Note: I was a paid consultant for Nyxoah for a decade, and this blog post includes references to their technology and a research study on which I was involved.

The 2026 annual scientific meetings of the International Surgical Sleep Society and American Academy of Otolaryngology – Head and Neck Surgery are just finishing up here in Los Angeles. There are so many wonderful things about these meetings, ranging from the educational (learning and sharing experiences) to social (seeing long-time friends and making new acquaintances) to emotional (the energy of colleagues and the younger individuals that are the future of this field). On this blog, I enjoy sharing some of what I consider to be some of the most intriguing research findings and learnings from the International Surgical Sleep Society, although I want to point out that those studies I do not mention are any less groundbreaking or interesting.

Like many others, I believe that GLP-1 and GIP/GLP-1 medications are a major step forward in the treatment of obstructive sleep apnea. Tirzepatide has been studied most thoroughly for its ability to treat obstructive sleep apnea in the SURMOUNT-OSA trials, where it has shown an approximately 20% reduction in body weight and meaningful improvement in sleep apnea. One question is whether these medications could make sleep apnea surgery entirely unnecessary. While it would be wonderful if we could resolve sleep apnea entirely with these medications, the reality is that this does not occur. Some patients do have their sleep apnea resolve with these medications, but other patients who are not surgical candidates because of very-high body mass index can lose weight on these medications to make themselves good surgical candidates. Based on my experience of treating a number of patients in both groups (no need for surgery after weight loss vs. becoming good candidates for surgery with weight loss), I have always felt that the net effect of these would be neutral, meaning that there would be no overall decrease in sleep apnea surgery. However, research from Jay Piccirillo, MD and his team at Washington University in St. Louis, using 2014-2022 data from the large TriNetX database, compared over 100,000 adults treated with GLP-1 medications to those without this treatment and showed that there was almost a 60% greater odds of treatment of obstructive sleep apnea with hypoglossal nerve stimulation (Inspire Upper Airway Stimulation, based on the dates of the study) in the group with use of the GLP-1 medications. The study is not perfect, as it was not able to include the severity of sleep apnea in the analysis, but it did confirm what many of us in the field think is occurring.

Mouth breathing has received quite a bit of attention in the lay press and on social media. I believe that mouth breathing is not ideal for snoring and sleep apnea but is not the root of all evils, as some might suggest. An interesting study from the University of Pennsylvania showed that mouth breathing was related to the space behind the palate (roof of the mouth), specifically the distance from the back of the hard palate (bone on the roof of the mouth) to the back of the throat. This makes sense, in that air flowing through the nose also has to pass behind the palate, such that a fixed narrowing (related to bone) would restrict airflow. In our large, multicenter studies of drug-induced sleep endoscopy, we have found that this same narrowing was associated with poorer outcomes of Inspire Upper Airway Stimulation and soft palate surgery.

Neurostimulation remains a major part of obstructive sleep apnea treatment. There are two technologies available for commercial use in the United States (from Inspire and Nyxoah), with another on the way (Livanova). A number of companies are entering this space, evaluating potential nerve stimulation targets such as a branch of the ansa cervicalis and the phrenic nerve. Initial research studies of various nerve stimulation technologies were presented, with encouraging data, so we expect to learn more about their potential in the years ahead.

Nyxoah has been conducting the ACCCESS Trial to evaluate outcomes of their bilateral hypoglossal nerve stimulation system (Genio) in patients in whom drug-induced sleep endoscopy shows complete concentric collapse related to the soft palate. These results were presented at this conference, with response rates similar to those in individuals without this specific finding. Everyone is awaiting peer review and publication of these results, as it could eliminate the need to perform drug-induced sleep endoscopy to be eligible for treatment with the Genio.

Similarly, other researchers presented results evaluating new approaches to hypoglossal nerve stimulation with the Livanova aura6000 technology. While the OSPREY randomized trial results have already been published, at this meeting there was discussion of different approaches to delivering stimulation (PolySync) that appeared to improve results substantially. Again, peer review and publication will allow a more-detailed review of their work.

Because fat deposited within muscles surrounding the throat can be a major factor in obstructive sleep apnea, a startup medical device company called Cryosa has been working for a number of years to apply cryolipolysis (application of cold to decrease fat) within the mouth and throat. Some of their research was presented, showing the ability to reduce tongue fat in humans after previous work in non-human animals (that I presented at the same conference last year). Unfortunately, Cryosa recently made the decision to stop their clinical trial and wind down their operations. I had been a consultant and member of their scientific advisory board for almost 8 years, and it was disappointing to see that their high-quality work is not continuing, at least not for now.