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 »

I have written previously on this blog about our research highlighting the extremely low quality of published “systematic reviews” and “meta-analyses” in the otolaryngology and sleep surgery literature. We have shown that many studies do not adhere to established, accepted research methods for these studies, creating a dangerous situation where publications that pretend to be… 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 »

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 »

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 »

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 »

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 »

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 »