Millions of individuals in the UK struggling with obstructive sleep apnea (OSA) may soon have access to a new generation of treatments that offer alternatives to the commonly used, yet often uncomfortable, continuous positive airway pressure (CPAP) machines. OSA affects approximately 8 million people in the UK and occurs when throat muscles relax excessively during sleep, leading to temporary breathing cessations that deprive the brain of oxygen. This condition disrupts sleep and is associated with an increased risk of heart disease and stroke.
For decades, CPAP machines, which use a mask to keep the airway open, have been the standard treatment. However, more than half of patients discontinue use within a year due to discomfort or issues with the mask. Now, several new options are becoming available.
Emerging Therapies
Oral Appliances and Patches
A custom-fitted mouthguard, known as a mandibular advancement splint, can hold the lower jaw forward during sleep to maintain an open airway. This approach is effective for many with mild OSA. While private custom devices can cost between £700 and £1,500, some are available on the NHS.
A novel, non-invasive approach involves a small, stick-on patch worn under the chin. Developed by King's College London, the Zeus device uses electrical pulses to stimulate the hypoglossal nerve, which controls tongue muscles, preventing airway collapse. A 2023 study in eClinicalMedicine indicated that this patch reduced breathing interruptions by half in about 50% of participants. A larger trial is currently underway, with potential NHS prescription by 2027.
Implantable Devices
For more severe cases of OSA, implantable devices offer another solution. The Inspire device, available to NHS patients since 2023 for those with moderate to severe OSA and a BMI under 32, is a small, battery-operated unit implanted in the upper chest. It sends electrical signals to stimulate tongue and throat muscles, synchronizing with breathing patterns. While it has shown a 50% reduction in breathing interruptions in about two-thirds of patients, its use is limited, and private implantation costs around £40,000.
A newer alternative, the Genio device, is a smaller implant inserted through a single incision under the chin, stimulating two nerves that control the tongue. It receives power wirelessly from an external chip worn at night. Genio was fitted to its first NHS patients in December 2024 and is available at select specialist centers. A study published in the Journal of Clinical Sleep Medicine in 2025 found that approximately 60% of patients experienced at least a 50% reduction in breathing interruptions after one year.
Pharmacological and Digital Solutions
Weight-loss medication, such as tirzepatide (Mounjaro), has shown promise. US regulators have approved tirzepatide for OSA in adults with obesity, marking the first such approval globally. This treatment can reduce breathing interruptions by about half in obese adults with moderate to severe OSA.
Another promising development is a daily pill, AD109, which combines atomoxetine and aroxybutynin. This medication aims to keep tongue and throat muscles more active during sleep. A small study in the American Journal of Respiratory and Critical Care Medicine in 2023 reported a 45% reduction in breathing interruptions. Larger trials are ongoing, with potential US approval this year and UK availability anticipated by 2027.
Additionally, researchers at Imperial College London are developing a smartphone app called CPAP Buddy to help patients adhere to CPAP therapy by providing tips and support for common issues encountered during the initial treatment phase. Experts note that CPAP remains the only treatment capable of completely preventing breathing pauses by directly counteracting disrupted airflow.