A six-person team in the suburbs of San Jose built a 30-minute surgery to keep your airway open while you sleep. No mask required.
The reversed-out AIRLIFT wordmark - the brand a sleep surgeon sees on the tray right before they pull a tongue forward and quietly change someone's nights.
Somewhere right now, an ear, nose and throat surgeon is threading a suture, tugging a patient's hyoid bone a few millimeters forward, and tying it off. Thirty minutes, give or take. The patient will go home the same day. In a few weeks they will snore less, breathe better, and - if the numbers hold - sleep through the night for the first time in years. The instrument set on that tray came from a company of about six people in Los Gatos, California, called Siesta Medical.
Siesta Medical doesn't make a gadget you wear. It makes the implants and tools surgeons use to physically reopen an airway that collapses every night. The flagship is the AIRLIFT procedure, performed with the FDA-cleared Encore System and a little instrument with a big name: the Revolution Suture Passer. The whole pitch fits on an index card - move the tongue and hyoid forward, keep the airway open, let people breathe - and yet it took four rounds of FDA clearances and the better part of a decade to make it boringly reliable.
"With over 2,000 patients treated to date, the AIRLIFT has emerged as a leading procedure for providing robust and consistent results in treating OSA."
- Siesta Medical company materialsFour numbers that do the company's bragging so it doesn't have to.
Obstructive sleep apnea is absurdly common and absurdly under-treated. Tens of millions of adults stop breathing dozens of times an hour, every night, because the soft tissue at the back of the throat - the tongue base, the hyoid - falls back and seals the airway shut. The body jolts awake just enough to gasp, then does it again. The standard answer is CPAP: a mask, a hose, a machine that pushes air all night.
CPAP is excellent. It also sits in a drawer in a frightening number of bedrooms. People find it loud, claustrophobic, or simply easy to skip. That is the central tension Siesta Medical exists inside: the best non-surgical therapy only helps the people who use it, and a lot of people don't. Oral appliances help some. Nerve-stimulation implants help others. But for the patient whose airway collapses at the tongue base, there was a stubborn gap - and surgery to close it was historically fiddly, hard to adjust, and inconsistent.
"The Encore System can be used to treat airway obstructions without any patient restrictions regarding airway anatomy, body mass index, or obstructive sleep apnea severity."
- Siesta Medical, on the Encore indicationIn 2009, four medical-device veterans placed a contrarian bet. Where the industry kept chasing the next wearable or the next implant-and-forget device, they went after the surgery itself. The wager: if you could make tongue-and-hyoid suspension knotless, fully adjustable, and reversible, you'd turn an inconsistent operation into a predictable one - and surgeons would actually adopt it.
The cast was unusually patent-heavy for a company you could fit around a dinner table. Peter Martin, who'd been CTO and head of R&D at Paracor Medical, took the CEO seat. Erik van der Burg - 25-plus years in device development and more than 75 patents to his name - became chairman and CTO. Michael Kolber took regulatory and clinical research; Chris Feezor ran R&D. They raised a famously modest sum - about $1.93 million across two rounds - and then did the unglamorous part: clearance after clearance, study after study.
"Hyoid suspension with the Encore System is much simpler and provides a greater degree of control over the final result than previous products."
- On the 2014 FDA clearanceStrip away the acronyms and Siesta Medical sells a system, a procedure, and a tool that makes both go faster.
Integrated implants and instruments for hyoid and tongue-base suspension. Knotless, fully adjustable, and the only FDA-cleared system of its kind - no limits on anatomy, BMI, or apnea severity.
The ~30-minute outpatient surgery, done by ENT surgeons, that pulls the hyoid and tongue base forward so the airway stays open while you sleep.
A small instrument with an outsized job: passing and placing sutures precisely, which is what turns a finicky operation into a repeatable one.
The detail that engineers love and patients should: the implant is adjustable and reversible. The surgeon can fine-tune exactly how far forward the tongue is held, and undo it if needed. That is the difference between a permanent gamble and a controlled instrument.
Marketing language is cheap; apnea-hypopnea index is not. In a multicenter study of AIRLIFT hyoid suspension combined with palate surgery, the median AHI fell from 49.9 to 15.4 - a 74% reduction. Eighty-four percent of patients who arrived with severe sleep apnea left in the mild-or-moderate range. Translated out of clinician-speak: people who were choking dozens of times an hour were choking a fraction as often.
Lower is better. A 74% median drop, with 84% of severe patients improving to mild or moderate. Bars scaled to the pre-op value. Combined hyoid suspension + palate procedure cohort.
The proof isn't only in a journal. It's in the operating rooms of otolaryngologists - surgeons like those at Metropolitan ENT in Alexandria, Virginia - who keep reaching for the Encore tray, and in the 2,000-plus patients who've been through the procedure. For a company that never raised more than two million dollars, that adoption is the loudest thing about it.
"Snore less. Breathe more. Skip the machine. The whole company is six people and a very specific promise."
- The pitch, distilledSiesta Medical never scaled into a logo wall of executives. It stayed small on purpose - engineering- and regulatory-driven, the kind of team where the chairman holds 75 patents and the org chart is short enough to memorize.
The mission has barely moved since 2009: a simple, effective and lasting treatment for obstructive sleep apnea. In an industry that loves the word "disruptive," Siesta Medical's ambition is almost contrarian in its modesty - make one surgery work well enough, often enough, that it becomes ordinary.
Sleep apnea isn't getting rarer. As more people are diagnosed - and as more of them quietly abandon the mask in the drawer - the question Siesta Medical was built around only gets louder: what do you offer the patient for whom CPAP isn't working? A reversible, adjustable surgery that takes half an hour is a genuinely different answer than "try the mask again."
Go back to that operating room. The surgeon ties off the last suture, the tongue sits a few millimeters forward, and the airway that has collapsed every night for years now stays open. The patient wakes up in recovery, goes home, and - weeks later - sleeps. No hose. No hum. No drawer. That's the change a six-person company in Los Gatos has been quietly engineering, one cleared device at a time.
"Move the tongue forward. Keep the airway open. Let people breathe. Everything else is just paperwork - four rounds of it, cleared."
- Siesta Medical, in one breathContact: pmartin@siestamedical.com · info@siestamedical.com · +1 408-320-9424 · 101 Church St, Los Gatos, CA 95030