Feeling tired or forgetful is often dismissed as a normal part of adulthood. But in some cases, these may be signs of sleep apnea in older adults. “It’s very common,” said Jordan Weiner, MD, an ear, nose, and throat (ENT) specialist in Scottsdale, Arizona. “Chances are you know someone who has it.” Sleep apnea has different causes, but most frequently, it’s due to an obstructed upper airway. This kind of sleep apnea is called obstructive sleep apnea (OSA). People with OSA often use a continuous positive airway pressure, or CPAP, machine at night. But for those who can’t tolerate them or don’t want to go that route, there are other options. “Surgical procedures can offer permanent treatment without the need for CPAP,” said Dr. Weiner.

One of those procedures is called hypoglossal nerve stimulation. It involves implanting a device in the chest that emits electrical pulses while you sleep. That activity stimulates a nerve that helps keep your airway open. Inspire was the first FDA-approved device for this use.¹ If you are considering Inspire for sleep apnea, it is important to understand how it works, who qualifies, the possible risks, and the costs involved. This guide explains the Inspire sleep device, insurance coverage, recovery, and alternatives so you can better understand your options. Many Inspire sleep apnea reviews describe positive results. But the device is not the right choice for everyone. Always talk with a qualified sleep medicine specialist to find out whether this treatment is appropriate for your specific health needs.

What is the Inspire sleep apnea device?

The Inspire sleep apnea device is an upper airway stimulation implant used to treat obstructive sleep apnea (OSA). "There is more than one form of sleep apnea," said Dr. Weiner. But Inspire is only used to treat OSA. "It's called 'obstructive' because the interruption of breathing is due to obstruction of the upper airway," said Dr. Weiner. This most commonly occurs when the tongue partially blocks the airway during sleep. When this happens, he said, "Air does not move in and out of the lungs. Carbon dioxide levels in the blood go up as oxygen levels go down." This causes you to wake briefly—often so briefly that you are unaware of it—and resume breathing. This can happen up to hundreds of times each night.

The Inspire implant aims to address that. It is placed under the skin during an outpatient surgical procedure. Once it is in place, the device sends gentle electrical pulses to the muscles that control your airway while you sleep. This helps keep those airways open so you can breathe more normally throughout the night. There is no mask, hose, oral appliance, oxygen, or medication required.

How does Inspire work?

The Inspire sleep device is made up of three parts that work together while you sleep. A small generator, placed under the skin in the upper chest, creates gentle electrical pulses. One lead monitors your breathing, while a second lead delivers those pulses to the nerve that controls your tongue and other airway muscles. Together, these parts help keep your airway open in time with each breath.

Unlike a CPAP machine, which pushes air through a mask, the Inspire sleep apnea device works completely inside your body. The implant is placed during an outpatient procedure through a few small incisions. After you heal, your doctor adjusts the settings to match your breathing needs. Each night, you use a small handheld remote to turn the Inspire device on before bed. The implant will begin working after a short delay so you have time to fall asleep. In the morning, you turn it off with the same remote before starting your day.

Inspire sleep apnea device: Pros and cons

For people who cannot tolerate a CPAP machine, the Inspire sleep apnea device offers another way to treat obstructive sleep apnea. Because the system works inside the body, there is no mask or tubing to wear while sleeping. Even so, Inspire is not the right choice for everyone. It requires surgery, so it is important to discuss the benefits and risks with a qualified sleep specialist before deciding whether it is a good fit. Here are some of the pros and cons of the Inspire sleep apnea device at a glance:

Who qualifies for Inspire?

Not everyone with sleep apnea can receive the Inspire sleep apnea device. In general, candidates must be adults with moderate to severe obstructive sleep apnea who have tried CPAP but could not use it successfully or did not get enough benefit from it. Most people also need a body mass index (BMI) within the current treatment guidelines. Some insurance plans may have their own requirements that are more restrictive than the FDA guidelines.

To qualify for Inspire for sleep apnea, you must first have a sleep study done. Your doctor will review the results to confirm you have obstructive sleep apnea. You also need to have tried a CPAP machine without success.

Next, you will meet with an Inspire-trained physician, who will review your medical history and decide whether additional testing is needed. Many people also have an airway evaluation called drug-induced sleep endoscopy (DISE). During this procedure, you are given medication to help you sleep while the doctor examines how your airway closes. This helps determine whether the Inspire device is likely to work for you. Even if you meet the basic medical guidelines, your insurance company may have additional requirements before approving coverage. Your doctor will help guide you through that process.

Who should not use Inspire?

The Inspire sleep apnea device is not the right treatment for everyone. It is designed for adults who have not been successful using CPAP to treat their obstructive sleep apnea (OSA). People with other types of sleep apnea, such as central sleep apnea, are generally not good candidates. In most cases, doctors also want to see that you have already tried CPAP and either could not tolerate it or did not get enough benefit from it before considering Inspire for sleep apnea.

Your overall health is also important. People with a body mass index (BMI) above the current eligibility limit may not qualify, although these guidelines can change over time. Your doctor will also make sure you are healthy enough to safely undergo outpatient surgery under general anesthesia. Other medical conditions or the way your airway collapses during sleep may also affect whether the Inspire device is a good choice.

If you are interested in Inspire for your sleep apnea, talk with a sleep medicine specialist or an Inspire-trained doctor. A specialist can review your sleep study, medical history, and treatment goals to help you decide whether Inspire or another treatment is the better option.

Inspire vs. CPAP: Which is better?

When comparing Inspire vs. CPAP, neither treatment is necessarily better overall—but one may be better for you. It depends on many factors, including your sleep apnea diagnosis, airway anatomy, how well you tolerate CPAP, your insurance coverage, and your personal preferences.

For most people with obstructive sleep apnea (OSA), CPAP is still the standard first-line treatment. CPAP uses a bedside machine, tubing, and a mask to deliver pressurized air while you sleep. It does not require surgery, but it does require regular cleaning, mask replacements, and ongoing maintenance. CPAP is non-invasive, well-studied, and widely covered by insurance. It is also often less expensive upfront compared to the Inspire implant.

The Inspire sleep apnea device is not meant to replace CPAP for everyone. But it is an option for adults with obstructive sleep apnea who have tried CPAP and cannot tolerate it or do not get enough benefit from it. The Inspire device is implanted under the skin and controlled with a small handheld remote. Many people find it easier to travel with because there is no large equipment to pack. On the other hand, Inspire requires outpatient surgery, regular follow-up visits, and another procedure when the battery eventually needs to be replaced. The Inspire sleep device can be covered by Medicare and many private insurance plans for people who meet the eligibility requirements. But the implant procedure can be costly without coverage. Working with a sleep specialist can help you decide which treatment is the best fit for your needs.

There are no large clinical trials directly comparing the two treatments. But using Inspire for sleep apnea has been shown to reduce breathing pauses to a degree comparable to CPAP in many eligible people.³ Some research has also found that people are more likely to use Inspire consistently than CPAP. This is likely because there is no mask or hose to wear at night.

Inspire vs. other sleep apnea treatments

The Inspire sleep apnea device is one of several ways to treat obstructive sleep apnea. CPAP, APAP (auto-adjusting positive airway pressure), and BiPAP (Bilevel positive airway pressure) machines remain the first treatments doctors recommend for many people because they are effective and do not require surgery. Still, Dr. Weiner said, "I've seen patients who were not even willing to get tested for sleep apnea until I reassured them that there are options besides CPAP to choose from. If you've been treated with CPAP and, in spite of the best intentions and effort, you simply cannot get used to it and use it consistently, seek out experts who are knowledgeable of CPAP alternatives and willing to support you to get the help you need. Get another opinion if a doctor tells you that CPAP is the only effective treatment."

Some therapies focus on the mouth. Oral appliances that move the lower jaw forward may help people with mild to moderate sleep apnea. "Special exercises can optimize tongue position in the mouth and increase the tone of upper airway muscles," said Dr. Weiner. "These exercises can reduce sleepiness and how much oxygen drops during apneas. These exercises are taught by certified orofacial myofunctional therapists (COMT). There are also smartphone apps that can demonstrate the exercises, which must be done regularly."

"Positional sleep apnea is more common in older adults," said Dr. Weiner. "This means that a larger number of apneas or hypopneas—when breathing stops or is reduced—happen when sleeping on your back. In these cases, sleeping on your side may be adequate to improve sleep apnea severity." If positional therapy may be right for you, see some of the best mattresses for sleep apnea. You can also explore our guides for the best mattresses for adjustable beds and best adjustable beds.

Weight loss, regular exercise, and other healthy lifestyle changes can also improve sleep apnea for some people. "Lifestyle changes can help a lot, but they are not always enough, especially if you have moderate or severe obstructive sleep apnea," said Dr. Weiner. "If sleep apnea is not treated, it raises your risk for high blood pressure, heart disease, stroke, memory problems, dementia, and other serious issues."

Other treatments may be recommended depending on the cause of your sleep apnea. Some people benefit from surgery to remove or reshape tissue in the airway. New medications may also be used for certain people with obesity-related obstructive sleep apnea as part of an overall treatment plan. Compared with Inspire, each option has its own benefits, risks, and level of commitment.

In some cases, one treatment is not enough. A person may use the Inspire sleep device along with weight management, positional therapy, or another approach to get the best results. The right treatment depends on how severe your sleep apnea is, what is causing it, your overall health, and what you are able to use consistently.

If sleep apnea is not treated, it raises your risk for high blood pressure, heart disease, stroke, memory problems, dementia, and other serious issues. There are many treatment options. Don't give up on getting your sleep apnea treated.” 

— Dr. Jordan Weiner

How much does Inspire cost?

The total cost of an Inspire sleep apnea device can be high, especially without insurance. Costs may include the initial consultation, sleep studies, airway testing, the outpatient surgery, the implanted device, follow-up visits, and future adjustments. The exact amount depends on where you live, the hospital or surgery center, and your health care provider.

Without insurance, the total cost is often reported to range from about $30,000 to $65,000 or more, although prices vary widely. Most people do not pay the full amount because insurance may cover part or most of the cost for those who qualify. Even with coverage, your out-of-pocket costs will depend on your deductible, copayments, coinsurance, and whether your doctors and hospital are in your insurance network.

Before deciding on Inspire for sleep apnea, ask your doctor and insurance company for a detailed estimate. Knowing your expected costs ahead of time can help you compare Inspire with other treatment options.

Does insurance cover Inspire?

Many people who qualify for the Inspire sleep apnea device can get insurance coverage. Medicare, the U.S. Department of Veterans Affairs (VA), and many private insurance companies cover Inspire for people with obstructive sleep apnea who have not been able to use CPAP successfully. Coverage rules vary by insurance plan, so approval is never guaranteed.

Most insurance companies require proof that the treatment is medically necessary. This often includes a diagnosis of obstructive sleep apnea, recent sleep study results, records showing that CPAP was not effective or could not be tolerated, and an evaluation by an approved specialist. Prior authorization is commonly required before surgery, and your doctor's office usually helps submit the needed paperwork.

Before moving forward with Inspire sleep apnea, ask your insurance company these questions:

• Is the Inspire device covered under my plan? What about follow-up visits?
• What medical requirements do I need to meet?
• Is prior authorization required?
• What will I owe for my deductible, copay, and coinsurance?
• Are the surgeon, surgery center, and follow-up sleep studies in my network?

Getting these answers before surgery can help you avoid unexpected costs and better understand what your insurance will pay.

What is the Inspire procedure like?

Getting an Inspire sleep apnea device involves several steps, including testing to qualify, surgery, and follow-up care. The process helps your doctor decide whether Inspire is the right treatment and makes sure the device is adjusted to work well for you.

Step 1: Review your sleep apnea diagnosis

Your doctor will review your sleep apnea diagnosis and your medical history. If your previous sleep study is out of date, you may need a new one to confirm that you still have obstructive sleep apnea.

Step 2: Review your CPAP history

Because CPAP is usually the first treatment for obstructive sleep apnea, your doctor will ask about your experience using it and discuss whether you were able to tolerate it and whether it helped improve your symptoms.

Step 3: Meet with an Inspire-trained doctor

If Inspire may be an option, you will meet with a doctor who specializes in the treatment. Together, you will review your symptoms, overall health, and whether Inspire for sleep apnea is likely to be a good fit.

Step 4: Have an airway exam

Before surgery, most people have a sleep endoscopy. During this test, medication helps you fall asleep while a small camera is passed through your nose to examine your airway. The exam shows your doctor how your airway closes during sleep and whether the Inspire device is likely to work.

Step 5: Have the implant surgery

If you qualify, the implant procedure is usually done as outpatient surgery under general anesthesia, so you can go home the same day. The surgeon makes small incisions, usually under the chin and on the upper chest, to place the device and a breathing sensor. The exact technique may vary depending on your anatomy.

Step 6: Heal after surgery

Your body needs time to recover before the device is turned on. Most people spend about a month healing while the incisions close and swelling goes down.

Step 7: Activate the device

About one month after surgery, you will return to your doctor's office to have the Inspire sleep device activated. Your doctor will program the settings and show you how to use the handheld remote before bed.

Step 8: Fine-tune the treatment

You will have follow-up visits and usually another sleep study to see how well the device is working. Your doctor can adjust the settings over time to improve your comfort and reduce sleep apnea episodes.

What are the risks and side effects of Inspire?

Like any surgery, getting an Inspire sleep apnea device carries some risks. Most people experience only mild, short-term issues such as soreness, swelling, bruising, or pain around the incision sites. Some people may develop an infection that needs treatment, and temporary tongue weakness can occur while the area heals. Although uncommon, more serious complications—such as nerve injury or problems with the implant—are possible. Your doctor will review your health history to help determine whether Inspire sleep apnea treatment is a safe option for you.

Some people also notice side effects after the device is turned on. These may include dry mouth, mild tongue discomfort, or an awareness of the stimulation while falling asleep. In many cases, these symptoms improve as you get used to the device or after your doctor adjusts the settings. If you read Inspire sleep apnea reviews, you may find that experiences vary widely from person to person.

Talk with your doctor if you have severe pain, increasing swelling, signs of infection, trouble swallowing, or symptoms that do not improve. Your doctor can help determine whether the device needs an adjustment or whether another treatment is needed.

What is Inspire recovery like?

Getting an Inspire implant is usually an outpatient procedure. Recovery varies depending on the person, but you can generally expect some soreness for the first few days after surgery. Over-the-counter pain medicine can help manage that discomfort. Many people can return to desk work or other light activities within several days, but your doctor may recommend waiting about two weeks before returning to heavy lifting or strenuous exercise. You can usually sleep in your normal position once you are comfortable, although your doctor may give you specific instructions based on your surgery.

The Inspire sleep apnea device is not turned on right away, giving your body time to heal. Most people return about one month after surgery to have the device activated. At that visit, your doctor programs the device and shows you how to use the handheld remote each night. A follow-up sleep study is often scheduled to see how well the treatment is working and whether the settings should be adjusted.

Call your doctor if you develop a fever, increasing redness or swelling around the incisions, bleeding, pain that is not relieved with over-the-counter medicine, or shortness of breath. As the incisions heal, you will have small scars under the chin and on the upper chest. The implanted battery is designed to stay in place for many years. If it eventually needs to be replaced, that is typically done with another outpatient procedure. The battery generally lasts about 10 to 11 years, depending on how the device is used.

Inspire maintenance, battery life, and warranty

Compared with CPAP, daily maintenance for the Inspire device is straightforward. There is no mask to clean, tubing to replace, or water chamber to refill. Instead, you use a handheld remote to turn the Inspire device on before bed and off when you wake up. You will still need regular follow-up visits so your doctor can check the device, review how it is working, and make any needed adjustments.

The battery inside the Inspire sleep apnea device is designed to last about 10 years, although some people may get closer to 11 years depending on their settings and how often the device is used. The battery does not need to be recharged. When it reaches the end of its life, the pulse generator can be replaced with another outpatient procedure.

Inspire Medical Systems also provides a limited manufacturer warranty. Current manufacturer materials state that implanted components are covered against defects for three years, while some accessories have shorter warranty periods. Your doctor or device provider can explain exactly what is covered and how the warranty applies to your situation. Regular checkups—often once or twice a year—help ensure the device continues to work properly.

Inspire sleep apnea device reviews and patient experience

Since Inspire received FDA approval in 2014, around 50,000 people have received the implant.⁴

Finding Inspire sleep apnea reviews is different from looking up reviews for a CPAP machine or another consumer product. The Inspire sleep apnea device is a prescription medical implant placed during surgery, so it is not sold through retail stores where people typically leave ratings. Most information comes from clinical studies, medical journals, and patient-reported outcomes collected by researchers. You may also find Inspire sleep reviews shared in online forums or on social media, but these personal accounts should not replace guidance from your doctor.

The Inspire website includes patient testimonials. These stories can help you understand what treatment was like for some people, but they come from the manufacturer and may not reflect every person's experience. For the most balanced Inspire sleep apnea review, look to clinical evidence, published research, and guidance from a sleep medicine specialist. These sources provide a clearer picture of how the Inspire device performs, who benefits most, and what risks to consider before choosing Inspire for sleep apnea.

Is Inspire worth it?

Whether the Inspire sleep apnea device is worth it depends on your health, your sleep apnea severity, and how well you have done with CPAP. For people with moderate to severe obstructive sleep apnea who cannot tolerate CPAP or other treatments, the implant may improve sleep, reduce breathing pauses, and lessen daytime fatigue. Many people also appreciate not having to wear a mask each night.

At the same time, the Inspire device is not the right choice for everyone. It requires surgery and regular follow-up visits. Only people who meet certain medical guidelines qualify. Some people do very well with CPAP or another treatment and may not need an implant. Before deciding, talk with a sleep medicine specialist about the benefits, risks, costs, and other treatment options that fit your needs.

Best alternatives to Inspire

The Inspire sleep apnea device was the first FDA-approved implant treatment for obstructive sleep apnea. But it is no longer the only option. Today, two other FDA-approved devices treat obstructive sleep apnea by gently stimulating the hypoglossal nerve, which helps move the tongue forward to keep the airway open during sleep. Like Inspire, these treatments are generally for people with moderate to severe obstructive sleep apnea who cannot use CPAP successfully and who meet certain health and anatomy requirements.

Inspire was first approved by the FDA in 2014 and has the longest track record of the three. Many people searching for Inspire sleep apnea reviews or an Inspire sleep apnea review choose it because it has been studied for years and is widely available. Newer options include:

• Genio by Nyxoah: A leadless system that uses an external battery and provides stimulation on both sides of the tongue
• Aura6000 by LivaNova: Received pre-market FDA approval in 2026. Unlike the Inspire, this device does not require a pre-op sleep endoscopy.

While all three are designed to treat obstructive sleep apnea in a similar way, they differ in how they are implanted, powered, and controlled. Your sleep specialist can help you decide whether the Inspire device, Genio, or Aura6000 is the best fit for your needs.

Frequently asked questions

What disqualifies you from Inspire?

You may not qualify for the Inspire implant if you have central sleep apnea, a body mass index above the approved limit, certain medical conditions, or airway anatomy that is not suitable for the device.

Can you feel the Inspire device in your chest?

Yes. Most people can feel the small implant under the skin, but many say they become less aware of it over time as they heal.

Can you remove Inspire if you don’t like it?

Yes. The Inspire device can be surgically removed if needed. This requires another procedure and should be discussed with your surgeon.

Questions? Email us at reviewsteam@ncoa.org.