Obstructive Sleep Apnea (OSA): 
Introduction and Need for Better Therapy Options

Obstructive Sleep Apnea (OSA) is a sleep disorder that causes intermittent blockage of a person's airflow while they sleep due to movement of their tongue, or other soft tissue, into the airway.   As a result, people with OSA are repeatedly deprived of oxygen during their sleep.  This oxygen deprivation can cause serious short-term and long-term health problems.  Health problems caused by OSA include: heart attacks; congestive heart failure; disrupted sleep; chronic fatigue; morning headaches; irritability; brain damage; cognitive dysfunction; impotency; high blood pressure; motor vehicle crashes; job-site accidents; and even death.  For example, in patients with heart failure, OSA is associated with an increased risk of death[1].  Despite these serious health hazards, it is estimated that only 5% to 8% of the population with OSA are treated.  Approximately 20 million Americans, and 35 million people, worldwide have OSA. These numbers are growing with the increased prevalence of obesity. 

First-line therapy for most people with Obstructive Sleep Apnea is CPAP (Continuous Positive Airway Pressure) or other pressure-based therapies such as BIPAP (Bilevel Positive Airway Pressure) or IPAP (Inspiratory Positive Airway Pressure).  All of these pressure-based therapies for OSA require a mask, or other air-channeling device, that covers or inserts into the nose and/or mouth.  The mask is the weak link in pressure-based therapy.   Such therapy only works if a person tolerates wearing the mask and if the mask does not leak too much air.  If the mask fits too tightly in some places, then this causes skin irritation, red marks, pain, and low patient compliance.  If the mask fits too loosely and there are gaps between the mask and the person's face, then the mask leaks air.  Air leaks erode clinical effectiveness.

Mask problems such as annoying air leaks, skin irritation and pain, red marks, and claustrophobic reactions contribute to unsatisfactorily-low rates of compliance with pressure-based therapy. Many people are not willing to wear a mask.  Estimates of the percentage of people who should wear a mask, but do not wear one, are in the range of 46 to 83%.[2,3].  Medical research confirms a relationship between reduction of mask leakage and better patient compliance[4].  Development of novel masks that are more comfortable, fit better, and leak less can improve patient compliance with wearing a mask, thereby reducing the oxygen deprivation and long-term adverse health events associated with OSA.

Since rates of patient compliance with pressure-based therapies are unsatisfactorily-low with currently-available OSA masks, better mask designs are needed.   A major challenge is how to create masks that closely conform to the contours of an individual's face while they sleep so that there are no places around the mask that fit too tightly (causing irritation, skin marks, pain, and low compliance) and no places that fit too loosely (causing air leaks and reducing clinical efficacy).  A second major challenge is how to create masks that are not dislodged by torque forces if a person presses the side of their face against a pillow while they sleep.   Masks that satisfactorily address these problems have the potential to increase patient compliance and improve treatment of OSA. 

Various approaches to address these mask design challenges have been tried.  These approaches include: masks with adjustable straps; masks whose overall size can be manually adjusted; masks with a cushion seal filled with a gas, liquid, or gel; masks with an inflatable single-compartment cushion seal; masks that are custom fitted for a person's face by pressing moldable material against their face; and masks that are custom fitted for a person's face using three-dimensional facial imaging and custom fabrication.   However, none of these approaches have been entirely successful.  Skin irritation from tight places around mask perimeters, air leaks from loose places around mask perimeters, and mask dislodging from head-to-pillow interaction remain ongoing problems for pressure-based OSA therapies.   According, there remains an unmet clinical need for development of innovative masks to correct these problems. 

Sleepnea's novel technologies are targeting these problems.  Sleepnea's long-term mission includes development of masks that are more comfortable, fit better, leak less, and are less prone to dislodging from head-to-pillow interaction than are currently-available masks, thereby improving patient compliance and reducing the adverse health effects of OSA. 

There are alternative approaches to treatment of Obstructive Sleep Apnea (OSA) that are not based on airway pressure and masks.  These approaches include: surgical removal or shaping of soft tissue along the airway; surgical implantation of anchors, sutures, stents, or fibrous members within soft tissue; neuroelectrical stimulation of soft tissue muscles (such as to cause contraction of the tongue); movement of soft tissue by the interaction of implants within that tissue via a magnetic field; external positioning of the sleeper's head and/or body by specially-shaped pillows or other body-positioning members; devices that cause forward movement of the jaw; and devices that hold the tongue in a forward position by means of suction or tissue piercing members.  All of these approaches have limitations. 

Sleepnea's intellectual property portfolio also includes innovative devices and methods for non-invasively engaging the tongue to: prevent the tongue from moving backwards into the airway during sleep; and/or move the tongue forwards out of the airway if it does move backwards during sleep.

________

1.  H. Wang et al., "Influence of Obstructive Sleep Apnea on Mortality in Patients with Heart Failure," Journal of the American College of Cardiology, 2007, Vol. 49(15), 1625-1631.

2.  Wolkove et al., "Long-Term Compliance with Continuous Positive Airway Pressure in Patients with Obstructive Sleep Apnea," Canadian Respiratory Journal: Journal of the Canadian Thoracic Society, 2008, October; 15(7), 365369.

3.  Weaver et al., "Adherence to Continuous Positive Airway Pressure Therapy: The Challenge to Effective Treatment," The Proceedings of the American Thoracic Society, 2008, 5, 173-178. 

4.  Sopkova et al., "Predictors of Compliance with Continuous Positive Airway Pressure Treatment in Patients with Obstructive Sleep Apnea and Metabolic Syndrome," Wiener Klinische Wochenschrift, Vol.121, No. 11-12, June, 2009, 398-404

Disclaimer: These products are not yet approved by the FDA 
and are not available for patient care.

Obstructive Sleep Apnea / Sleepnea: Company / Sleepnea: Technology
Sleepnea: Team / Sleepnea: Contact Us
© 2010 Sleepnea LLC