While checking recent sleep e-mail alerts, I came across a headline that caught my attention, “28 years later, and CPAP still best treatment for apnea.” In the article, Susan Harding, MD, medical director of the University of Alabama at Birmingham Sleep/Wake Disorders Center and professor of medicine, said, “I think all of us are surprised that CPAP is still the best treatment we have for sleep apnea.” Could 2010 be a year when the sleep industry sees something different, yet as effective in terms of treatment? Using 2009 as an indicator, we can see that there is a push to tap into the lucrative market of sleep apnea treatment.

In 2009, we saw the introduction of PROVENT Professional Sleep Apnea Therapy, a noninvasive treatment for OSA. The product uses a MicroValve design that attaches over the nostrils and is secured in place with hypoallergenic adhesive. The MicroValve opens and closes, redirecting air through small holes to create resistance when breathing out. Thinking back to the early days of oral appliances, Philip Westbrook, MD, emeritus professor of medicine at UCLA and Ventus Medical’s chief medical officer, said, “For 25 years, there has been nothing new in terms of the approaches to treat patients. So this to me is a very exciting breakthrough.”

ImThera’s aura6000 neurostimulation system for the treatment of OSA was also showcased in 2009. The aura6000 system uses an implanted electrode and pulse generator to deliver muscle tone to key tongue muscles, preventing the tongue from collapsing into the upper airway, and thus permitting normal breathing during sleep. The product is undergoing clinical trials.

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In another move toward a new OSA treatment, Cortex Pharmaceuticals Inc proceeded with clinical development of CX1739, a pharmaceutical for the treatment of sleep apnea. The UK’s Medicines and Healthcare products Regulatory Agency gave Cortex Pharmaceuticals permission to proceed with the clinical development of CX1739 in treating subjects with moderate to severe sleep apnea.

After more than 2 decades of relative silence in the development of new approaches to OSA treatment, 2009 saw a push for different modalities. These developments are evidence that entrepreneurs are seeking out alternative approaches. No doubt, the inertia for new development still exists. Perhaps 2010 will be the year when effective, game-changing treatments for OSA will alter the market and patient care.

—Franklin A. Holman,
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