In a pilot study of 15 patients, when negative pressure was created within a soft silicone collar on the neck, most had either a partial or excellent response.
A recent pilot study of 15 patients with obstructive sleep apnea suggests that continuous negative external pressure (cNEP) may one day be an alternative to CPAP. The system evaluated in the study, which is published in the Journal of Clinical Sleep Medicine, has been dubbed “aerSleep” by creator Sommetrics.
AerSleep is a soft silicone collar fitted over the neck and attached to an adjustable vacuum pump. The collar applies negative pressure that alters the spatial relationships of soft tissue structures in the airway to deter structural collapse, similar to the mechanism behind an iron lung.
“The concept of negative external pressure for airway maintenance is actually fairly old, but its application to its possible use in sleep apnea was actually developed by Dr Richard Rose from Sommetrics in order to create this device,” says study lead author Jerrold Kram, MD. “He had the vision to conceive of the fact that if we can prevent the airway from collapsing, it could be an additional option for treatment of sleep apnea.”
Kram, who is also on the board of the National Sleep Foundation, lead the design and execution of this pilot study. “The approach to the study is basically parallel to the way CPAP was tested in that we applied the external negative pressure and started it low, and increased it gradually looking for a response and trying to identify the ideal amount of pressure.”
Though it was a small study, Kram says it was encouraging to see the response to the cNEP system. Of the 15 subjects who underwent cNEP titration, 13 (87%) of them responded favorably with 9 (60%) of those having an excellent response.
On the other hand, there’s a lot more work to be done. Kram says, “We now need to go again and do studies where it’s used for more than one night to see if it remains effective, safe, and comfortable over time when the patient is at home and not being monitored and aided. There’s a number of practical and technical things that will help turn this from a one-night in-lab study into a long-term home use application—but the principles will stay the same.”
There is also still work to be done to ensure the design of the collar will be comfortable, fit well, and stay in place while the patient sleeps. “The creation and production of this collar is no small task. The technical requirements of creating this collar and having it fit and stay in place are actually challenging for the engineers,” Kram says.
Though it’s early still, Kram is optimistic that this device will ultimately be helpful for those who are struggling with CPAP compliance. “We know that despite its great efficacy, CPAP has had limitations in being embraced by the general population,” he says. “People dread the idea of having to wear a mask and use a machine with extra baggage. This removes something from over their face, and in its final form will be self-contained with an internal battery driven pump, so there’s no wires or electricity needed except for charging the battery.
“We think if it proves to be useable over a long period of time and remains efficacious, that it may be more acceptable as an option other than CPAP, at least for those who struggle to remain compliant with it.”
Dillon Stickle is associate editor of Sleep Review.
I would try it!
CPAP could provide a warm wet air. It will let throat more comfortable. AerSleep looks let mouth cavity are small. Does it can prevent the throat too dry after a night? Thanks!
I just read the article published on AerSleep and wondering if they are looking for testing sites? If so please provide the information that I would need. Thank you
Kala
Or patients could opt for oral appliance therapy(OAT) which keeps the tongue out of the airway and protects the teeth at the same time. After all, the teeth are the orthopedic support for the airway. with OAT, the patient can continue their breathing pattern; there is little risk of damage to the teeth(decay) as air from the CPAP dries the mouth causing changes in the pH of the saliva( we call this “cpap mouth”).
It would be nice to know what “favorable” and “excellent” response means.
I purchased a Winx system before they went out of business. While I have some issues with its performance, I was/am an overall happy customer.
Since they folded, I am no longer able to buy replacement mouthpieces. I continue to use the mouthpiece that came with my original unit. I can tell it is starting to get “old”.
The times that I don’t use it, I wake up tired the next day. I will probably go back to MAD’s. I unfortunately have a high tendency to rip the CPAP mask off in my sleep, and the machine noise bothers me, so I’m reluctant to get another CPAP anymore.
I hope someone revives Winx or offers a similar system back on to the market. Heck, I’d be happy to just buy the mouthpiece!
I am interested in more on this item what’s involved and so on