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Volume 13 No. 08
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Accepted Papers

Emerging Technologies

Evaluation of Continuous Negative External Pressure (cNEP) for the Treatment of Obstructive Sleep Apnea: A Pilot Study

Jerrold A. Kram, MD, FAASM1; Robyn V. Woidtke, MSN, RN1; Kenneth B. Klein, MD2; Richard M. Rose, MD3
1California Center for Sleep Disorders, Alameda, California; 2Endpoint, LLC, Bainbridge Island, Washington; 3Sommetrics, Inc., Vista, California

Study Objectives:

To determine if the application of continuous negative external pressure (cNEP) is effective and safe in individuals with obstructive sleep apnea (OSA) during an overnight in-laboratory sleep study.


A prospective, open-label pilot study in subjects with documented OSA recruited from the patient population at one sleep clinic. The intervention was application and titration of cNEP during overnight polysomnography.


Of the 15 subjects studied (mean apnea-hypopnea index [AHI] at baseline, 43.9 events/h), 13 (87%) were responders to cNEP: 9 had an excellent response (AHI < 5 events/h) and 4 had a partial response (AHI < 50% baseline and < 15 events/h). Three minor, self-limited adverse events occurred, which appeared related to contact pressure of the cNEP device on the skin.


In this pilot study, cNEP appears to be safe and effective during short-term use in subjects with OSA. Further studies are warranted.


Kram JA, Woidtke RV, Klein KB, Rose RM. Evaluation of continuous negative external pressure (cNEP) for the treatment of obstructive sleep apnea: a pilot study. J Clin Sleep Med. 2017;13(8):1009–1012.

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