An estimated 15 million Americans have obstructive sleep apnea severe enough to warrant treatment, but this field has been chronically underserved by traditional continuous positive airway pressure systems that are inconvenient and uncomfortable to use. To address this problem, CPAP manufacturers are making design improvements to optimize comfort and compliance; at the same time, promising new technologies are emerging – including neurostimulation devices for OSA – that could help reshape the future management of this often overlooked, but serious disorder.

Apnex Medical is developing a tiny device that it thinks could become an enormous game changer in the bid to better treat obstructive sleep apnea. The technology is similar to a pacemaker in both size and concept. But instead of the heart, the device stimulates the musculature of the upper airway at the base of the tongue - the genioglossus - via the hypoglossal nerve. In obstructive sleep apnea, the muscle doesn't always activate sufficiently, which can lead to a collapsed airway.

Although more than 20 million people in the US are affected by obstructive sleep apnea (OSA), the standard of care for the disorder--a continuous positive airway pressure (CPAP) machine applied at bedtime with a nasal or facial mask to keep airways propped open--carries a noncompliance rate of almost 50%. ImThera Medical Inc. is developing a new implantable neurostimulation device that stimulates certain tongue muscles during sleep to open the upper airway and potentially help patients who are unable or unwilling to use CPAP or pursue surgical alternatives.