Body Mass Index and Inspire Upper Airway Stimulation

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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

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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 »

ImThera/LivaNova aura6000 THN3 Randomized Trial Outcomes

Posted by & filed under Surgery, Tongue Surgery.

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 »

A call for improving the quality of the otolaryngology – head and neck surgery literature

Posted by & filed under Sleep Apnea, Surgery.

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 »

What really is long-term CPAP adherence?

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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 »

New research evaluates trouble swallowing after sleep apnea surgery

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

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 »

Giving Thanks for Our Sleep Medicine and Sleep Surgery Fellows

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Thanksgiving is a time to reflect on our good fortune and express gratitude with family and friends. What a perfect time to express appreciation to current and former fellows who continue to invigorate me with their enthusiasm, intellect, and curiosity. This September at our International Surgical Sleep Society meeting in Philadelphia, I was delighted to… Read more »

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 »