Mentoring and training the next generation of leaders in the field is one of the great joys of my career. I have been fortunate to train numerous sleep surgeons who are achieving tremendous things and already surpassing what I have accomplished in my career. In 2017, I wrote about a sleep surgery fellowship program that… Read more »
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Maybe I am not the only one concerned about tongue tie surgery and myofunctional therapy for sleep apnea
Yesterday, the New York Times podcast “The Daily” focused on tongue tie surgery in children with “The Booming Business of Cutting Babies’ Tongues”. The podcast pointed to the explosive growth in aggressive tongue tie surgery for children. Simple snipping of tissue under the tongue has been done for centuries, with proven benefits for some children… Read more »
Will there be a new era of (sleep apnea and snoring) medical education conferences?
On February 16-17, 2024, we will hold the 29th annual Advances in Diagnosis and Treatment of Sleep Apnea and Snoring course. We are delighted to have an outstanding faculty to speak on what we feel are interesting and provocative topics. As I do every year, I will share what I feel are some of the… Read more »
Predicting oral appliance outcomes in sleep apnea with drug-induced sleep endoscopy
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 »
Can we stop publishing “systematic reviews” of myofunctional therapy for obstructive sleep apnea?
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 »
UCLA: My New Career Adventure
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 »
Body Mass Index and Inspire Upper Airway Stimulation
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 »
LivaNova THN/Aura6000 Stimulation Has Variable Tongue Movements That Are Associated with Outcomes
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 »
2023 Advances in Sleep Apnea and Snoring Course Highlights
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 »
What really is long-term CPAP adherence?
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 »