunded or am I being fobbed off? Should I sell a kidney to fund a private approach? It’s about all I have left after loosing job, partner and home due to exhaustion and lack of focus which I am almost certain is caused by sleep issues. How do I get a foot in the door to get this taken seriously? What you do, Mr Veer, is quite extraordinary for those that have access to you but is far, far out of reach for so many of us. Especially those of us that are mentally drained by sleep deprivation and lack the drive to make it happen. I am fairly fit, my BMI is 27 and my breath obstructs on exhale and feels deeper down than tongue.

[@elaineinnz]

You don't have to be overweight to have sleep apnoea. I knew a slim woman who had been diagnosed with sleep apnoea caused by having an enlarged tongue. While you wait for your test, I recommend downloading a Snore Lab as it will record your sleep. I recorded myself for 6 months & the recording proved I had a snoring problem and at times I wasn't breathing at all! My GP wasn't convinced the app was accurate, but did refer me for a Sleep test. Another 6 months later, I was diagnosed with severe sleep apnoea (so severe, I was issued a CPAP device in the same week). Another gadget you can buy is the Wellue o2 ring. It fits on a thumb or finger and reads the oxygen % and will alert you if it falls below normal range.

[@DawnMcShane-l1n]

I am your patient (Dawn McShane) Mr Veer and would be happy for you to document and video my journey. I am currently still waiting for the overnight sleep study and a DISE,

[@NathanielRises606]

I’ve watched some DISEs and they can be a little distressing to watch if the patient has awful apnea. Given that we are sedated and cannot wake up, how do you keep the airway open during the DISE?

[@VikVeerENTSurgeon]

I don't allow hypoxia, as it doesn't provide additional benefit to watch it happen (we have the sleep study for that information). so I just use oxygen wafted over the mouth and a jaw thrust / chin lift occasionally to maintain the airway if needed. it also gives me information about the tongue by doing so. good question!

[@shus5787]

Thanks for Information

[@MJB0110]

Hi Mr Veer thank you for the excellent video. I was dgx with OSA almost 30 years ago and struggled with the CPAP machine for over a decade, finally giving up and using a mandular device that seems to help a little but still I feel drowsy during the day every day and have brain fog. I have also had ops for deviated septum, trimmed turbinates and also removal of my tonsils to help historically. I now also suffer from BP and ED. Life is tough (though I am sure there are others who are much worse). Would it be possible for my GP to refer me to your good self for a new Sleep Study and DISE as I think I may have the condition you’re describing and could be eligible as my BMI is just under 30? Would it be at the Royal National ENT hospital? Is there any other specific info you require in the GP referral? Tia

[@usaman7358]

Dr. Veer, you make me very sad as well as very happy at the same time. I've been dying a slow death now for 25 years, and this is no exaggeration. I've never been able to use cpap, it never worked, and I've never even remotely found a Dr. like you here in the US. It's always the same story: sleep test, a few minutes with the dr. afterwards when he gives you a referral to go get a cpap, then I'm pretty much on my own to fail at home, alone, time after time. This has been going on every 5 years or so for 25 YEARS, with ZERO improvement. I've had all the questions you've brought up and not one dr. has ever addressed them . Questions such as "Is it my deviated NOSE thats causing all this? Do I need nose surgery FIRST before any of this will work? What about my tonsils? Why do I even have severe sleep apnea when I'm not obese and never had sleep problems in the past? Why am I UNABLE TO FUNCTION AS A NORMAL PERSON as I once used to when nothing has changed/happened to cause such a drastic reduction in quality of life? So many questions, never any answers. I certainly have never even been offered a DISE! You give me hope but after 25 years, I've honestly given up on ever getting any help. It's just nice to know there is SOMEONE out there who cares as much as you do and doesn't just have the "get a cpap" answer to everything. You may not be able to help me unfortunately, but I'm sure those that you do are eternally grateful.

[@VikVeerENTSurgeon]

My apologies for your treatment thus far. Have a look at this video - it might help? kzbin.info/www/bejne/j4KYfKN3q9WSj7c - also consider speaking to Dr Ahmed Mahmood ENT in New Jersey - I think he might be able to help you? Not sure how it works in the USA. Good luck!

[@Supergravity]

Thank you

[@VikVeerENTSurgeon]

Welcome!

[@sarahhunt7005]

Hi i was diagnosed around 4 years ago with OSA. After several at home sleep studies i was told that it's not naturally occurring OSA but due is to the medication that I take to help control my chronic back pain. I still really struggle with using my CPAP machine even though it really helps me. I can barely get a few hours sleep per night before it wakes me up. I've beenslowly reducing my dose of my pain medication hoping it would help with my OSA but it doesn’t seem to have helped. I've now reached the lowest possible dose in pain medication while still keeping my pain levels low enough to function & stay active. It has taken 20 years to get my pain under enough control to be able to function properly using the medication that i take now, as nothing else has worked for me & this medication was the last option that i could try. Therefore it isn't an option to switch to a different pain medication to avoid having OSA. Could you please tell me if I would I be eligible for the implant please even though it's not naturally occuring? Many thanks 🤞😊🙏

[@VikVeerENTSurgeon]

that's a tough one. even if I agree, there may be someone on the MDT who may disagree. I can't be sure I'm afraid.

[@sarahhunt7005]

@@VikVeerENTSurgeon thank you for your honest comment 😀🙏

[@huay_]

Dr Veer - what are your thoughts on Stem Cells as a treatment for ENS? Especially for someone who has their turbinate volume but is suffering from some nerve damage/airflow issues?

[@goodtimesbeatz6718]

I was about to leave the same question 💯

[@VikVeerENTSurgeon]

I have not seen any studies that show benefit in ENS. they might help those who have atrophic rhinitis.

[@huay_]

@@VikVeerENTSurgeon what would be you’re solution for somebody who has their turbinates, but due to the removal of the soft tissue + turbinate bone is suffering from dryness and an impaired airflow (nerve damage)? Thank you for your help in this matter, you are doing wonders for people.

[@huay_]

When you have a chance, please answer my second question Mr Veer🙏, that would be all, thank you for your work!!

[@Stesmith-xg4ry]

Hi dr veer. I am a 27 year old guy and i have severe obstructive sleep apnea, and also have bad tonsil stones to. I am getting a tonsillectomy soon. I know that a tonsillectomy will mean the stones wont come back. Will the tonsillectomy also help the obstructive sleep apnea? Could it possibly cure it? I dont like using the cpap machine. Thanks a lot

[@CUTSUK]

I have severe sleep apnea & I'm struggling with CPAP. Every mask I've tried leaks in some way which wakes me. I have a BMI of 24. I'd love to find out if I qualify for this procedure, if via NHS, would it have to be NHS locally to me?

[@VikVeerENTSurgeon]

centres are popping up around the country, but we will take anyone from the UK. I see people in Scotland and northern Ireland etc. I understand there is a centre in Manchester just opened if you live there?

[@CUTSUK]

@@VikVeerENTSurgeon Oh that's wonderful, Should I contact your private surgery? thanks so much for the reply and for this channel. I've learned so much about sleep apnea from here.

[@suchen2000]

Hello Veer I am using CPAP but it leaks and is causing huge issues with my eyes and waking me middle of the night. Looking at the criteria I fit the parameters how do I get the next steps on the implants

[@VikVeerENTSurgeon]

You just need to ask your GP for a referral to see us on the NHS.

[@suchen2000]

@@VikVeerENTSurgeon I have initiated the request from my GP . My name is Suchen Janjale hopefully you should receive the request

[@AbhiSharma-lg4pb]

What are you doing for treatment empty nose syndrome

[@VikVeerENTSurgeon]

I have a video on this, you should be able to find it a few months ago.

[@elaineinnz]

That's a coincidence! I just heard this implant has been recalled (although it could be certain models in the USA). I was shocked to hear and read about many others that have been rejected or caused significant medical problems. I wouldn't consider having one even though my apnoea is severe, and most nights I don't sleep too well with a cpap device. You may be interested in the video and documentation that I reviewed: kzbin.info/www/bejne/gZqZdqx9eNd0mbssi=kK2Z69PS8kUbWnYg Nicko is seeking surgeons and specialists like yourself to provide further insight.

[@mundevaibhav7939]

Hello sir I’m Vaibhav I’m 26 yrs of age and started having sudden severe sleep issues s but it took long time to diagnose earlier it was mild last report came out to be ahi of 43 I tried Cpap and been suffering since 2020 I am not able to use cpap i e tried and tried but no relief my quality of life has gone down very badly I’m from India and I would really really appreciate any information on how I can get relief from this condition and can I come to London and do these process and get evaluated properly I’m really hoping something will help at least now please reply thank you

[@NathanielRises606]

Crazy to think this is all because of the invention of animal husbandry and agriculture. Hunter gatherers had larger jaws, human tech is essentially responsible for our small oral cavities and jaw shrinkage the last 12,000 years.

[@VikVeerENTSurgeon]

that is one theory for tongue based obstruction. no proof yet for any of these theories. I see loads of people with OSA with large jaws. we don't know OSA rates in prehistoric man. hard to know what is causing it as it is such a heterogeneous condition.

[@maxaffe3195]

@@VikVeerENTSurgeon how do you define large jaws tho? it is also about the transversal space in the maxilla etc.

[@jphanks]

You seem to be a shill for this device. Do you have any financial conflicts you should disclose?

[@VikVeerENTSurgeon]

I should have said that yes. will add to the video description. for clarity, I have absolutely no conflicts to disclose. I do not make any extra money or benefits for doing this operation. thank you for pointing this out.

[@BrianSmith-ow9gy]

Don't be so bloody rude. These devices are provided on the NHS, free of charge, and the surgeons and doctors who implant devices of any kind or fit other types of device don't receive anything for doing so. They just get their NHS salary.

[@MSjackiesaunders]

@jphanks Vik is like any doctor who is involved with a new technology. He is excited about it.

[@VikVeerENTSurgeon]

Dear Mr Smith, thank you for coming to my rescue. I am guessing JPHanks is from a country where there is a different culture and relationship with doctors. probably a very reasonable question from over there. although this is a UK channel I do get a lot of Americans etc on the comments. it is quite hard for me to remember about those looking at my videos who aren't my intended audience. many thanks again.

[@VikVeerENTSurgeon]

hahaha, I am quite excited! I first tried to bring Inspire to the UK back in 2018. years of meetings and horrible paperwork to get this technology here. it is great to finally get it available for NHS patients. sorry for not being doctor-like, it has always been my failing even during my training years.

[@The_Savage_Wombat]

It seems like a really invasive surgery for something you only use while sleeping. With all the technology we have now, this device seems very primitive. 39 million OSA sufferers in the US alone. Lifespan of 8 to 18 years after diagnosis. Seems like OSA is really a bigger killer than cancer and heart disease (which is often caused by OSA).

[@VikVeerENTSurgeon]

you are right, it is a massive problem. thx for the comments

[@MSjackiesaunders]

@The_Savage_Wombat Invasive? Possibly. Worth it?Without a doubt for those who suffer from OSA. Many people don't have the time to wait for the technology to get better. Every medical advancement takes a huge effort from those involved, not to mention the money needed. How do I know? I spent several months in an iron lung in the early 1950s during the polio epidemic before they found out the strain of polio I had did not require it. Not an enjoyable experience, but something that happened while they were still struggling to come to terms with how polio works. My Mom volunteered me to test the vaccines that were developed, and I thanked her for it.

[@ashmahmood70]

Dr veer.i have seen your videos n today spoke to my gp regarding this new treatment.he wasn't aware of it.i live in Yorkshire. Under the nhs can I get this treatment if I travel to London if its not yet available in my region?also could you tell me the qualifying criteria please. Many thanks