Man miserable at night needs to try out the latest sleep apnea devices

The Latest Sleep Apnea Devices – Everything You Need to Know

By Jason Wooden, PhD | February 22, 2019

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.

women using cpap machine for sleep apnea

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.

This makes it 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.  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.

More about 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.

More about 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.

More about sleep apnea

B) The 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.

As you can see, your doctor will play an important role in helping you figure out which of the new sleep apnea devices are worth trying, getting the prescription, and qualifying for insurance.

Recommended for central sleep apnea:  AirFit F30 cpap mask, Airing micro-CPAP, remede System

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:  In US online or through local CPAP suppliers via prescription
     Find local suppliers
     Authorized online suppliers

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

Proof it works:  clinical studies (1, 2)

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

Availability:  US online or local supplier (prescription required), Australia, Canada, Europe, and many other countries.
International Provent Suppliers
Doctors in US who already prescribe Provent

Insurance coverage:  may not be covered

Made by:  Provent Sleep Therapy, LLC
Phone: 888-757-9355
E-mail: info@proventtherapy.com
Frequently Asked Questions
Learn more

Video:  Provent Therapy demonstration

aerSleep:

Man using aerSleep for sleep apnea treatment

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 US approval

Insurance coverage:  may not be covered by all insurance plans

Made by:  Sommetrics, Inc.
     Phone: 800-209-2841
     E-mail (US): info@sommetrics.com (US)
     E-mail (Canada): aersleep@avantsleep.com
     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: info@respicardia.com
     Learn more

NightShift:

Photo of nightshift, one of the latest sleep apnea devices

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

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, Europe

Insurance coverage:  US; Europe, covered by some insurers depending on country

Made by:  Philips
     US
     Europe
     Frequently Asked Questions

Video:  NightBalance Overview

Inspire Upper Airway Stimulation Device:

Drawing showing Inspire, one of the latest sleep apnea devices

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: info@inspiresleep.com
     Frequently Asked Questions
     Learn more

Video:  New treatment for Sleep Apnea (CNN)

remedē System:

How it works:  Monitors and stabilizes breathing during the night using a pacemaker-like device that signals the large muscle which controls breathing.

Recommended for:  moderate to severe central sleep apnea in adult patients

Proof it works:  clinical studies (7, 8)

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: info@respicardia.com
     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:  Undergoing tests in clinical trials

Insurance coverage:  To be determined

Made by: Nyxoah
     Phone: +32 10 45 90 75
     E-mail: info@nyxoah.com
     Learn more

THN Sleep Therapy (aura6000):

How it works:  Implantable device that mildly stimulates the tongue during the sleep to keep the airway open and reduce sleep apnea events

Recommended for:  obstructive sleep apnea

Proof it works:  clinical studies (9, 10)

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 in clinical trial

Cost:  To be determined

Insurance coverage:  To be determined

Made by:  LivaNova
   Phone:  858-259-2980
   Learn more

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: info@siestamedical.com
     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 positionOver 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

Some things to try if you don’t have insurance coverage:

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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