If CPAP isn’t working for you, it’s not your fault. It may be time to consider a therapy such as Nyxoah Genio.
After more than 20 years of treating patients with obstructive sleep apnea (OSA), I’ve met countless people who thought CPAP was their only option. When they can’t tolerate the CPAP mask, the pressure, or the sleepless nights, they believe they’ve failed. That’s not true, of course. It’s just the treatment wasn’t right for them.
Here’s what I tell my patients: sleep apnea treatment isn’t one-size-fits-all, and if one approach doesn’t work, there are others that can. The Nyxoah Genio (Genio) system, which the FDA approved in August 2025, gives us a new therapy to help patients who’ve struggled with traditional treatments and I’m happy to share more about it in this article.
What is Genio and How Does it Work?
Genio’s approach to OSA treatment that’s somewhat similar to others, but with some important differences.
Obstructive sleep apnea is caused by collapse of your airway while you sleep. This can include the palate, tongue and even the side walls of the throat. Genio works by stimulating the hypoglossal nerve, which controls your tongue muscle, to cause the tongue to shift forward. In most cases, this keeps your airway open throughout the night.
How Genio works
A small neurostimulator is implanted under your chin. Every night, you attach an activation chip to a patch under your chin. The chip wirelessly powers the implant, controlling the stimulation. In the morning, you remove the patch and charge it for the next night’s sleep.
Who is a Candidate for Nyxoah Genio?
The FDA approved Genio for patients with moderate to severe OSA, specifically, those with an Apena-Hypopnea (AHI) between 15 and 65 events per hour.
In my practice, we will consider Genio for patients who:
- Can’t tolerate CPAP therapy
- Haven’t found CPAP effective
- Want an alternative to nightly mask use
- Meet the anatomical and health requirements
- Have concentric airway collapse
- Prefer an external generator and battery rather than an implanted one
Not everyone’s a candidate for Genio therapy, so speaking with a sleep medicine specialist is your next step.
The Research Behind Nyxoah Genio
The DREAM study (NCT03868618), which was submitted to the FDA as part of the Genio approval process, tracked 115 patients across the United States, Australia, Belgium, and Germany. The results were promising: 63.5% of study patients saw their AHI drop to acceptable levels, and 71.3% had significant improvement in oxygen levels during sleep. The median AHI reduction was more than 70%.
The study revealed another important finding: Genio functions effectively regardless of sleeping position. Even for back sleepers, where sleep apnea is usually worse, this is a promising result.
Will it work for everyone? No. Like Inspire, there will be patients who do not achieve adequate improvement in their sleep apnea.
How Does Genio Compare to Inspire?
There are some important differences from the Inspire device, which also stimulates the tongue to move forward to keep the airway open. The first and most significant is that Genio stimulates both sides of the tongue rather than just one side.
Second, the generator component that powers it is worn externally with an adhesive patch under the chin, whereas with Inspire, the generator is implanted. This means that the Inspire device does not need daily charging but will require a procedure in 10-12 years to replace the generator and battery.
Third, the Genio device can be placed without performing an examination of the airway during sleep. This is required with Inspire.
Finally, Genio can be implanted in individuals with a concentric collapse pattern. With Inspire, patients with this pattern of collapse are not candidates for their technology.
What to Expect from a Genio Procedure
The Genio implant procedure is straightforward. It will be performed as an outpatient surgery under general anesthesia through a small incision below the chin. Most people will go home that day and return to regular activities within a few days.
After four to six weeks of healing, the Genio implant will be turned on. Then we fine-tune the settings over a few visits to find the right stimulation level that keeps your airway open without disrupting your sleep.
Why This Matters
As I wrote at the beginning, I’ve been treating sleep apnea for over two decades, and watched patients struggle with limited options for too long. When CPAP fails, some people assume they have to live with poor sleep and the health issues that come with it. Knowing that people give up on treatments keeps me up at night; there’s real hope for them!
Here’s why it’s so important they don’t give up: untreated sleep apnea doubles your stroke risk and almost doubles your cardiovascular mortality rate. If that’s not enough to convince you, OSA contributes to high blood pressure, heart disease, diabetes, and cognitive decline. Quality sleep isn’t a luxury. It’s a must for good health and longevity.
Every patient I see has a unique situation. Some do well with CPAP. Others need surgical solutions. Some benefit from oral appliances. And now, some will find their answers with Genio.
The key is having options and a sleep doctor who will take the time to find the right approach for each unique patient.
The Bottom Line on Nyxoah Genio
If you’ve been told there aren’t alternatives to CPAP, that information’s wildly out-of-date. Sleep medicine advances quickly, and treatments like Genio expand our ability to help patients who haven’t yet found success with traditional approaches.
Sleep apnea treatment should work for your life, not against it. If you’re struggling with CPAP or feel like you’re out of options, it’s worth a conversation with a sleep specialist about the alternatives available to you.
References:
U.S. Food and Drug Administration. Approval of Genio® System for Treatment of Obstructive Sleep Apnea. August 8, 2025. Based on DREAM trial data (NCT03868618).
“Understanding Your AHI Score.” WebMD, WebMD LLC, www.webmd.com/sleep-disorders/sleep-apnea/sleep-apnea-ahi-numbers. Accessed 10 Oct. 2025.
This post is for educational purposes only. Every patient is unique, so please consult with Dr. Weiner or your healthcare provider for personalized medical advice tailored to your specific needs.