When Maria Chen, a 52-year-old teacher from Ohio, tried using a CPAP machine for her sleep apnea, she couldn't tolerate the constant air pressure and noisy motor. She stopped using it after three months and felt stuck.
"I was tired all the time, but I didn't know what else to do," Chen said.
Stories like hers are incredibly common, according to researchers at the University of Chicago Medicine. They estimate that more than 80 million U.S. adults live with obstructive sleep apnea, a condition where the soft tissue at the back of the throat collapses during sleep, blocking breathing and lowering oxygen levels. This not only ruins sleep quality but also increases the risk of serious health problems like diabetes and heart disease.
"We all know how bad it feels when we sleep poorly, but obstructive sleep apnea is a silent danger we don't talk about enough," said Dr. Neil Kondamuri, an ear, nose, and throat resident physician at the University of Chicago Medicine who led a new study on the topic.
The standard treatment involves a CPAP machine that sends air through a mask to keep the airway open. While it works well, many patients find these devices noisy, uncomfortable, or just too much hassle to use every night.
"We see people every single day who don't like their PAP machine and say they are not using it," Dr. Kondamuri said. "If it's such a poorly tolerated treatment option, we need another treatment that can provide similar or better downstream benefits."
His research, published in the medical journal JAMA Otolaryngology–Head & Neck Surgery, looked at an alternative called hypoglossal nerve stimulation, or HGNS. This involves a small surgical implant that connects to the tongue nerve and monitors breathing. When a person inhales during sleep, the device gently stimulates the tongue nerve, pushing the tongue forward so it doesn't fall back and block the airway.
Dr. Kondamuri and his team compared data from nearly 3,400 patients who received the HGNS implant against nearly 120,000 patients with sleep apnea who couldn't reliably use a CPAP machine. The results were striking: patients with the implant were less likely to be diagnosed with new cases of diabetes or high blood pressure within just two years.
"Studies demonstrate that if patients are not using PAP consistently and regularly—five to six hours per night most days of the week—they may not see the benefits we demonstrate with HGNS in preventing downstream health risks," Dr. Kondamuri explained.
While the study period wasn't long enough to measure long-term heart outcomes like heart failure or coronary artery disease, the researchers saw encouraging signs that those risks are also declining. This is the first rigorous study showing that HGNS may help prevent both high blood pressure and diabetes.
Dr. Kondamuri hopes future research will confirm the long-term heart benefits and explain exactly how the implant leads to these improvements. For now, he wants patients to know that multiple treatment options exist.
"If you feel your PAP machine does not help you feel rested or you just want to hear about alternative options, talk to a sleep-trained ear, nose, and throat specialist about what other treatments might work specifically for your anatomy and preferences," he said.
For the millions of people struggling with sleep apnea and hating their machines, this research offers genuine hope that better nights—and better health—may be closer than they think.