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 »

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 »

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 »

It is known that biomedical research studies include a disproportionate share of non-Hispanic White, middle-aged men. I am no expert, but it is obvious to me that research is most valuable when it reflects the diversity of our patient population and, indeed, our country. On this day that honors Jackie Robinson and his legacy in… Read more »

My entire career has focused on sleep disorders, especially obstructive sleep apnea and snoring, and I enjoy spreading science-based information about sleep to the public. I am fortunate to receive inquiries from members of the media and appreciate the opportunity to help in any way I can. Kathryn Drury Wagner contacted me for an article… Read more »

We have just completed the 27th Annual Advances in Diagnosis and Treatment of Sleep Apnea and Snoring course in San Francisco, California. It has been wonderful to be a co-director for about 15 years, and I learn so much myself in every course. This year we did something different: a virtual format! We can thank… Read more »

The December 2021 Journal of Clinical Sleep Medicine included two papers outlining the American Academy of Sleep Medicine (AASM) recommendations regarding surgical consultation for adults with obstructive sleep apnea (OSA). The first publication was an assessment of the literature, finding that: Upper airway surgery was associated with meaningful improvements in OSA signs and symptoms Upper… Read more »

Well-done randomized trials offer the highest-quality scientific evaluation of any medical intervention. Unfortunately, randomized trials of surgical interventions are extremely difficult to perform, for numerous reasons. In sleep surgery, there have been a number of randomized trials showing that surgical treatment of obstructive sleep apnea can offer important benefits that matter to patients. These include… Read more »

One of the many benefits of working at an academic medical center is the opportunity to work with residents and fellows, where I am often explaining the research evidence supporting the decisions I make in taking care of patients. In every field of medicine, there are decisions that we make in the absence of perfect… Read more »

A recent article published in the Journal of Clinical Sleep Medicine showed that a lower proportion of published articles in sleep medicine were systematic reviews or meta-analyses. The authors suggested that systematic reviews and meta-analyses were underused in sleep medicine. Normally, this would not be cause for alarm, but I was prompted to speak up…. Read more »