Researchers examine every night without fail straps on a mask that prevents him from repeatedly waking up, gasping for air. It is been his routine since he was diagnosed with a condition called sleep apnea. While it helps, he does not like wearing the mask. It's been two decades since doctors fully recognized that breathing that stops and starts during sleep is tied to a host of health issues, even early death, but there still isn't a treatment that most people find easy to use.
Airway pressure masks, the most common remedy, have improved in design, getting smaller and quieter, but patients still complain about sore nostrils, dry mouths, and claustrophobia.
New ways of conquering sleep apnea, and the explosive snoring that comes with it, are vying for a place in the bedrooms of millions of people craving a good night's sleep. Products range from a $350 restraint meant to discourage back sleeping to a $24,000 surgical implant that pushes the tongue forward with each breath.
In people with the condition, throat and tongue muscles relax and block the airway during sleep, caused by obesity, aging or facial structure. They stop breathing, sometimes for up to a minute and hundreds of times each night, then awake with loud gasping and snoring. That prevents them from getting deep, restorative sleep.
They are more likely than others to have strokes, heart attacks, and heart rhythm problems, and they are more likely to die prematurely. But it's hard to tease out whether those problems are caused by sleep apnea itself, or by excess weight, lack of exercise or something else entirely.
For specialists, the first-choice, most-studied remedy remains continuous positive airway pressure. It's a motorized device that pumps air through a mask to open a sleeper's airway. Sleep medicine is a relatively new field. The most rigorous studies are small or don't follow patients for longer than six months, guidelines panel that reviewed sleep apnea treatments before recommending against screening adults who have no symptoms.
Researchers are now focused on how to get people to use a mask more faithfully and predicting who is likely to abandon it and could start instead with a dental device.
A pacemaker-like device that stimulates a nerve to push the tongue forward during sleep. Now, more than 3,000 people worldwide have received the Inspire implant. Infections and punctured lungs have been reported; the company says serious complications are rare.
As the search for better treatments continues, listening to patients will be key. They are just treating a very tiny percentage of people effectively.