What Signifier Medical Technologies does

Signifier Medical Technologies is a privately held medical device company founded in 2015 and headquartered in London, with commercial operations in the United States (Needham, MA) and Germany (Berlin). The company develops and commercialises eXciteOSA, a daytime, intraoral neuromuscular electrical stimulation (NMES) device that targets the genioglossus muscle for 20 minutes per day to improve upper-airway muscle endurance and prevent airway collapse during sleep. The product is the first FDA-authorised daytime therapy for mild obstructive sleep apnea (OSA) and primary snoring, having received FDA De Novo clearance in February 2021, EU MDR certification in February 2025, and dedicated HCPCS reimbursement codes (E0490/E0491).

The company's offering comprises the eXciteOSA hardware device, a smartphone companion application for adherence and remote monitoring, and a web-based clinician portal. Signifier monetises primarily through hardware sales to patients, routed via durable medical equipment (DME) suppliers, sleep specialists, pulmonologists, ENT physicians, and dentists across the US, Canada, the UK, and Germany. Reimbursement coverage under US Medicare/Medicaid (with state-level Medicaid coverage in Georgia and South Carolina), UK NHS Supply Chain, and private insurers is a critical revenue enabler. As of June 2024, more than 15,000 patients had been prescribed the therapy and the company recorded its largest commercial order — 10,000 units from US distributor Spectrum Sleep Solutions Inc.

Signifier has raised approximately $58 million across disclosed funding rounds (Series B of $13M in June 2019, $10M in September 2020, and a Series C of $35M in July 2021), supplemented by a $49 million secondary share purchase by Waha Capital, Angelus Sano, and Segulah Medical Acceleration in March 2022. The company employs 11–50 staff and operates a sales-led, channel-partner-enabled go-to-market model targeting healthcare professionals, with marketing focused on clinical publications, KOL webinars, and major investor/medtech conferences.

Name

Signifier Medical Technologies

Legal name

Signifier Medical Technologies Limited

Website

https://signifiermedical.com

Company type

Private

Founded year

2015

Operating status

Operating

Headcount range

11–50 employees

Short description

Signifier Medical Technologies is a UK-based medical device company that develops and commercialises eXciteOSA, the first FDA-authorised daytime neuromuscular electrical stimulation device for treating mild obstructive sleep apnea and primary snoring, sold primarily through healthcare providers and DME channels in the US, UK, Germany, and Canada.

Ownership category

akta.pro rank

Product category

Sleep Apnea Medical Devices

NAICS

Electromedical and Electrotherapeutic Apparatus Manufacturing (334510)

SIC

Electromedical & Electrotherapeutic Apparatus (3845), Surgical & Medical Instruments & Apparatus (3841)

akta.pro primary industry

Sleep Apnea Therapy Devices (CPAP/APAP/BiPAP/ASV) (HLAHAGAA)

akta.pro secondary industries

Neurological Monitoring (EEG, Seizure/Sleep/Neuro Wearables) (HLAHACAE), Sleep & Airway Orthodontics (OSA Appliances/Expansion) (HLABABAI), Respiratory & Sleep RPM (COPD, asthma, sleep apnea) (HLALAFAB)

Keywords

• Daytime sleep apnea therapy
• Neuromuscular electrical stimulation devices
• Snoring treatment devices
• Intraoral tongue stimulation
• FDA authorized medical devices

Headquarters

HQ city

London

HQ country

United Kingdom

HQ region

Europe

Offices4 records

Markets served

GTM type

B2B

Offering type

Hardware or Manufacturing

Cost components

Technology or R&D, Marketing or Sales, Personnel, Operations, Supply Chain

Revenue model

1. eXciteOSA Device Sales: Signifier generates revenue through the sale of its eXciteOSA medical device, which is sold to patients through healthcare providers, DME suppliers, and distributors. The company has established reimbursement coverage through Medicare and Medicaid programs in the US, and NHS coverage in the UK.
2. Insurance Reimbursement: Revenue is supported by insurance reimbursement through Medicare (HCPCS codes E0490 and E0491), Medicaid programs (Georgia, South Carolina), and private insurers, enabling patients to access the therapy through their health coverage.

Pricing tiers

Go-to-market motion3 records

Distribution channels5 records

Marketing channels6 records

Core offering

Signifier Medical Technologies develops, manufactures, and commercializes eXciteOSA, the first FDA-authorized daytime therapy device for treating mild obstructive sleep apnea (OSA) and primary snoring. The device uses intraoral neuromuscular electrical stimulation (NMES) applied for 20 minutes per day during wakefulness to improve tongue muscle endurance, targeting the root cause of airway collapse rather than managing symptoms during sleep. The product ecosystem includes the hardware device (with a dedicated SKU 18010 variant featuring CMS-compliant remote control), a mobile companion app for adherence tracking, and a clinician portal for remote patient monitoring.

Product overview

Signifier Medical Technologies offers a single core product ecosystem centered on the eXciteOSA device—the world's first and only FDA-authorized daytime therapy for mild obstructive sleep apnea and primary snoring. The product portfolio consists of the eXciteOSA hardware device (SKU 18010 with hardware remote for CMS compliance), paired with a proprietary mobile application for patient engagement and a web-based clinician portal for remote monitoring. The therapy uses intraoral neuromuscular electrical stimulation to strengthen tongue muscles during 20-minute daytime sessions, addressing the root cause of airway collapse rather than merely managing symptoms during sleep.

Differentiator

Problem solved

Functional benefit

Brands

• eXciteOSA: Daytime therapy device for treating mild obstructive sleep apnea and snoring using neuromuscular electrical stimulation (NMES). The first FDA-authorized daytime therapy for primary snoring and mild OSA.

Products and services

• eXciteOSA Daytime Therapy Device The first FDA-authorized daytime therapy device using intraoral neuromuscular electrical stimulation (NMES) to improve tongue muscle endurance, targeting the root cause of mild obstructive sleep apnea and primary snoring. Used for 20 minutes daily during wakefulness for an initial 6-week therapy period, then twice weekly for maintenance. Designed for adults with mild OSA (AHI <15) or primary snoring who seek non-invasive alternatives to CPAP.
• eXciteOSA SKU 18010 with Hardware Remote Control Specialized product configuration of eXciteOSA featuring a dedicated hardware remote control designed to meet Centers for Medicare & Medicaid Services (CMS) durable medical equipment (DME) requirements, enabling Medicare and Medicaid reimbursement under HCPCS codes E0490 and E0491.

Quantifiable outcome

• 52% mean reduction in Apnoea-Hypopnoea Index (AHI) in responder subgroup (78% of patients)
• +6 more outcomes

Named customers7 records

Segments4 records

Ideal customer profiles3 records

Technology focussed Yes

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

Feature3 records

Partnerships

Three partnerships are on record, tiered core.

• Spectrum Sleep Solutions Inc.coreChannel Partner/ Reseller/ Distributor · 11 June 2024Spectrum Sleep Solutions, a leading home medical equipment provider in the US, placed a milestone order of 10,000 eXciteOSA devices - the largest commercial order in Signifier's history. The partnership supports distribution across US-wide commercial channels to expand patient access to eXciteOSA therapy.
• SunrisecoreGTM or Marketing Partner · 9 May 2023Signifier Medical Technologies partnered with Sunrise to capture the patient intake funnel and streamline the pathway from sleep apnea diagnosis to treatment. Sunrise revolutionizes home sleep testing for sleep apnea diagnosis, enabling Signifier to reach more patients through integrated diagnostic and treatment solutions.
• UK NHS (National Health Service)coreChannel Partner/ Reseller/ Distributor · 22 December 2020Signifier was awarded the UK Non-invasive Ventilation, Sleep Therapy and Sleep Monitoring Tender, confirming Signifier as an approved NHS supplier. This provides direct access to the NHS supply chain including relevant coding, inventory, and ordering systems for eXciteOSA distribution in the UK.

Scale indicators16 records

Recent moves7 records

Expansion highlights6 records

Broad incumbents

• ResMed: Global leader in CPAP and sleep-disordered breathing devices with deep payer relationships and a large installed base. Directly competes with eXciteOSA in OSA therapy and is the dominant benchmark against which adherence and reimbursement are measured.
• Fisher & Paykel Healthcare: Major respiratory care and OSA device manufacturer with CPAP, humidification, and nasal interface products. A broad incumbent competitor in the OSA therapy category alongside ResMed and Philips Respironics.

Direct peers

• Inspire Medical Systems: Markets an implantable hypoglossal nerve stimulation system for moderate-to-severe OSA. Competes with Signifier in the neurostimulation-for-OSA category and is a key comparable for evaluating NMES-based OSA therapies as an alternative to CPAP.
• Nyxoah: Belgian-listed developer of a hypoglossal nerve stimulation implant (Genio) for OSA. Closely comparable mechanism (neuromuscular stimulation of upper-airway muscles) to eXciteOSA, though delivered via an implanted device rather than daytime intraoral stimulation.
• ProSomnus Sleep Technologies: Manufactures precision oral appliance therapy devices for OSA. Directly competes with eXciteOSA in the CPAP-alternative space, particularly for mild-to-moderate OSA patients seeking non-invasive, non-CPAP options.
• SomnoMed: Global provider of mandibular advancement devices for OSA and snoring. Competes with Signifier for CPAP-intolerant and mild OSA patients, and overlaps in the dentist-prescribed channel.
• Oventus Medical: Developer of the O2Vent oral appliance platform for OSA and snoring. Comparable to Signifier as a non-CPAP, intraoral therapy competing for the mild OSA and primary snoring patient.

Emerging players

• ApniMed: Clinical-stage pharma-medtech company developing pharmacological and combination therapies for OSA. Relevant adjacent comparable as a non-device, alternative-mechanism OSA therapy pursuing the same CPAP-disenchanted population.
• Itamar Medical (ZOLL Itamar): Provider of WatchPAT home sleep testing devices that Signifier itself references in clinical data. Comparable as a connected, home-based sleep diagnostic and monitoring platform enabling the OSA diagnosis pathway.

Others

• LivaNova: Neuromodulation company with devices that electrically stimulate nerves (e.g., vagus nerve stimulation). Adjacent comparable for Signifier's NMES-based mechanism of action and the regulatory/clinical playbook for neurostimulation therapies.

Market position

Strengths5 records

Weaknesses5 records

Competitive moat5 records

Key risks7 records

Key highlights7 records

Customer concentration

• Xx.com/snoozeal

Compliance4 records

Revenue estimate

Valuation estimate

Number of profiles

Profiles12 records

Funding overview

Funding rounds3 records

Investors4 records

Funding detail is available on the Subscription and Enterprise plan.Contact sales →

M&A

Investments

M&A and investment is available on the Subscription and Enterprise plan.Contact sales →

Frequently asked questions about Signifier Medical Technologies