2026 Clinical Trials on Sleep Apnea Treatments in United States

Overview of Obstructive Sleep Apnea

Obstructive sleep apnea (OSA) is a condition marked by repeated lapses in normal breathing due to upper airway collapse during sleep. This disorder affects millions of adults in the United States and is associated with various health risks, such as hypertension, cardiovascular disease, and impaired daytime functioning. Diagnosis is typically confirmed through sleep studies, including polysomnography or home sleep apnea tests.

Current Research Trends in 2026

Research into OSA treatment in the United States encompasses both pharmacological interventions and device-based therapies. Investigations aim to better understand disease mechanisms and evaluate new treatment modalities.

Pharmacological Investigations

Recent clinical trials have focused on oral medications targeting neuromuscular control of the upper airway. One example includes ongoing Phase 3 studies evaluating an investigational combination of aroxybutynin and atomoxetine. This therapy seeks to influence upper airway muscle function as a potential approach to reduce airway collapse. These studies enroll adults with varying severities of OSA regardless of body mass index (BMI) and assess outcomes related to respiratory events and sleep quality.

Other pharmacologic research examines the role of metabolic agents in patients with OSA, particularly those with comorbid obesity. Medications initially developed for metabolic conditions, such as dual glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1) receptor agonists, have been studied for their impact on weight and apnea severity. However, these agents are not specifically approved for OSA treatment by the U.S. Food and Drug Administration, and research continues to clarify their clinical utility within integrated care models.

Device-Based Treatment Developments

Positive airway pressure (PAP) devices remain the most established therapy for OSA. In 2026, several studies focus on improving PAP technology to increase patient comfort and adherence. Innovations include automatic titration of expiratory positive airway pressure (Auto-EPAP) to adjust pressure settings dynamically based on airway obstruction patterns. Research conducted at institutions such as the University of California, San Diego has evaluated safety and effectiveness parameters for devices incorporating Auto-EPAP features.

Additionally, implantable devices and novel airflow modulation systems are under investigation. These devices aim to provide alternatives for patients who cannot tolerate or do not respond adequately to traditional PAP therapies. Ongoing clinical trials assess these technologies’ performance in reducing apnea–hypopnea index (AHI) scores and improving sleep architecture.

Selected Clinical Trials in United States (2026)

Clinical trial registries and academic medical centers report active studies addressing distinct aspects of OSA pathophysiology and treatment.

University of California, San Diego (UCSD)

• Do Endotypes Predict Response and Sequelae in OSA Patients?
  • Objective: To investigate various underlying causes (endotypes) of OSA and how they relate to symptoms such as daytime sleepiness and hypertension. The study also examines responses to diverse therapies including CPAP, sedative-hypnotics, and supplemental oxygen.
  • Eligibility: Adults aged 21 to 65 years.
  • Location: La Jolla, California.
• Auto-EPAP for Upper Airway Obstruction Management
  • Objective: To compare automatic and manual EPAP settings on the Vivo 45 LS Ventilator concerning safety and efficacy.
  • Eligibility: Adults aged 18 years and older.
  • Location: San Diego, California.

University of California, Los Angeles (UCLA)

• Endotypic Traits and OSA Surgery Outcomes
  • Objective: To evaluate factors influencing outcomes after surgical interventions targeting the soft palate and the effects of medications acting on specific physiological traits related to OSA.
  • Eligibility: Adults aged 21 years and older.
  • Locations: Santa Monica and other sites in California.
• Sleep Treatment in Stroke Management and Recovery
  • Objective: To determine the impact of positive airway pressure treatment initiated shortly after ischemic stroke on recurrent stroke rates, cardiovascular events, mortality, and functional outcomes.
  • Eligibility: Adults aged 18 years and older.
  • Location: Los Angeles, California.

Understanding Endotypes in OSA

Emerging research emphasizes the heterogeneity of OSA and identifies biological mechanisms termed endotypes. These include muscle responsiveness, arousal threshold, loop gain (ventilatory control stability), and pharyngeal collapsibility. Recognizing specific endotypes may provide insight into personalized treatment strategies by matching therapy type to underlying pathophysiology.

Epidemiology and Public Health Context

In the United States, estimates suggest that over 50 million adults have OSA, though many cases remain undiagnosed. The disorder is more prevalent in men and individuals with obesity. OSA has substantial socio-economic impacts, including increased healthcare usage and reduced workplace productivity. Public health initiatives continue to focus on early identification and comprehensive management approaches.

Typical Costs in United States (2026)

When considering obstructive sleep apnea diagnostic and treatment options in the United States, typical price ranges are as follows:

• Basic Diagnostic Testing: Approximately $150 to $300 for home sleep apnea tests; in-lab polysomnography can range from $1,000 to $3,000.
  • Suitable for initial diagnosis or confirmation of suspected OSA.
• Standard Treatment Devices: Continuous positive airway pressure (CPAP) machines generally cost between $500 and $1,500, including basic accessories.
  • Includes devices with standard pressure settings and standard mask options.
• Advanced Treatment Devices and Therapies: Auto-titrating PAP devices, bilevel PAP, and implantable devices may range from $1,500 to over $4,000.
  • May include specialized features aimed at comfort or for patients with complex conditions.

Medical management costs, including medications and clinical follow-up, vary widely depending on therapy type and insurance coverage.

Summary

Research into obstructive sleep apnea therapies in the United States during 2026 includes pharmacologic and device-based approaches. Clinical trials continue to examine how to optimize treatment according to underlying physiological traits and comorbidities. Understanding epidemiology, treatment modalities, and associated costs can inform patients, clinicians, and public health stakeholders managing this common sleep disorder.