New Published Study Explores Cost-Effectiveness of Neuromuscular Electrical Stimulation for the Treatment of Mild Obstructive Sleep Apnea

Signifier Medical Technologies LLC (“Signifier” or the “Company”), a Boston-based medical technology company, announces that The International Journal of Technology Assessment in Health Care has recently published an exploratory analysis entitled “Cost-Effectiveness of Neuromuscular Electrical Stimulation for the Treatment of Mild Obstructive Sleep Apnea.” The study led by Drs. Shan Liu, Jan Pietzsch, and a collaborative research team explores the cost-effectiveness of using neuromuscular electrical stimulation (NMES) as a treatment option for patients with mild obstructive sleep apnea (OSA).

Recent estimates suggest that 55 million adults in the United States suffer from OSA, with over half falling into the mild range. Patients with mild OSA often experience a diminished quality of life compared to controls, and epidemiological analyses reveal increased risks of hypertension, diabetes, and abnormal fasting glucose among them. Despite the prevalence of OSA, the current standard of care, positive airway pressure (PAP) therapy, faces challenges such as low adherence and patient satisfaction, which creates a demand for alternative OSA treatment options.

The researchers in this study used a decision-analytic model to assess the incremental cost-effectiveness ratio (ICER) of neuromuscular electrical stimulation compared to no treatment and continuous positive airway pressure (CPAP) therapy. The analysis, conducted from the US healthcare system perspective, considered both direct medical costs and health outcomes measured in quality-adjusted life years (QALYs). The results of the exploratory analysis indicated that neuromuscular electrical stimulation may be a cost-effective treatment option for mild OSA compared to no treatment. Furthermore, it showed that neuromuscular electrical stimulation, depending on long-term adherence, may be preferred over CPAP therapy, suggesting that this alternative treatment approach could provide a valuable and more accessible option for individuals with mild OSA.

“We are excited to see the results of this study reinforce the potential of neuromuscular electrical stimulation as a revolutionary treatment option for individuals with mild obstructive sleep apnea,” states Mujtaba Chohan, Head of Finance & Chief of Staff at Signifier.

While CPAP therapy has been the standard treatment for moderate to severe OSA, it has long been plagued with low adherence and low patient satisfaction. With over 14,000 patients being prescribed eXciteOSA, and real-world data demonstrating strong adherence of patients using therapy over 80% of days, this simple, non-invasive NMES therapy allows patients to complete a session for just 20 minutes during the day, offering them the freedom to breathe naturally, all night long, on their own.

Senior author Dr. Jan B. Pietzsch, who directed the study, emphasized the significance of the findings, stating, “Our research provides important insights into the potential cost-effectiveness of using neuromuscular electrical stimulation for individuals with mild obstructive sleep apnea that are relevant for patients, clinicians, and healthcare payers.”

This study contributes to the ongoing efforts to improve the quality of life for individuals with sleep apnea by exploring innovative and more accessible treatment alternatives. As researchers continue to explore the cost-effectiveness of various treatments, patients and clinicians will benefit from a wider range of evidence-based options for managing obstructive sleep apnea.

About Signifier Medical Technologies

Signifier is a pioneer in addressing the root causes of sleep-disordered breathing. The Company is focused on developing and commercializing innovative and non-invasive solutions to help people breathe normally and naturally all night – without needing to use a wearable medical device or a surgical implant. Founded in 2015, Signifier is at the forefront of sleep therapy, with a mission to develop therapies to improve population health, increase the quality of patients’ healthcare experience, and generate healthcare savings. Signifier has offices in London (UK) and Needham (Massachusetts, USA).

About eXciteOSA®

eXciteOSA is a revolutionary daytime therapy for sleep-disordered breathing. Clinically proven to target a common root cause of OSA, eXciteOSA uses NMES to “exercise” the upper airway muscles, working the intrinsic and extrinsic tongue muscles to improve endurance and prevent airway collapse during sleep. Unlike other devices that are used while patients sleep, eXciteOSA is the first commercially available device used while awake.
Signifier is dedicated to engaging with the sleep research community to produce high-quality evidence from rigorous clinical trials.

To learn more about eXciteOSA, please visit or


Jay Cranston
Signifier Medical Technologies LLC

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