Vivaer
Vivaer is a proprietary procedure that uses low-temperature radiofrequency energy to remodel tissue in the nasal valve — the narrowest part of the nasal airway. It targets a specific and commonly missed cause of nasal obstruction, and it is worth being clear that it treats the nose rather than sleep apnea itself.
The nasal valve is a specific site
The internal nasal valve is the narrowest segment of the nasal airway, and because resistance rises steeply as a passage narrows, a small reduction here produces a disproportionate increase in the work of breathing. Nasal valve collapse — where the sidewall draws inward on inspiration — is a distinct problem from a deviated septum or enlarged turbinates, and it is regularly missed because examination at rest looks unremarkable. A useful indication is whether breathing improves when you pull the cheek outward or use an external nasal strip.
What the procedure involves
It is performed in a clinic setting under local anaesthetic. A handpiece delivers controlled low-temperature radiofrequency energy to the tissue of the nasal valve, causing it to contract and remodel so the sidewall becomes stiffer and less prone to collapse. It takes around fifteen minutes, involves no incisions, no packing and no external change to the nose, and most people return to normal activity the same day.
Where it fits in sleep care
It treats nasal obstruction — that is its claim and the extent of it. That matters for sleep because nasal obstruction drives mouth breathing, which worsens airway collapsibility, and because it is a leading reason CPAP is abandoned and a reason oral appliances underperform. Improving nasal patency frequently makes another treatment tolerable or effective. Presented as a treatment for obstructive sleep apnea it would be overstated, and improvements in the apnoea-hypopnoea index from nasal treatment alone are generally small.
Who assesses and who performs it
Nasal airway assessment is an ENT matter, and identifying which component of nasal obstruction is dominant — septum, turbinates, valve, or mucosal inflammation from allergy — determines which treatment is appropriate. Our role is recognising that nasal obstruction is undermining airway treatment and ensuring it is assessed rather than worked around. Where allergic rhinitis is the driver, medical management should be optimised before any procedure is considered.
Common questions
- Will this cure my snoring or sleep apnea?
- Not on its own. It improves nasal breathing, which can reduce snoring and often makes CPAP or an appliance work considerably better. Nasal treatment alone produces small changes in the apnoea-hypopnoea index in most studies.
- How is it different from septoplasty or turbinate reduction?
- Those address different structures — a deviated septum and enlarged turbinates respectively. Vivaer targets the nasal valve. Which is right depends on where your obstruction actually is, and more than one can coexist, which is why proper ENT assessment comes first.
- How long does the benefit last?
- Published follow-up out to around two years reports maintained improvement in most patients. Longer-term durability data are still accumulating, and results vary with the cause and severity of the original obstruction.
Not sure where to start?
Request a virtual consultation with Dr. Samadian. In-person visits are by appointment in New York.
Book An AppointmentRelated Care
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- Home Sleep StudyDiagnosis in your own bed.
- Nasal BreathingWhy the nose decides how the night goes.
- Myofunctional TherapyRetraining the tongue and airway muscles.
- Lingual FrenectomyReleasing a tongue tie that limits the airway.
- NightLaseLaser tightening of soft palate tissue.