Research Themes and Publications in Sleep Surgery

Enhanced obstructive sleep apnea care delivery in terms of CPAP alternatives is vital.  Patients considering options for sleep apnea treatment display high decisional.  Our work has identified some key patient goals, values, preferences and concerns important for the shared decision-making process for choosing therapy.  We are interested in how decision aids can influence the decision process, improve patient satisfaction, and influence outcomes and cost of care. 

Limitations in knowledge about the medical and surgical treatment options for OSA, travel, wait-times, and insurance coverage are common themes that impact evaluation for PAP alternative therapies especially at our safety net hospital, Zuckerberg San Francisco General Hospital.  We have worked on understanding patient and provider perspectives and creating interventions to improve equity of knowledge for OSA treatment pathways.

We also focus on understanding differences in OSA in women compared to men.  Phenotypic differences include the worsening of sleep apnea after menopause in women and severity of disease that is not always captured entirely on a sleep study. 

We have found longitudinal tracking can show 50% reduction in snoring with hypoglossal nerve stimulation.  With these technologies we can measure individual variabilities in sleep and cardiovascular metrics related to OSA treated and untreated states. This has implications for understanding who is at higher risk for health risks associated with OSA.

Using a novel technique to test laryngeal sensation developed at UCSF called the Cheung-Bearelly aesthesiometer, we found the laryngeal adductor reflex is reduced in sensitivity and latency in OSA compared to non-OSA patients.  This has implications in understanding the neurosensory changes in chronic OSA.

This was a large effort led by faculty at UCSF to summarize the evidence on OSA treatment diagnosis, therapies, comorbidities and impact of OSA therapies.  We also actively study surgical outcomes of treatments for OSA.