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Obstructive Sleep Apnea: A Growing Concern—And Opportunity

Kathleen L. Yaremchuk, MD

Wake Up Call: The Why, What, and How of Advance Sleep Training
8:45 – 9:45 am, Today
Room 290

Whether it’s caused by obesity, smoking, neurologic, or anatomical abnormalities, obstructive sleep apnea (OSA) is a serious sleep disorder. It’s estimated that one in five Americans suffers from OSA. Without proper treatment, these patients may develop a host of chronic disorders, including diabetes, heart disease, stroke, weight gain, memory issues, and more.

Who will care for the burgeoning number of OSA patients in the coming years?

With the right training, ENTs could be positioned to diagnose and treat this growing category of patients.

“The purpose of our session is to inform our audience about the important role of otolaryngologists in the management of OSA patients, to identify opportunities for advanced sleep practice and new surgical modalities, and to compare traditional sleep medicine versus sleep surgery training pathways for physicians-in-training,” said Christopher Gouveia, MD, with Kaiser Permanente – Santa Clara, and the session moderator.

Within the last 10 years, sleep medicine has become board-recognized as a subspecialty. Formal fellowships are available, but
Dr. Gouveia said many of the new treatment paradigms, including sleep surgery, are not making their way to trainees. “Despite the acknowledgement that OSA is a public health problem, there is a dearth of subspecialty-trained sleep surgeons,” he said.

Kathleen L. Yaremchuk, MD, MSA, with Henry Ford Health System, agreed.

“The population burden
of OSA patients is greater than
can be served by our current training programs,” said
Dr. Yaremchuk, one of three sleep specialists on the panel. “There are opportunities currently being discussed to offer alternatives to the existing sleep fellowships for otolaryngologists. For example, 10 months of sleep training could be incorporated into the residency program.”

Noninvasive interventions for OSA, most notably the CPAP machine, remain essential in the care of OSA patients. However, many people don’t tolerate or benefit from nonsurgical options. “The role of sleep surgeons will be to encourage noninvasive means for appropriate patients, and to carefully select good candidates for surgical treatment,” said Dr. Gouveia.

According to Dr. Yaremchuk, many in the field are still skeptical about surgery to treat OSA. “Surgery is not the right choice for patients whose OSA is the result of neurologic or pulmonary issues. But for patients with anatomical disease, upper airway surgery is effective,” she said.

Although Dr. Yaremchuk endorses a multidisciplinary approach to the treatment of OSA, she said, “I believe ENT physicians have the opportunity to contribute to future developments within the field of sleep medicine.”

To learn how you can be part of the solution to the growing OSA problem, attend this panel presentation sponsored by the AAO-HNS Sleep Disorders Committee and Section for Residents and Fellows. It could be a powerful career wake-up call.