Chief polysomnographic technologist David Moore recently became the first sleep disorders tech in the world to be fully certified in the Inspire Care Pathway, which is a set of best practices that guide use of the Inspire upper airway stimulation device that is implanted to treat sleep apnea.
The UAB Medicine Sleep/Wake Disorders Center provides various treatments for sleep disorders, but one advanced treatment uses an implanted electronic device to open airways and improve breathing during sleep. The device relies on precise adjustments and a specific care pathway, which is a set of best practices. Chief polysomnographic technologist David Moore recently received full certification for this care pathway, making him the first sleep disorders tech in the world to do so.
A major advancement in treating OSA arrived with the development of the Inspire II upper airway stimulation (UAS) device, which was approved by the U.S. Food and Drug Administration in 2014. The implanted device stimulates a nerve in the brain called the hypoglossal nerve, resulting in contractions that gently extend the tongue, relax airway muscles, and stabilize breathing during sleep. It eliminates the need for the masks, hoses, and machines used in certain other sleep disorder treatments. Described as a “sleep-control pacemaker,” it is clinically proven to reduce OSA events and has a high level of patient satisfaction and compliance.
Why the Pathway Matters
The device is activated about four weeks after implantation, followed by a post-operative sleep study to calibrate stimulation levels according to patient response. Some patients may not get perfect results right away, or they may not tolerate the stimulation well. The Inspire Care Pathway was developed to manage these problems. That’s where Moore – the sleep center’s chief polysomnography tech – comes in.
Moore works with patients who have difficulties with the hypoglossal nerve stimulation that the device provides. In following the Inspire Care Pathway, he assists with activation, observes patient responses and progress over several weeks, and fine-tunes the UAS device for optimal stimulation levels. He also troubleshoots any problems patients may encounter with the technology.
Moore, who started his career at UAB Medicine in 1996, says the Inspire Care Pathway has had a major positive impact on outcomes. In other words, most patients who get this therapy are now getting a good night’s sleep.
“When we started this therapy in 2015, we didn’t have as many options in making adjustments,” Moore says. “About two years ago, the pathway was created to help certain patients better tolerate the therapy in its initial phase, which called for adjustments to the device’s default settings. We did a lot of consulting with Inspire representatives and employees to get better outcomes, and out of that work and feedback, the company developed the care pathway. Now that it’s in place, along with additional training for providers, we are seeing the benefits. We have more than 200 patients using Inspire, and the majority of them are doing well with this therapy.”
Moore is the first technician worldwide to be certified in the Inspire Care Pathway. Not only has he gained expertise in managing the pathway, he also played a role in developing it. Patricia Patterson, MD, medical director of the UAB Medicine Sleep/Wake Disorders Center, says Moore is modest about his certification and understates his contribution to the success of the pathway.
“The extremely careful and skillful adjustments David makes provide a crucial step for patients who are having difficulties in the early period of use,” Dr. Patterson says. “The sheer volume of patients he’s treated, and with such precision, has led to his expertise. By communicating with Inspire Medical Systems and sharing data with them and with other technicians in the field, he’s become the expert in this care pathway. When we visited the Inspire headquarters for a seminar, there were sleep techs from all around the nation who knew who David was. We were told that he had more experience and was more familiar with the Inspire device than some of the company’s employees. He’s modest about it, but this is quite an accomplishment. We are all really proud of David.”