Obstructive sleep apnea (OSA) affects 30 million Americans (26% of adults 30–70) yet remains under-diagnosed — home sleep apnea testing (HSAT) accessibility has improved diagnosis rates but CPAP adherence remains the central clinical challenge. The 2-hour definition of PAP "adherence" (≥4 hours/night, ≥70% of nights) is met by only 50–60% of CPAP-prescribed patients, leaving a substantial population who need effective alternatives.
Inspire: Hypoglossal Nerve Stimulation
Inspire (upper airway stimulation): FDA-approved for moderate-severe OSA (AHI 15–65) in patients who have failed or cannot tolerate CPAP, without complete concentric palatal collapse (CCCP, assessed by drug-induced sleep endoscopy). The device senses breathing effort and delivers synchronized electrical stimulation to the hypoglossal nerve, advancing the tongue base and opening the pharyngeal airway. STAR trial (n=126, 12-month): 68% reduction in AHI, 70% AHI <15 (response), 85% of bed partners reporting no or mild snoring. 5-year follow-up: sustained efficacy (AHI reduction maintained) with minimal adverse events. The Zepbound (tirzepatide) OSA approval in 2025 adds pharmacological options — 62% AHI reduction in non-CPAP-requiring OSA patients — positioning GLP-1 agonists as the first medical therapy with meaningful OSA efficacy. For respiratory care facilities, our respiratory section includes CPAP and BiPAP supplies, masks, tubing, and humidifier components for PAP therapy management.
