The Upper Airway Stimulation system from Inspire Medical Systems has been an important and exciting addition to the array of treatment options for obstructive sleep apnea. I was the first surgeon in the Western US to offer it to patients after FDA approval in 2014, and I have seen the tremendous difference it has made…

Obstructive sleep apnea and snoring are common, but it is naive (and incorrect) to think that any single approach is going to work for all patients. This is true for CPAP and is clearly true for surgical procedures and oral appliances. I have written previously on working with sleep dentists to evaluate whether a certain… Read more »

Nashville, TN was the site of both the 2023 International Surgical Sleep Society (ISSS) Educational Symposium and American Academy of Otolaryngology – Head and Neck Surgery Foundation Annual Meeting. It is always wonderful to see colleagues and long-time friends. However, I wanted to take the chance to share some of what I found to be… Read more »

In the United States and many other countries, obstructive sleep apnea surgery is generally considered a second-line therapy for patients who do not tolerate or benefit from positive airway pressure therapy (for example, continuous positive airway pressure, or CPAP). This is based on two arguments: Surgery clearly has greater risks than CPAP Surgery does not… Read more »

UPDATE: a version of this has been accepted for publication as a letter to the editor in the medical journal Laryngoscope. Systematic reviews and meta-analyses are supposed to be high-quality reviews of the medical literature that represent the highest level of scientific evaluation and evidence. Unfortunately, all that glitters in not gold. I have written… Read more »

I am excited to announce that I have now started a new adventure in my career, joining the UCLA Department of Head and Neck Surgery. I have been fortunate to train and then work at outstanding places with such talented people. This move will be no different, as the UCLA team has consistently been one… Read more »

Earlier this month, the US Food and Drug Administration expanded the approved indications for the Inspire Upper Airway Stimulation system, raising the upper limit for body mass index from 32 to 40 kg/m2 and increasing the upper limit for the apnea hypopnea index to 100 events/hour. This has been met with some surprise by colleagues,… Read more »

Hypoglossal nerve stimulation is an important treatment option for patients with moderate to severe obstructive sleep apnea who cannot tolerate positive airway pressure therapy (for example, CPAP). The only currently-FDA-approved technology is Upper Airway Stimulation (Inspire Medical Systems, Golden Valley, MN), but multiple technologies are in human clinical trials or under development. One of these… Read more »

Since its FDA approval in 2014, the Upper Airway Stimulation system from Inspire Medical Systems has dominated the landscape of nerve stimulation in the treatment of obstructive sleep apnea. A number of companies have been involved in development of hypoglossal nerve stimulation technologies, and this month one of those companies (LivaNova) had publication of results… Read more »