eXciteOSA Daytime Treatment for Snoring and Mild Sleep Apnea

eXciteOSA is a recently FDA approved daytime treatment for patients suffering from snoring or mild obstructive sleep apnea (OSA). Approved by the FDA on 2/5/21, this device is an intra-oral neuromuscular stimulator that is used 20 minutes per day for 6 weeks followed by twice a week resulting in significant reduction in OSA and snoring scores. Keep in mind that this device only addresses OSA and snoring due to tongue collapse (as opposed to obstruction that stems from the palate or large tonsils); this finding can be determined by transnasal endoscopy.

Of note, this is one of the very few bona fide FDA approved devices to treat snoring.

Please note that you are not a candidate if:
- if you have moderate or severe OSA (AHI > 15)

- you are under 18 years old

- you are pregnant or maybe pregnant.
- you have a pacemaker or implanted electrodes.
- you have dental braces or jewellery in your mouth.
- you are suffering from mouth ulcerations.
- you have gum disease or have bleeding from your gums or other oral conditions.
- you experience pain, numbness or bleeding after using this product.

Normal temporary side effects using this device include:
- accumulation of saliva
- tingling sensation on tongue

In a study of 65 mild obstructive sleep apnea patients, 79% of patients responded to therapy with a mean reduction of 52% in AHI (Apnea Hypopnea Index), a 50% reduction in ODI (Oxygen Desaturation Index), and a 3.9 point reduction in ESS (Epworth Sleepiness Scale).

Made by Signifier Medical Technologies, this device can be purchased with a doctor's prescription at: https://www.exciteosa.com

At this time, this device has an initial out-of-pocket cost of $750 followed by $95 recurring cost every 90 days. However, HSA/FSA can be used for the purchase of this device.

References:
Short-term electrical stimulation alters tongue muscle fibre type composition. Archives or Oral Biology 2007;52(6):544-551.

First results on daytime submandibular electrostimulation of suprahyoidal muscles to prevent night-time hypopharyngeal collapse in obstructive sleep apnea syndrome. International Journal of Oral and Maxillofacial surgery. 1999;28(1):21-5.

Sleep-related breathing disorder: 2—pathophysiology of obstructive sleep apnoea. Thorax. 1995; 50:797–804. (PubMed: 7570420)

Intraoral electrical muscle stimulation in the treatment of snoring. Somnologie. 2018; 22 (Suppl 2): 47–52. 

Daytime Intraoral Neurostimulation with eXciteOSA for Treatment of Snoring and Mild Sleep Apnea. CHEST Annual Meeting Notes. 2018.

A novel intraoral neuromuscular stimulation device for treating sleep-disordered breathing. Sleep and Breathing. 2021 Mar 26. doi: 10.1007/s11325-021-02355-7. Online ahead of print.