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An unforgettable night

How Inspire® therapy helped one Kentucky woman through a community crisis
By Anthony Iozzo
Published on June 5, 2024

JoAnna Schroer and her neighbors will never forget the night of Dec. 10, 2021. Schroer, who is a constable in Graves County in Kentucky, remained awake for 72 hours following the aftermath of a line of tornadoes that ripped through her beloved community. At one point, Schroer was stationed on top of a candle factory as she and others looked for survivors below. Needing to rescue people from the chaos and destruction was just one part of the struggle, however, because several people who with sleep apnea needed electricity for their Continuous Positive Airway Pressure (CPAP) and Bi-Level Positive Airway Pressure (BiPAP) machines. Schroer was also diagnosed with obstructive sleep apnea, but she had received the Inspire® implant about six months earlier and didn’t need electricity. “We were having to get them either in a location together where we can get a generator or get generators to each of these people, and it was a huge, huge problem,” Schroer said. Schroer talked to one person, a large man in a wheelchair, and he told her he couldn’t go to sleep. When she asked why, he told her if he went to sleep without his CPAP machine, he wouldn’t wake up. Schroer and others realized they needed to find power for him and others in similar situations. “It was just that crazy fear,” she said. “We get power and then the power would go off or we would get these generators hooked up but then they would run out of fuel. So these people are afraid. They are afraid they will be asleep and then their equipment goes off.” The devastation is still visible in the area with only a few dozen homes being rebuilt over a year later. Schroer said she could hear people yelling and banging during the three days, and she went looking for them to help, not concerned about the debris and potential holes around her. She was very tired but kept pushing through with adrenaline. Once she finally was able to lie down, she fell asleep in less than two minutes. The last thing she remembered was turning Inspire on. “Once I laid down, my body knew it could just quit,” she said. “I woke up about six, six-and-a-half, seven hours later, and I was fully rested, fully rejuvenated and ready to go again.”

JoAnna Schroer helped neighbors as the constable for Graves County following a devastating night of tornadoes in December 2021. One of the concerns as power remained off was for those who needed electricity for their CPAP machines.

The fear of losing electricity

Sleep wasn’t always so great for Schroer, with the time before Inspire bringing several challenges. Strong tornadoes are not something that happen every day, but she said her area does have several power outages each year due to high winds that may knock down powerlines. Schroer said it was catastrophic for people who rely on CPAP machines.

She was too afraid to fall asleep before she bought a generator for her entire house. She also dealt with obstructive sleep apnea for decades, dating back to her childhood. She would fight going to bed, scared she would not wake up. It affected her schoolwork, and she routinely was yelled at for sleeping in class.  Schroer vividly remembers some of the worst nights. She would be holding her breath in a dream but couldn’t stop even though she tried. “I would start saying, ‘Help me,’ and I said it loud enough that someone in my house would hear it and they would know I was in trouble,” Schroer said. “Generally, by the time they got to me, I woke up. But I was so out of breath, I felt literally suffocated.”

A collage of photos from the tornado damage in Graves County Kentucky from December 2021. JoAnna Schroer is a constable in the county and searched for survivors in the rubble.

Trouble finding the right mask

Schroer was introduced to the concept of sleep apnea as she hit her teens and 20s and was given a CPAP machine for early treatment. She went from one machine to another, trying to find one that worked for her. CPAP and BiPAP machines are effective at treating OSA for those who can tolerate it, but there are those who don’t get good benefits or cannot use it.

Schroer’s other problem is that she had to try several masks, and seven if she found one that seemed comfortable and allowed her to sleep, it would be discontinued later on.  “It is just devastating to start all over again,” Schroer said. She tried everything from buying products that holds your nose open or sleeping with three pillows under her head. She tried full face, nasal and mouth masks. But nothing helped in the long term. Schroer was struggling with constant headaches and exhaustion, and the lack of sleep was also worsening her depression. Everything changed when she learned about Inspire and went in for a consultation. She later qualified and was implanted July 15, 2021. She said it felt like “magic.”

Getting to the right level

Schroer said she was excited during the first week after Inspire was activated because she knew she began to feel better. Schroer didn’t want to be disappointed, however, and wasn’t ready to believe the feeling was going to last. It took about a month before she realized how much Inspire was helping her. Schroer began waking up with energy she never had before. “I never felt that fog of walking through the day was all I could do,” she said. “I had the ability to get up, to work, to meet people’s needs and to get things done. And that is a huge difference.” But like most patients, there are adjustments to be made over time, and there is a period of getting used to using Inspire. Inspire works inside your body while you sleep. It’s a small device placed during an outpatient procedure. While you sleep, Inspire moves your tongue forward and opens the airway muscles allowing you to breathe normally. Someone is usually activated around 30 days after surgery to make sure a patient is fully healed, and there is a follow-up sleep study done 90 days later. The recommendation is for Inspire patient to follow-up with their doctor every six months to a year after reaching their therapeutic level. There are many customizable settings with Inspire, and an Inspire trained doctor can find the correct settings for each person. Schroer reached her fifth level on her Inspire remote with her initial settings, and she slept like a baby. After her follow-up, she was given a new set of settings to reach her therapeutic level. Schroer said she went up levels again until she had one night where her sleep was a little off. She went back down one level and has been at the same one for well over a year now. Schroer also said her tongue muscles needed to get used to Inspire. She said if she had any irritation, it passed in a day or two. Now, she doesn’t feel anything after using Inspire.

Newfound energy

Schroer’s depression is no longer insurmountable, and she anticipates spending more time with her children and grandchildren.  She doesn’t fear going to bed, instead welcoming the opportunity to sleep each night. Schroer also feels fine walking around with friends and family in a flea market for several hours. Before, she said she would wait behind and fall asleep wherever she was sitting. “If you’ve never lived through that fog of poor sleep, it’s hard to understand,” Schroer said. “You just feel like every step you take that your foot weighs twice as much as it does. “Now, I am the person who wants to go. I am not the person who wants to stay behind and watch the bags.”

JoAnna Schroer’s town of Hickory, Kentucky has not fully recovered from the damage, seen here the day after tornadoes touched down in December 2021.

Good Samaritan

Success doesn’t mean Schroer wasn’t scared before going on her Inspire journey. She knew there was something that would be implanted in her, and she needed to get used to the idea. She said wished she had someone to talk to who had Inspire and could tell her what to expect and how the process went. This is why she volunteers her time.

Schroer recently took a friend to one of her follow-up Inspire appointments to learn more about Inspire. Schroer is no stranger to being helpful. Just look back to that unforgettable night in December 2021. Even then, one of the biggest takeaways is how much sleep can affect us. Schroer said she’s thankful that Inspire gave her the energy and ability to push through to help her community in the days following the tornado. “People say, ‘How do soldiers stay awake when they are at war?’ I know from dealing with the tornado,” she said. “I mean, I was up for 72 hours. I don’t know how I did that. I know my body knew that it had to because it was in a state of emergency and adrenaline took over. “But I know when it was over, I needed recovery sleep, which we all need every single night.”

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