For years, Frank Garces felt like he was running on empty. The 83-year-old Air Force veteran and longtime Miami resident was diagnosed with obstructive sleep apnea (OSA), a condition that caused him to stop breathing dozens of times every hour as he slept.

The standard treatment, a continuous positive airway pressure (CPAP) machine, proved to be more of a burden than a benefit. “The mask was very uncomfortable,” recalls Mr. Garces, pictured above with his wife, daughter and son, “If you’ve seen those ads on TV where a group of sleep apnea patients are pulling their masks off with great relief, that was me.”

His struggle is a common one, but his quest for a better night’s sleep led him to an alternative solution that has controlled his OSA and restored his quality of life.

Guided by the expertise of Harneet Walia, M.D., medical director of sleep medicine at Baptist Health Miami Cardiac & Vascular Institute and chief of clinical transformation for Baptist Health Medical Group, Mr. Garces found lasting relief through an advanced implantable therapy, moving beyond the limitations of traditional treatments.

Understanding Obstructive Sleep Apnea (OSA)

Obstructive sleep apnea is more than just loud snoring. It is a potentially serious sleep disorder where breathing repeatedly stops and starts. According to Dr. Walia, these interruptions are caused by the throat muscles relaxing and blocking the airway during sleep.

“Obstructive sleep apnea generally is caused by structural abnormalities or some physiological abnormalities,” explains Dr. Walia. This blockage triggers a survival reflex, briefly waking the person to reopen the airway. The cycle can repeat hundreds of times a night, preventing deep, restorative sleep.

Mr. Garces’ diagnosis came after his family doctor recommended a sleep test. The results were alarming. “The sleep test showed that I was stopping breathing 30 times an hour,” he says.

The Risks and Symptoms of Untreated OSA

Many individuals are unaware they have sleep apnea. The symptoms can be subtle or attributed to other causes. Dr. Walia notes that common signs include excessive daytime sleepiness, fatigue, impaired concentration and irritability. However, some symptoms are less obvious.

“Nocturia – having to use the restroom multiple times in the middle of the night – actually can be a symptom of sleep apnea,” explains Dr. Walia. “Sleep apnea can pose certain stress on the heart, which causes the release of this hormone that causes folks to use the restroom quite a bit.”

The consequences of untreated OSA extend far beyond a poor night’s sleep. The recurring drops in blood oxygen levels place significant strain on the cardiovascular system.

“Obstructive sleep apnea can pose an increased risk of various cardiovascular parameters, such as increased risk of hypertension, arrhythmias and coronary artery disease,” Dr. Walia cautions. “Some studies have shown an increased risk of death.”

The Challenge of Traditional OSA Treatment

For decades, the primary treatment for OSA has been the CPAP machine, which delivers a constant stream of air to keep the airway open. While effective for many, a significant number of patients find it difficult to tolerate. Mr. Garces was one of them. The discomfort of the mask and the constant air pressure disrupted his sleep, defeating the purpose of the therapy.

Determined to find a better solution, Mr. Garces began researching sleep medicine specialists and found Dr. Walia. “I looked her up on Baptist’s website,” he says. “I read up on her and her qualifications.”

Dr. Walia worked with Mr. Garces, attempting to troubleshoot his issues with PAP therapy. “He was on CPAP initially, and then he was transitioned to bi-level PAP, which is sometimes used in patients who are intolerant to CPAP,” she says. “But he did express to us that he had difficulty tolerating the PAP therapy and was unable to sleep with it.”

An Innovative Path Forward

Mr. Garces had heard about an alternative: an implantable device for treating OSA. He brought it up as a potential option with Dr. Walia.

“I am his sleep specialist, so I knew he was a good candidate for this device,” says Dr. Walia, adding that the evaluation process is thorough. “To determine if a patient is a candidate for implantable OSA therapy, they undergo a sleep study and an examination by an ear, nose and throat (ENT) specialist to ensure their airway anatomy is suitable for the treatment.”

Implantable Therapy: A Breakthrough in Sleep Medicine

Implantable therapy, also known as hypoglossal nerve stimulation, works differently from a CPAP machine and represents a significant advancement in the treatment of OSA. A small device is implanted under the skin in the upper chest.

The innovative device monitors breathing patterns during sleep and delivers gentle stimulation to a nerve that controls tongue movement, gently moving the tongue forward to keep the airway open. By activating the nerve, the therapy helps maintain an open airway, reducing the likelihood of sleep disruptions caused by airway collapse.

Dr. Walia explains, “This therapy is designed to address airway obstruction at its source by stimulating the muscles that hold the tongue forward, which can be especially beneficial for patients who are unable to tolerate traditional therapies.”

Clinical outcomes have demonstrated improvements in both sleep quality and overall well-being for patients who are eligible for this treatment. Dr. Walia notes, adding that this approach is transforming the management of sleep apnea for those seeking relief beyond standard therapies.

“The evidence shows meaningful reductions in the number of times a patient’s breathing stops or becomes shallow during sleep, with a corresponding improvement in quality-of-life indicators,” says Dr. Walia. “For appropriately selected individuals, hypoglossal nerve stimulation offers a safe and effective alternative when conventional options are not suitable.”

Life After the Implant

According to both Mr. Garces and Dr. Walia, the procedure was a success. After a period of healing following implantation, the device was activated and fine-tuned by Dr. Walia. “The results were transformative. With the implant, his breathing events dropped from 30 times an hour to just five,” she notes.

Today, Mr. Garces is finally experiencing the restful sleep that eluded him for so long. He simply uses a small remote to turn the device on before bed and off in the morning. He no longer battles with a cumbersome mask or a noisy machine.

“I think I’ve been on the new therapy now for close to a year,” he says. He feels better and the data from his device confirms the treatment is working. Each morning, he can see the results of his sleep on an app on his phone.

Dr. Walia has seen the positive impact of this therapy on many patients like Mr. Garces. “I was one of the early adopters of this therapy when it was approved for use by the FDA in 2014,” she states. “I have done research and I’ve shown improvements in those quality-of-life indices.”

For Mr. Garces, this innovative treatment has provided more than just better sleep. It has given him back his energy and peace of mind, allowing him to fully enjoy his retirement and keep up with his many projects in and around the house.

“I keep busy all day, it’s my nature,” says the jack-of-all-trades "retiree" who still does his own household and car repairs. “I was up on my roof yesterday fixing something and I was out early this morning waxing my truck. I could probably run circles around a 50-year-old man.”

Click here for more information about sleep medicine at Baptist Health Miami Cardiac & Vascular Institute.