AURORA, Colo. — In June 2025, Myles Gilbert of Colorado became the first pediatric patient in the United States to receive the fifth-generation Inspire device, a permanently implanted nerve stimulator being used to treat obstructive sleep apnea in children with Down syndrome.
The device, referred to by Dr. Norman Friedman at Children’s Hospital Colorado as a “pacemaker for the tongue,” senses breathing and delivers a small electrical stimulus that moves the tongue forward to keep the airway open during sleep. Friedman, surgical sleep program director at the hospital, said the implant eliminates the need for external chest leads and can be adjusted in clinic to find optimal settings for each patient.
“For children with Down syndrome, [sleep apnea] is highly prevalent,” Friedman said, noting that lower muscle tone and large tonsils or tongues often contribute to lifelong breathing difficulties. “This is a very good alternative, especially for children that have larger tongues.”
Myles' family said the implant has markedly improved his sleep and daytime function after years of unsuccessful trials with CPAP masks.
“He’s definitely sleeping better,” said Tim Gilbert, Myles’ father. “He’s more awake during the days. He’s not falling asleep in the car on short drives. All those pieces just add to Myles’ quality of life.”
The device is adjusted in follow-up visits and can be controlled with a remote control, and monitored with an app the family carries on their phones. Doctors can also remotely monitor usage and breathing data.
Beyond improved sleep, Myles said the change has helped him participate more in school and community activities. He’s active in unified sports, and loves being the equipment manager for the Arapahoe High School football team.
