The Latest Sleep Apnea Devices – Everything You Need to Know
By Jason Wooden, PhD | Updated for 2021
While CPAP is one of the most effective treatments for sleep apnea, many patients stop using their machines within a year. Good news, they’re now plenty of alternatives you can try.
The latest sleep apnea devices include more comfortable air pressure systems, body positioners, innovative nerve stimulators, and surgically implanted suspension lines.
A) The truth about sleep apnea treatment
Before we talk about the latest sleep apnea devices, let’s review the basics…
Sleep apnea is a very common sleep disorder in which breathing stops or gets shallow during sleep.
These breathing interruptions wreck sleep and in the US alone over 18 million adults struggle with sleep apnea every night.
CPAP (Continuous Positive Airway Pressure) uses an air pump and face mask to apply mild air pressure which helps the airway stay open during sleep.
It’s one of the most effective treatments for sleep apnea and can be a real life changer. Unfortunately, many patients stop using their CPAP machines within the first year of treatment.
Some find the CPAP mask uncomfortable while others complain about the blowing air, system leaks, dry nose, red eye, and nasal congestion. The vibrating noise may also be a nuisance for the sleep of the patient and a bed mate.
So, while CPAP is great when it’s working, it doesn’t work for everyone.
If this describes you, don’t give up – the health effects of untreated sleep apnea are serious.
Yes, sleep apnea can disrupt sleep and leave you feeling miserable throughout the day. It can also put you at risk for other serious health issues such as high blood pressure, heart disease, stroke, diabetes, and depression.
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Before you pull the plug on CPAP, a couple questions:
- Have you tried any of these practical remedies?
- Have you tried sleep counseling? Research shows it can really make a difference for people starting CPAP. Read more about this here.
If you’ve tried everything you can think of (including counseling), it’s really important to find an alternative as soon as you can if CPAP is not working out for you.
In the past, your choices have been limited to oral appliances and surgery in some cases. (Oral appliances are devices which are used to reposition the jaw and tongue so that the airway stays more open).
Today there are more options than ever before with more on the way. Leaner face masks, smarter oral appliances, and new treatments.
If you’re suffering from sleep apnea, there’s no reason to keep living in misery, so don’t give up.
What’s your sleep apnea type?
Obstructive Sleep Apnea, the most common type, is mechanical problem in which the muscles in the throat relax during sleep causing the airway to collapse.
Central Sleep Apnea is less common and occurs when the brain fails to sent the right signals to the muscles that control breathing.
Complex Sleep Apnea is when you have symptoms of both obstructive and central sleep apnea.
What’s your sleep apnea type?
Obstructive Sleep Apnea, the most common type, is mechanical problem in which the muscles in the throat relax during sleep causing the airway to collapse.
Central Sleep Apnea is less common and occurs when the brain fails to sent the right signals to the muscles that control breathing.
Complex Sleep Apnea is when you have symptoms of both obstructive and central sleep apnea.
What’s your sleep apnea type?
Obstructive Sleep Apnea, the most common type, is mechanical problem in which the muscles in the throat relax during sleep causing the airway to collapse.
Central Sleep Apnea is less common and occurs when the brain fails to sent the right signals to the muscles that control breathing.
Complex Sleep Apnea is when you have symptoms of both obstructive and central sleep apnea.
B) Latest sleep apnea devices
With more options than ever before, we’re living in a golden age for sleep apnea treatment.
They include more comfortable air pressure-based systems, body positioners, new nerve stimulation technologies, and surgically implanted suspension lines.
As you read through the list of treatment options, here are some things to keep in mind:
Who is it recommended for?
Many of the treatments are for obstructive sleep apnea which is the type that most people have. Some will also work for central sleep apnea.
You need a treatment that works for your specific sleep apnea type. If you’re not sure about this, get diagnosed.
Prescription requirement
Most of the treatments are medical devices which by law require a prescription in the US and many other countries. For this reason, you’ll have to work with a doctor to get properly diagnosed and a recommendation for a specific treatment.
Insurance coverage
Depending on your diagnosis, some are covered by insurance while others are covered partially or not all.
A sleep specialist can help you:
- figure out which devices to try
- get a prescription
- qualify for insurance
Here’s a quick look at the CPAP alternatives:
Recommended for obstructive sleep apnea: AirFit F30 cpap mask, Airing micro-CPAP, Winx Oral Pressure Therapy, Provent Sleep Apnea Therapy, aerSleep, O2Vent Optima, NightShift, NightBalance, GENIO, Inspire, THN Sleep Therapy, AirLift
Recommended for central sleep apnea: AirFit F30 cpap mask, Airing micro-CPAP, remede System
JUMP TO CATEGORY:
Air pressure
Oral appliances
Positional therapy
Nerve stimulation
Suspension lines
Air pressure treatments:
Uses air pressure to help keep your throat from collapsing and blocking your airway.
AirFit F30 cpap mask (US, UK, Australia, Canada)
Provent Sleep Apnea Therapy (US, UK, Australia, Canada, New Zealand)
aerSleep (Canada; awaiting eslewhere)
Winx Oral Pressure Therapy (not available)
Airing micro-CPAP (in development)
Oral Appliances:
Repositions the jaw and tongue to keep airway more open.
O2Vent Optima (Australia, Canada, US)
Positional therapy:
Trains you to sleep on your side instead of your back which can help keep the airway more open.
NightShift (US, Australia)
NightBalance (US, Europe)
Nerve stimulation:
Doctors implant a pacemaker device that stimulates the body to keep the airway more open.
Inspire (US, UK)
remede System (US)
GENIO (approved in EU)
THN Sleep Therapy (clinical trials)
Here’s a more in depth look at your CPAP alternatives:
AIR PRESSURE TREATMENTS
AirFit F30 CPAP mask:
How it works: Similar to other CPAP masks, uses positive air pressure to keep the throat from collapsing so that you breathe better. The AirFit F30 is a smaller full-face mask designed to sit more comfortably, cover less of the face, and leave behind fewer facial marks.
Recommended for: obstructive and central sleep apnea
Proof it works: ResMed clinical studies, CPAP users preferred this type of mask over others and found it more comfortable.
Pros:
- quieter
- fewer facial marks and less irritation
- better for wearing glasses
- easier to sleep on your side
- fewer sleep disruptions from vent flow for users and their bed partners
Cons:
- Some may still find a mask uncomfortable
- Prone to leakage in certain positions if not fitted properly
Availability:
US local suppliers
US authorized online suppliers
UK
Ireland
Australia
Canada
Insurance coverage: covered by most insurance providers
Made by: ResMed
Customer Assistance (US and Canada): (800) 424-0737
User guide
Learn more
Video: AirFit F30 Full Face CPAP Mask Review
Provent Sleep Apnea Therapy:
How it works: Disposable adhesive valves are placed over the nose to increase air pressure which keeps the airway more open during sleep. Unlike CPAP, Provent uses the patient’s own breathing to create pressure during exhalation.
Recommended for: obstructive sleep apnea
Pros:
- simple, discreet
- disposable device, no need for cleaning
- no mask or machine required
- portable, ideal for travel
Cons:
- may not work as well for mouth breathers
- some may have a hard time getting use to adhesives
Insurance coverage: may not be covered
Made by: Provent Sleep Therapy, LLC
Phone: 888-757-9355
E-mail: [email protected]
Frequently Asked Questions
Learn more
Video: Provent Therapy demonstration
aerSleep:
How it works: Uses a battery-operated tiny pump to create a vacuum on the outside of the neck which shifts throat tissues and the tongue forward to keep the airway open.
Recommended for: obstructive sleep apnea
Proof it works: clinical study; currently being evaluated in additional clinical trials
Pros:
- non-invasive, discrete
- small and portable
- no masks, machine, hoses, cords, or humidifiers required
- quick set up
Cons:
- May not work on patients with facial hair around mandible and neck area
- May cause mild redness on neck for 20-30 minutes after use
Availability: Canada; awaiting approval in US, Australia, Europe, and Asia
Insurance coverage: may not be covered by all insurance plans
Made by: Sommetrics, Inc.
Phone: 800-209-2841
E-mail (US): [email protected] (US)
E-mail (Canada): [email protected]
Frequently Asked Questions
Learn more
Video: How aerSleep Works
Winx Sleep Therapy System:
How it works: Inserted into the mouth to provide a gentle suction that pulls the soft palate and tongue forward which keeps the throat more open for better breathing
Recommended for: obstructive sleep apnea
Proof it works: clinical trials
Pros: no bulky mask or restraining headgear
Cons:
- requires you to be able to breathe through your nose without mouth breathing
- sucks saliva into a canister that must be emptied in the morning
- possible issues if you have loose teeth or gum disease
Availability: manufacturer appears to have gone out of business
Made by: ApniCure
Airing Micro-CPAP:
How it works: Will use positive air pressure to keep the throat more open and promote breathing during sleep. Device will be a disposable battery-operated nose implant that contains hundreds of micro-blowers to create airway pressure.
Recommended for: obstructive and central sleep apnea
Proof it works: under development
Pros: compact, no mask, lightweight, and cordless
Cons: too soon to know
Availability: under development
Made by: Airing
Phone: +1-952-540-4470
E-mail: [email protected]
Learn more
ORAL APPLIANCES
O2Vent Optima:
How it works: Mouthguard-like device that allows unobstructed air to flow to the back of the throat, bypassing common sites of obstruction such as the nose, tongue, and soft palate. Unlike other oral devices, it adds stability to the airway in two ways, moving the jaw forward and providing and airway channel.
Recommended for: snorers, obstructive sleep apnea (mild to moderate)
Proof it works: clinical studies
Pros:
- works in two different ways (moving the jaw + airway channel)
- lightweight and durable
- noninvasive
- good for patients who suffer nasal congestion or a blocked nose and revert to mouth breathing during sleep
- good for patients allergies or nasal congestion
Cons: may not work as well for more severe sleep apnea
Availability: Australia, Canada, US
Insurance coverage: some insurers may cover the full cost, while others may cover part of the cost (see reimbursement information)
Made by: Oventus Medical
Contact
Frequently Asked Questions
Company Website
Recent news:
Oventus Medical (ASX:OVN) receives U.S. Medicare approval for O2Vent Optima
POSITIONAL THERAPY
NightShift:
How it works: Trains patients to sleep in healthy positions. Wearable device placed around the back of the neck, vibrates when you sleep on your back and slowly increases in intensity until you change positions.
Recommended for: positional obstructive sleep apnea (patients with airway obstruction that worsens when sleeping on back compared to any other position)
Proof it works: clinical studies
Pros:
- noninvasive
- easy to use
- comfortable
- easy to maintain
- can monitor your sleep
Cons:
- some may find it uncomfortable
- may not work as well with patients with acute neck, shoulder, back pain, or issues such as skin sensitivity
- not covered by insurance
Availability: US (physician network) and Australia (online) via prescription
Insurance coverage: may qualify toward your high deductible healthcare insurance (per manufacturer website)
Made by: Advanced Brain Monitoring, Inc.
Phone: (760) 720-0099
Frequently Asked Questions
Learn more
Recent news:
Why Clinicians May Miss Identifying Patients Who Could Benefit from Positional Sleep Apnea Therapies
Video: Night Shift Introduction
NightBalance:
How it works: Trains patients to sleep in healthy positions. Wearable device placed around the chest, vibrates when you sleep on your back to encourage you change position.
Recommended for: positional obstructive sleep apnea (patients with airway obstruction that worsens when sleeping on back compared to any other position)
Proof it works: clinical studies
Pros:
- noninvasive
- easy to use
- comfortable
- easy to maintain
- can monitor sleep
Cons:
- some may find it uncomfortable
- not covered by insurance
Availability: US, Canada, Europe
Insurance coverage: US; Europe, covered by some insurers depending on country
Made by: Philips
US
Europe
Frequently Asked Questions
Recent news:
Philips introduces NightBalance device for sleep apnoea
Philips launches NightBalance, increasing therapy options for positional obstructive sleep apnea patients
Why Clinicians May Miss Identifying Patients Who Could Benefit from Positional Sleep Apnea Therapies
Product reviews:
NightBalance Lunoa Review (thecpapshop.com)
Video: NightBalance Overview
NERVE STIMULATION
Inspire Upper Airway Stimulation Device:
How it works: A small device is surgically implanted in the chest and can be turned on using a remote. During sleep, it monitors your breathing and stimulates a nerve that keeps the upper airway open.
Recommended for: obstructive sleep apnea (find out here if you qualify)
Proof it works: clinical studies
Pros:
- no mask or oral appliance
- less invasive than conventional obstructive sleep apnea surgeries
- preserves the natural airway anatomy
- designed to work with body’s natural anatomy & breathing processes
- simple, easy to use
Cons:
- requires surgery, although minimal (all surgeries carry a small risk)
- some patients might feel a mild tingling sensation when in use
- potential limitations on participating in very strenuous activities for the upper body
Availability: US; UK (just introduced, inquire with manufacturer)
Insurance coverage: Covered on a case by case basis (learn more)
Made by: Inspire Medical Systems, Inc
Phone: (844) 672-4357
E-mail: [email protected]
Frequently Asked Questions
Learn more
Recent news:
Ohio State otolaryngologist implants more upper airway stimulation devices than anyone in the world
Therapy Update: Implanted Neurostimulators for Sleep Apnea
Couple struggling with sleep apnea finds relief
Medicare contractors back use of Inspire’s sleep apnea device
Video: New treatment for Sleep Apnea (CNN)
remedē System:
Pros:
- no mask or oral appliance
- minimally invasive outpatient procedure
- simple, easy to use
Cons:
- requires surgery, although minimal (all surgeries carry a small risk)
- some insurers cover on a case by case basis
Availability: US
Insurance coverage: some insurers
Made by: Respicardia, Inc
Phone: 952-540-4470
E-mail: [email protected]
Learn more
Video: remedē system helps patients with central sleep apnea at Saint Luke’s Hospital
GENIO Implantable Stimulator:
How it works: A tiny neurostimulator is implanted close to the nerve of the tongue and turned on at night by placing an activation chip placed under the chin. This triggers the tongue to contract and open the airway.
Recommended for: obstructive sleep apnea
Proof it works: In progress
Availability: Approved in EU, undergoing clinical trials in US
Insurance coverage: To be determined
Made by: Nyxoah
Phone: +32 10 45 90 75
E-mail: [email protected]
Learn more
First US patient implanted in the DREAM pivotal IDE study, with the Genio® system for the treatment of Obstructive Sleep Apnea
Nyxoah Gets FDA OK to Begin Study on Its Implanted Neurostimulator for Sleep Apnea
Novel hypoglossal nerve stimulation device improves OSA
Nyxoah’s Genio Implant for Obstructive Sleep Apnea Cleared in Europe
Therapy Update: Implanted Neurostimulators for Sleep Apnea
THN Sleep Therapy (aura6000):
Pros:
- minimally invasive, surgically implanted system usually as an outpatient procedure with quick recovery time
- procedure is completely reversible
- no masks, hoses, or mouthpieces
Cons: requires surgery, although minimal (all surgeries carry a risk)
Availability: In clinical trials
See if you qualify to participate
Cost: To be determined
Insurance coverage: To be determined
Made by: LivaNova
Phone: 858-259-2980
Learn more
SUSPENSION LINES
AirLift:
How it works: Uses suspension lines to reposition the hyoid bone or tongue to hold the airway open
Recommended for: obstructive sleep apnea
Proof it works: clinical studies (see “Publications”)
Pros:
- minimally invasive, well-tolerated
- reversible
- can be performed in an outpatient setting
- no mask or oral appliance to wear
Cons:
- surgery
- requires implant of screws and sutures which some may find intrusive or uncomfortable
Availability: US
Find an AIRLIFT trained Doctor
Insurance coverage: yes
Made by: Siesta Medical, Inc
Phone: 408-320-9424
E-mail: [email protected]
Learn more
Video: AirLift Procedure
C) How to try them out
Ready to try out one of the new CPAP alternatives?
Here are some things that can help move the process along:
Do your homework – Educate yourself about the various options so that you’re ready to discuss pros and cons with a doctor.
Schedule a doctor appointment – A sleep specialist will play an important role in helping you figure out which treatments are worth trying, getting the prescription, and qualifying for insurance.
Work with your sleep specialist – As you try out a new treatment, they may be able make adjustments so that it works better for you.
Some of the latest sleep apnea devices may not yet be available. If you’re interested in something that’s still under development, talk to your doctor and the manufacturer about trying it out as a participant in a clinical trial.
D) What else can I do?
Don’t limit your search for sleep apnea relief to devices only.
Be sure you’re practicing good sleep hygiene so that you’re not sabotaging your sleep apnea treatment.
Sleep hygiene sets the stage for good sleep. Once you fall asleep, your sleep apnea treatment will help you sleep more deeply with fewer breathing interruptions.
Some other practical things you can do:
Weight loss – Excessive weight has been linked to sleep apnea. Studies have shown weight loss can help improve symptoms and, in some cases, eliminate the need for surgery or long-term CPAP therapy.
Avoid alcohol and smoking – Both have been linked to sleep apnea in studies. Alcohol can relax the throat muscles that control breathing. Tobacco use can worsen inflammation and swelling in the airway.
Change your sleep position – Over half of obstructive sleep apnea cases are due to sleep position. Sleeping on your side or stomach are believed to help keep the airway open. If you’re not a natural side sleeper, some of the new sleep apnea devices (positional therapy) can help retrain your body.
E) Insurance tips
Some of the newer treatments may be only be partly covered or only on a case by case basis. Your doctor will be important for getting you qualified for a specific diagnosis and working with your insurance provider.
Some things to try if you are denied coverage:
- Make sure the right billing codes were used and the claim properly submitted
- Check your policy to see if the claim was legitimately denied
- Ask your HR department for help
- Contact your insurance company directly
- File an appeal
- Check with your state insurance department
Organizations that help with insurance claims:
Patient Advocate Foundation
Alliance of Claims Assistance Professionals
Consumer Coalition for Quality Health Care
What else you can try if you don’t have insurance coverage:
- Ask your doctor for suggestions
- State-Sponsored Programs
- Health Programs for Veterans
Sources:
1. A novel nasal expiratory positive airway pressure (EPAP) device for the treatment of obstructive sleep apnea: a randomized controlled trial. Sleep. 2011; 34(4):479-85.
2. Nasal Expiratory Positive Airway Pressure Devices (Provent) for OSA: A Systematic Review and Meta-Analysis. Sleep Disord. 2015; 2015: 734798.
3. Evaluation of Continuous Negative External Pressure (cNEP) for the Treatment of Obstructive Sleep Apnea: A Pilot Study. J Clin Sleep Med. 2017; 13(8):1009-1012.
4. A multicenter evaluation of oral pressure therapy for the treatment of obstructive sleep apnea. Sleep Med. 2013 Sep;14(9):830-7.
5. Assessment of a neck-based treatment and monitoring device for positional obstructive sleep apnea. J Clin Sleep Med. 2014; 10(8):863-71.
6. Outcome after one year of upper airway stimulation for obstructive sleep apnea in a multicenter German post-market study. Laryngoscope. 2018; 128(2):509-515
7. Sustained 12 Month Benefit of Phrenic Nerve Stimulation for Central Sleep Apnea. Am J Cardiol. 2018; 121(11):1400-1408.
8. Transvenous neurostimulation for central sleep apnoea: a randomised controlled trial. Lancet. 2016; 388(10048):974-82.
9. Targeted hypoglossal nerve stimulation for the treatment of obstructive sleep apnea: Six-month results. Laryngoscope. 2016; 126(11):2618-2623.
10. Targeted hypoglossal neurostimulation for obstructive sleep apnoea: a 1-year pilot study. Eur Respir J. 2013; 41(2):360-7.
11. Weight loss for obstructive sleep apnea: the optimal therapy for obese patients. J Am Diet Assoc. 1994; 94(11):1291-5.
12. Alcohol and the risk of sleep apnoea: a systematic review and meta-analysis. Sleep Med. 2018; 42: 38–46.
13. Interaction between smoking and obstructive sleep apnea: not just participants. Chin Med J (Engl). 2012; 125(17):3150-6.
14. The role of sleep position in obstructive sleep apnea syndrome. Eur Arch Otorhinolaryngol. 2006; 263(10):946-50.
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