What is Remede therapy?
Remede is an FDA-approved, implanted treatment for central sleep apnea — a less common form of apnea in which the brain briefly stops sending the signal to breathe. Unlike obstructive sleep apnea, where the airway physically collapses, in central apnea the airway is open but the effort to breathe pauses. Because there's no blockage to hold open, mask-based and airway therapies don't always solve it.
During a minor procedure, a physician places a small device under the skin near the collarbone — much like a pacemaker — with a thin lead to the phrenic nerve, which controls the diaphragm. While you sleep, Remede senses pauses in your breathing and gently stimulates that nerve so the diaphragm contracts and a normal breath happens. It's a different therapy from Inspire, which treats obstructive apnea by stimulating the airway muscles.
How it works
Senses your breathing
The implant continuously monitors your breathing pattern through the night and detects the pauses of central apnea.
Stimulates the phrenic nerve
When it detects a pause, it delivers a gentle signal to the phrenic nerve — the nerve that drives your diaphragm.
Restores a normal breath
The diaphragm contracts and a steady, natural breath follows — helping keep your oxygen and sleep on track.
Works automatically
There's no mask and no nightly remote to operate — therapy turns on while you sleep and off when you wake.
Who qualifies?
Remede is for a specific group of patients, and candidacy is decided individually. General considerations include:
- Adults with moderate-to-severe central sleep apnea
- Central apnea confirmed on a sleep study
- Often alongside heart failure or atrial fibrillation
- Couldn't tolerate — or aren't a fit for — mask therapy
- Able to have a minor implant procedure
- Reviewed and cleared by your care team
These are general guidelines, not a diagnosis. Central sleep apnea is closely tied to heart and neurological conditions, so an evaluation looks at the whole picture before recommending any path.
What to expect
Risks & side effects
Remede is generally well tolerated, but — like any implanted device — it carries some risks and side effects. Because central sleep apnea is closely tied to heart health, your sleep physician and the implanting cardiologist will review all of them with you before you decide.
From the procedure
The device is implanted near the collarbone with a thin wire (lead) placed through a vein — much like a pacemaker — so there can be temporary pain, swelling, or bruising at the site, and a small risk of bleeding, infection, or the lead needing repositioning. Serious complications are uncommon, and your cardiologist reviews them in detail.
From the therapy
Some people feel the stimulation or a sensation near the implant, especially at first — usually mild, and often easing as we fine-tune the settings.
The implant is battery-powered and, like a pacemaker, will eventually need a minor procedure to replace the generator; your care team plans for this over time. It also has specific MRI considerations your care team will explain, and it works best with ongoing follow-up — which is why the evaluation, activation, and long-term tuning we provide, in coordination with your cardiologist, matter so much.
Remede vs. mask therapy
CPAP and ASV (adaptive servo-ventilation) masks are often tried first for central apnea. They help many people — but not everyone tolerates them, and mask therapy isn't the right fit for every patient, particularly with certain heart conditions.
Remede
An implanted, mask-free therapy that works automatically. An option for qualifying central-apnea patients — including some for whom mask therapy isn't suitable.
CPAP / ASV
Mask-based airflow therapies, usually the first approach for central apnea. Effective for many when tolerated, and a reasonable place to start.
Whether mask therapy or Remede fits depends on your specific diagnosis and heart health — which is exactly what an evaluation sorts out. Learn more about sleep apnea overall.