Dr. Kezirian’s Blog

I am writing from our 28th Annual Advances in Diagnosis and Treatment of Sleep Apnea and Snoring course in Orlando, Florida. This is our first in-person course since 2019, and it was wonderful to be together. I do think more and more educational events will be offered virtually, as it increases access for people who… Read more »

Continuous positive airway pressure (CPAP) is the first-line treatment for obstructive sleep apnea (OSA) in almost all patients in my practice. There are rare cases where I may order mandibular respositioning devices (aka, oral appliances), but CPAP is the primary option, even in patients who specifically request surgical treatment. CPAP has many advantages over alternatives,… Read more »

Surgery for obstructive sleep apnea often involves surgery of the throat that removes, repositions, and/or tightens tissue. Although the goal is to improve or eliminate the sleep apnea, the risks include the potential to disrupt normal function, especially speech and swallowing. Fortunately, speech changes have always been rare, but changes in swallowing have always been… Read more »

Thanksgiving is a time to reflect on our good fortune and express gratitude with family and friends. What a perfect time to express appreciation to current and former fellows who continue to invigorate me with their enthusiasm, intellect, and curiosity. This September at our International Surgical Sleep Society meeting in Philadelphia, I was delighted to… Read more »

Upper Airway Stimulation (Inspire Medical Systems, Golden Valley, MN, USA) is an excellent treatment option for many patients with moderate to severe obstructive sleep apnea who are unable to tolerate positive airway pressure therapy (for example, CPAP or BPAP) well. There are a number of specific criteria to determine whether a patient is eligible for… Read more »

I just returned from a trip to Philadelphia for the back-to-back meetings of the International Surgical Sleep Society and American Academy of Otolaryngology – Head and Neck Surgery. Coming together in-person with long-time colleagues who are also friends to share experiences and ideas was wonderful. A great deal of the meeting was focused on neurostimulation,… Read more »

Twitter and other social media platforms are tremendous resources for sharing information about sleep disorders. I do not pretend to be a social media expert, so I apologize for my simplistic explanations or mistakes here. Patients and health care providers may rely on information available on the Internet (I know I sometimes do). Hashtags allow… Read more »

Drug-induced sleep endoscopy has demonstrated clearly that the epiglottis can play an important role in obstructive sleep apnea in about 5-10% of patients. Surgical treatment approaches suggest that that treatment of the epiglottis specifically can provide substantial improvement in these cases. Multiple procedures have been proposed as options in cases of epiglottis-related obstruction; two of… Read more »

When patients with obstructive sleep apnea cannot tolerate positive airway pressure therapy (e.g., CPAP), they should consider other treatment options, including surgery and oral appliances. My career has focused on the surgical evaluation and treatment of obstructive sleep apnea and snoring. When I started in this field, the main surgical option was traditional uvulopalatopharyngoplasty, and… Read more »

Weight loss has been proven to be a key cause of obstructive sleep apnea (OSA). I have written previously on the research from Richard Schwab, MD at the University of Pennsylvania, showing that the connection appears to be related to fat storage (and likely muscle mass too) in the head and neck. This work is… Read more »