Insomnia and Anxiety Limit Use of Inspire Upper Airway Stimulation

Posted by & filed under Sleep Apnea, Surgery.

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 »

ISSS and AAO-HNS 2022: Update on Neurostimulation for OSA

Posted by & filed under Surgery.

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 »

Epiglottis Stiffening Operation for Epiglottis-Related Obstruction in OSA

Posted by & filed under Surgery, Tongue Surgery.

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 »

Will an oral appliance successfully treat my sleep apnea?

Posted by & filed under Sleep Apnea, Surgery.

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 »

Race/ethnicity and sex representation in sleep surgery research studies

Posted by & filed under Sleep Apnea, Snoring, Surgery.

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 »

Advances in Sleep Apnea and Snoring 2022 Course Highlights

Posted by & filed under Palate Surgery, Sleep Apnea, Snoring, Surgery, Tongue Surgery.

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 »

How long do the benefits of sleep surgery last?

Posted by & filed under Palate Surgery, Surgery, Tongue Surgery.

Like most surgical treatments throughout medicine, research studies typically evaluate short-term outcomes. In sleep surgery, most studies report results at 3-6 months following surgery. There are notable exceptions – including 5-year outcomes reported for Inspire Upper Airway Stimulation in the STAR Trial presented at the Sleep 2017 meeting and then published in the medical journal… Read more »

American Academy of Sleep Medicine Guideline for Referral of Adults with OSA for Surgical Consultation

Posted by & filed under Sleep Apnea, Surgery.

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 »

Sleep Apnea Multilevel Surgery (SAMS) Randomized Trial: Surgery Improves the AHI and Sleepiness More than Conservative Treatment

Posted by & filed under Palate Surgery, Sleep Apnea, Surgery, Tongue Surgery.

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 »

Antibiotics are associated with lower odds of bleeding after soft palate surgery for OSA

Posted by & filed under Palate Surgery, Sleep Apnea, Surgery.

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 »