Inclusion Criteria:  hypotonia obstructive sleep apnea on polysomnogram with AHI>=10 presence of at least one symptom of OSA (such as snoring 3 or more nights per week, daytime sleepiness, or hyperactive/inattentive behaviors)  Exclusion Criteria:  AHI <10 any reason why ssNPA may not be suitable Psychiatric, medical, or social factors likely to invalidate assessments, make adherence with ssNPA highly unlikely or make local follow-up at 8 weeks unfeasible Safe Continuous positive airway pressure therapy (CPAP) use is possible and tolerated Supraglottic airway collapse Distal airway stenosis Tracheobronchomalacia Active COVID 19 infection Need for anticoagulative therapy Bleeding disorder More than mild elevation of end tidal carbon dioxide (ETCO2) or transcutaneous carbon dioxide (TCO2) values >60 mmHg for >10% of sleep time Restrictive thoracic disorders Silicone, lidocaine, neosynephrine allergy