The eXciteOSA by Signifier Medical Technologies is the first daytime therapy device, using Neuromuscular Electrical Stimulation (NMES), which has been clinically proven to target the root cause of snoring and mild obstructive sleep apnoea. However, there is also a high probability that in suitable patients, the eXciteOSA may reduce the severity of moderate-severe obstructive sleep apnoea which could result in lower CPAP pressures. Time will tell, and we shall be monitoring this as genuine feedback comes in, but in the meantime you can read genuine reviews on TrustPilot.

Why is it important to treat Snoring, Sleep Apnoea and UARS (Upper Airways Resistance Syndrome)?

Snoring is one of the most common signs of obstructive sleep apnoea, although not everyone who snores does have sleep apnoea, but if you do snore it is very important to check for signs and symptoms as untreated sleep apnoea can have serious medical consequences, and especially causing or exacerbating strokes, heart attacks, high blood pressure and driving accidents etc. Please see our information page about 'What Is Sleep Apnoea.' If you do suspect sleep apnoea please ask your GP for a referral to your local sleep clinic or you can even take our own diagnostic sleep study to check for sleep apnoea.

UARS has many of the signs and symptoms of sleep apnoea, but sleep study results show up below the criteria for a diagnosis and it does usually eventually progress into obstructive sleep apnoea with age, weight gain and loss of muscle tone. Please see our information page about Upper Airways Resistance Syndrome (UARS).

Even benign snoring needs addressing, as apart from the fact it causes disrupted and unrestful sleep (and for the bed partner) which affects how you feel during the day, there have been studies^1,2 stating that snoring can lead to cardiovascular disease even in people without sleep apnoea, due to it resulting in the thickening of the inner walls of the carotid arteries.

There are tips and products that can improve or even reverse snoring in combination with other tips and products like the eXciteOSA and can sometimes even help with sleep apnoea, as listed below, depending on the root cause, and the eXciteOSA is certainly a clinically approved device to target what is often the root cause - the tongue! 

Self-Help Tips for Improving Snoring and Sleep Apnoea:-

• Refraining from alcohol within 3-4 hours of bedtime.

• Avoiding any medication which causes the muscles to relax, like some anti-depressants, certain painkillers, sleeping pills, cold remedies etc - prescribed medications will need discussing with your GP before stopping.

• Sleeping on your side, as snoring and sleep apnoea is usually worse with back sleeping.

• Sleeping slightly elevated by raising the head of the bed by 4-6 inches.

• Ensuring the nasal airways are clear of congestion with the use of saline or prescribed nasal sprays  and/or nasal strips, nasal cones and oral strips. (Always read the label of over-the-counter sprays as many should only be used for a short time or can make things worse - especially when trying to come off them, which is known as the rebound effect).

• Mandibular devices (mouth appliances) to pull the jaw forwards. Whilst off-the-shelf cheaper devices can be tried, if needed long-term then it is advisable to have a bespoke one made by a dentist due to the risk of jaw ache and TMJ with an ill-fitting one.

• Losing weight if applicable.

^1.Snoring and carotid artery intima-media thickness
Robert Deeb MD, Paul Judge MD, Ed Peterson PhD, Judith C Lin MD, Kathleen Yaremchuk MD

^2.Objective snoring time and carotid intima-media thickness in non-apneic female snorers
Jinyoung Kim, Allan I. Pack, Barbara J. Riegel, Julio A Chirinos, Alexandra Hanlon, Seung Ku Lee, Chol Shin

Hope2Sleep Charity says:-

The unique selling point for the eXciteOSA for patients diagnosed with sleep apnoea or UARS (Upper Airways Resistance Syndrome) and using CPAP, a mandibular device or other forms of therapy, is that with this being a daytime device the prescribed therapy can (and should) still be used. If it is suspected that the eXciteOSA has achieved a cure for sleep apnoea or diagnosed and treated UARS, then a repeat sleep study should be taken to check, as it is never ever recommended to stop using CPAP or other form of therapy and leave sleep disordered breathing untreated, due to the many risk factors - see our information page for this. If it is noticed that the AHI reading has come down or the average pressure on the CPAP readings reduced, then it is advisable to discuss this with the sleep clinic to see if any changes to the settings are needed or a repeat sleep study carried out. 

We helped Signifier Medical, the manufacturer of the eXciteOSA (when the product was previously called Snoozeal) recruit participants to test the device before it went to market, and the results of improvements were encouraging, which has prompted us to add the product to our charity's stocklist. See the table below and additionally out of the 11 participants, 9 are still using the eXciteOSA, 1 stopped during the COVID-19 Lockdown but noticed how his results fell and just 1 person is no longer continuing use it:-

As the saying goes "no gain without pain" so although using the device isn't 'painful' it is necessary to use the eXciteOSA every day for 20 minutes for at least the first 6 weeks (remembering to adjust the intensity as required), and once any improvements have been achieved, then it is necessary to have at least a once a week regular maintenance regime (just like when maintaining physical fitness with exercise).

Try eXciteOSA Risk-Free*

Signifier Medical's Risk-free Trial

*Terms and Conditions of the Sleep Guarantee:

​You must start using the device within 1 x calendar week of buying eXciteOSA. For optimal results, you should use it every day for 6 weeks. However, we know that we are all only human and people forget things – so we ask that you use it for a total of 6 weeks (a total of 42 days) within an 8 week period (56 days). A session is equivalent to 20 minutes. In addition, it is recommended that you increase the therapy intensity gradually over the treatment period to ensure that you give the treatment every chance of being effective. Please note that once the initial therapy is finished and to maintain the treatment you need to use the device at least twice a week forever.

The mouthpiece is a precision piece of engineering responsible for delivering neuromuscular electrical stimulation targeted primarily at the tongue. It must be replaced every 3 months and, therefore, will not be refunded as part of the ‘try before you buy offer’. 

If you feel the eXciteOSA has not been beneficial, then please contact us before returning so that we can discuss your snoring and try to help and advise, and we may be able to suggest other options - even things we can't supply ourselves, as our mission at the charity is to support people with all forms of sleep disordered breathing, including benign snoring rather than being a commercial business only trying to sell products, and can often signpost you to other areas of expertise.

There are many gimmicky products invading the sleep market promising cures of snoring and sleep apnoea, which we stay well clear of, but the eXciteOSA is in no way one of these. In fact in February 2021 the FDA approved the eXciteOSA for the treatment of snoring and mild sleep apnoea and there have been studies proving its effectiveness with the following results:-

References:-

1. E.Wessoleck et al. Intraoral electrical muscle stimulation in the treatment of snoring. Somnologie (Berl). 2018; 22(Suppl 2): 47–52.
2. A.Sama et al. Daytime Intraoral Neurostimulation with Snoozeal® for treatment of Snoring and Mild Sleep Apnea. CHEST Annual Meeting Notes, 2018.
3. Clinical study of 115 patients with snoring or mild OSA (Apnea- Hypopnea Index (AHI) <15 n=65) completed the trial. Objective snoring and respiratory parameters were recorded with 2 consecutive WatchPat night sleep studies before and after the use of the device. An intra-oral tongue stimulator device was used for 20mins, once a day for 6-week period. (Internal publication by SMT for educational purposes and submission).

Clinical Evidence Video

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What is Neuromuscular Electrical Stimulation (NMES)? 

NMES is a non-invasive therapy which safely activates nerves, exercises and trains muscles. NMES is in no way a new technique and is well-established in both medicine and sports, including veterinary treatment. In fact there are currently 646 articles of study, research and discussion listed on the NICE (National Institute for Health and Care Excellence) website for many different medical conditions and the eXciteOSA aims to physiologically retrain the upper airway and tongue via NMES to stay in the natural position during sleep. 

Obstructive Sleep Apnoea (OSA) itself often has multiple causes, and a common one is the tongue and the upper airway muscles. Ageing, diet, and other contributors can lead to neuromuscular degeneration in these areas resulting or worsening of OSA. The same cause is responsible very often for benign snoring, which is why the eXciteOSA is a daytime treatment for snoring too.

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Signifier Medical Technologies say:-

Target the root cause - not the symptoms!

 

Sleep apnoea and snoring is a problem for many people whose tongue muscles relax during sleep, causing partial airway collapse. eXciteOSA® is the world’s first therapy to target the root cause of this problem.

 

Sleep better with eXciteOSA®

 

eXciteOSA® is the first daytime therapy proven to strengthen weak tongue muscles known to be the root cause of sleep apnoea and snoring.

 

 

Using eXciteOSA - just 20 minutes once a day for 6 weeks (followed by weekly maintenance therapy).

                                                               

When we sleep our tongue and throat muscles are known to relax and cause snoring. In some people, these over relaxed muscles cause the tongue to fall back in the mouth, partially blocking the airway and resulting in snoring. Snoring deprives the body of quality sleep and can also create problems in relationships, such as sleeping in separate rooms.

Loud snoring often indicates the first stages of a serious medical condition called sleep apnoea. Sleep apnoea causes the sleeper to stop and start breathing during sleep, often jolting them awake. Night after night of this, interrupted sleep can have a big impact on quality of life and health. In particular, there is a strong clinically proven link between sleep apnoea and comorbidities like diabetes hypertension and strokes.^1-7

 

References:-

1. Sleep-related breathing disorder. 1995 
2. Peppard et al. Prospective study of the association between sleep disordered breathing and hypertension. 2000
3. Gottlieb et al. Prospective study of obstructive sleep apnea and incident coronary heart disease and heart failure. 2010
4. Yaggi et al. Obstructive sleep apnea as a risk factor for stroke and death. 2005
5. Redline et al. Obstructive sleep apnea-hypopnea and incident stroke. 2010
6. Peker et al. Increased incidence of cardiovascular disease in middle-aged men with obstructive sleep apnea. 2002
7. Marin et al. Long-term cardiovascular outcomes in men with obstructive sleep apnea-hypopnoea. 2005

 

Now there is a new way to target the root cause of snoring and mild sleep apnoea.

eXciteOSA® is a daytime therapy that uniquely targets the root cause of snoring and mild sleep apnoea by using safe electrical currents to stimulate and improve muscle function in the mouth and tongue.

 

 

So that you regain good quality sleep and a healthier life.
The strengthened tongue muscle no longer blocks the airway at night, allowing for a restful night’s sleep. The body can rest, recharge and repair itself so that you can wake up bright, refreshed and ready to face the day.
 

 

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Using eXciteOSA

Before starting your therapy be sure to: check the silicone on the Mouthpiece is not cracked or broken before use. If there is any evidence of damage to the silicon – DO NOT USE THE MOUTHPIECE.

Before use, wash the Mouthpiece with cold and running safe-to-drink tap water as shown in Fig 4. Avoid water reaching the USB port. Dry with a clean towel.

To start using eXciteOSA, connect the Mouthpiece with the Control Unit as shown on Fig 5.

 

Insert the Mouthpiece into the mouth and allow it to sit around the tongue as shown in Fig 6. and gently close your mouth. Avoid grinding or clenching the Mouthpiece.

Using eXciteOSA with a SmartPhone App

eXciteOSA device can be controlled by the eXciteOSA Smartphone application which is highly recommended to keep track of progress.

In order for the eXciteOSA device to work, you need to allow Bluetooth connection and for iOS 13 or above you need to manually allow Bluetooth permission. (Always make sure that you have the latest version of the eXciteOSA App).

Full instructions are in the App and if you have any problems at all there is a 'chat' feature and Signifier Medical are very responsive and helpful.

Smartphone Apps can be downloaded from the App Store (Apple iOS) or the Play Store (Google Android).

   

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Included in the Box:

• Flexible Silicone Mouthpiece with Electrodes (which must be replaced every 3 months/90 days).

• USB-C type Connectors

• Control Unit with Bluetooth (with LED light under logo)

• USB Cable and Adapter with UK 3-pin plug (15cm cable)

​The Mouthpiece has a 90 day warranty and the Control Unit which power the Mouthpiece has a 1 year warranty.

Please see important notes below for 'after purchase' as a new Mouthpiece must be attached to the eXciteOSA for safety reasons. You can purchase the Mouthpiece separately or order a spare with your first order on THIS LINK.
 

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VERY IMPORTANT TO READ BEFORE PURCHASE

Contraindications:-

DO NOT USE eXciteOSA in the following circumstances:

• if you are pregnant or may be pregnant.

• if you have a pacemaker or implanted electrodes.

• if you have dental braces or jewellery in your mouth.

• if you are suffering from mouth ulceration or recent dental work.

• if you are under the age of 18 years old.

​Precautions:-

Consult your Doctor/Dentist if:

• you have gum disease or have bleeding from your gums or other oral conditions.

• you experience pain, numbness or bleeding after using this product.

• you have any nose, throat conditions and previous oral surgery

• you have any medical conditions or;
  - Facial skeletal abnormalities
  - Obesity (BMI greater than 35)

This device should NOT be used:

• as a cure for diagnosed moderate to severe obstructive sleep apnoea with a AHI of 15+ although it could improve the severity in the right circumstances. It must never replace the prescribed CPAP machine or other therapy (even for mild sleep apnoea) unless a repeat sleep study has proved the sleep apnoea has been cured and therapy is no longer needed.
   

• to treat central sleep apnoea as it will provide no benefit, unless you happen to be a snorer as well, as central sleep apnoea is not caused by obstructions in the airway.
   

• whilst asleep (device only to be used when awake).
   

• in contact with your head, neck, spine, chest, eyes, ears or any other parts of the body other than inside the mouth as instructed.

Common Expected Reactions:

• accumulation of saliva
• tingling sensation on tongue

Intended Use:-

eXciteOSA is intended as a daytime therapy for the reduction of snoring and mild obstructive sleep apnoea for patients over 18 years old, by strengthening tongue muscles via electrical muscle stimulation.

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VERY IMPORTANT TO READ AFTER PURCHASE AND USE

Medical Warning - Untreated Sleep Apnoea

We very much hope people achieve desired improvements, but if you are diagnosed and treated for obstructive sleep apnoea, please do not automatically assume it's safe to stop your existing CPAP or other therapy without having a repeat sleep study, as apnoeas and hypopnoeas can still happen without snoring - not everyone who snores has sleep apnoea, but also not everyone with sleep apnoea snores! Always speak with your sleep clinic before coming off therapy and ask if it's possible to have a repeat sleep study, or you can book our own sleep study for evidence which you can even take to your sleep clinic on THIS LINK. Likewise, if you are a snorer and suspect sleep apnoea (stopping breathing in between the snores) then please visit your GP for a sleep clinic referral or book our home sleep study, as untreated sleep apnoea has serious health consequences.

Replacement of Mouthpiece

Due to safety issues, the mouthpiece will function safely and as intended for 90 days. Beyond this period, the safety and functional performance of the mouthpiece is not guaranteed and places eXciteOSA users at undue risk, so to eliminate this risk the device will not function without a new mouthpiece attached on day 91 of each mouthpiece replacement. You can purchase a new mouthpiece on THIS LINK. 

Manufacturer's Warnings

To avoid the risk of electrocution, burns, fire or physical injury:

• The device is only to be used while awake. It should not be used while sleeping.
• Only the supplied products should be used together. Do not use attachments other than those recommended by the manufacturer.
• Discontinue use if the product appears damaged in any way.
• Never attach the Mouthpiece directly to a charging source other than the control unit provided.
• This device should only be charged using the USB Cable provided.
• Do not operate in close proximity (e,g. 3.4 feet) to a shortwave or microwave unit as other Electromagnetic equipment may produce instability in the simulator output.
• Always keep the Control Unit away from water.
• Unplug the Control Unit immediately if it falls into water.
• Never use a damaged USB Cable to charge the Control Unit.
• This product contains no user serviceable parts. Refer to “Warranty” and “Trouble Shooting” if appliance no longer works as expected.
• The device is only to be used as specified in this document.

To avoid the risk of physical injury:

• This device should not be used by persons:
  – children (under 18 years of age)
• eXciteOSA should be kept away from children and pets (choking hazard and electrical hazard).
• eXciteOSA to be used in a home or healthcare environment (or equivalent).
• eXciteOSA’s durable controller unit can be repurposed for use by multiple successive patients
• eXciteOSA’s disposable mouthpiece is for single patient use
• Do not use eXciteOSA when driving a vehicle or operating machinery and other
  equipment.
• When charging the device, keep away from all liquids.
• No modification of this device is allowed. Do not try to alter, trim or change any components of the device.
• The silicon on the Mouthpiece must be intact before use. If there is any breach of the silicon (including electrodes) – DO NOT USE THE MOUTHPIECE.

 

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Click Here to download the User Guide

Click Here to download Quick Start Guide

Click Here to download some Frequently Asked Questions

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ORDERS

Shipping

We try our best to ship all orders received by us Monday-Friday on the same working day if received before 12 noon, and more often than not orders processed before 3pm will be despatched the same day whenever possible.  Weekend or UK bank holiday orders are sent out the next working day.  An automated email is sent when products have been despatched so please check your spam box and add us to your safe senders list.  Also, if you do not receive an email confirmation, please check that you have typed the correct email address in your account.

All orders are sent via 1st class mail within the UK.  Masks and some other more expensive products are always sent via 'signed for' insured delivery and cannot be left in 'safe' places, but there is the option for an alternative shipping address when processing the orders. 

Delivery charges are worked out automatically by weight and you can clearly see the delivery charges before making a payment.  On the rare occasion delivery charges are miscalculated by the website, a refund will be sent, as it is not our policy to make money on postage charges and neither do we add the cost of delivery into the price and offer so-called  'free delivery' like some sites and Ebay pressurise sellers to do! 

Wherever possible with larger parcels, we try to re-use boxes to keep shipping costs down and protect the environment.

If a product is out of stock and the order contains multiple items, the 'in stock' items will be sent immediately and further items will follow upon arrival with no further postage charges incurred.  

Important for International Orders

We can ship most products internationally, but all prices are in UK British Pounds and if paying by debit or credit card the bank will automatically convert to the current conversation rate.  Likewise, if you choose the Paypal option, they will convert into your currency for you as payment is made.  

International orders are sent via tracked Airmail, and whilst we're happy to ship internationally, we cannot be held responsible for any delays at Customs at your end, or charges that may be added in your own country, such as customs fees and import tax on delivery, which are determined by your country’s import laws and are beyond our control. Therefore, it is the customer’s responsibility to pay these charges, and certain courier companies will not be able to deliver the goods to you without pre-payment of any charges. From our experience, it appears to be randomised as to which parcels incur extra charges, but please know that all accompanying paperwork is filled in correctly when shipping and there is nothing more we can do, as much as we'd like to.

If you purchase from us out of the UK or you move to another country after purchasing products, please be aware that the warranty for CPAP machines, masks and parts from the manufacturers are under warranty  with the manufacturer based in the UK, so you will be responsible for sending the product back to us and will need to pay postage to get the product back to you after exchange or repair, as the manufacturer will not pay for shipping in any country outside of the UK.

RETURNS

Masks, CPAP machines and and most other products are exempt from a refund or exchange unless faulty due to health and hygiene issues - as stated in our 'Terms and Conditions', and in particular due to the risk of cross contamination as they cannot be re-sold. The Consumer Contracts Regulations 28.(3)(a) confirms exemption as follows:-  "exemption in the case of a contract for the supply of sealed goods which are not suitable for return due to health protection or hygiene reasons, if they become unsealed after delivery."

Unopened (sealed) products in their original packing can be returned within 14 days for a refund of the product cost, but the purchaser is to pay the return postage, and we would advise retaining proof of postage. This excludes any faulty goods, for which postage will be reimbursed.  A full refund for the price of the product will be issued when received by us, less the original postage charges when the order was sent to you.

VAT DECLARATION/INFORMATION

Most of the products we sell are eligible for Zero Rated VAT in the UK, and in order to qualify, you should meet the criteria for the following HMRC VAT Declaration:-

1. You or the person you are purchasing on behalf of have "a condition that the medical profession treats as a chronic sickness, that is a long term health condition" (sleep apnoea and sleep disordered breathing, which require therapy, are such conditions).
2. "The goods or services are for the personal or domestic use of the customer."

Please note, you do not need to be registered as disabled or in receipt of any other benefits in order to be eligible for VAT relief - you only need to meet the criteria of the above 2 points.

We cannot advise on individual cases, but more information can be found on HMRC’s website under notice 701/7 on the following link  https://www.gov.uk/government/publications/vat-notice-7017-vat-reliefs-for-disabled-people. 

If you are not eligible for Zero Rated VAT then please make sure that the VAT Relief box in unticked so that VAT is applied to the order.

If you are purchasing on behalf of someone else who meets the above criteria, you must provide their name and address, and you will be prompted of this during the checkout process.

Customers living outside of the UK do not pay UK VAT charges, so please leave the the VAT Relief box ticked.  However, we cannot be held responsible for any additional costs incurred when the products reach your own country.

If you are purchasing with the intention of re-selling any products, you are liable to pay VAT on all products so you must untick the 'zero rate eligibility' box which will add VAT to your order.

Any products that our not eligible for zero rate VAT, will not display the VAT Declaration, and VAT will be added at checkout.