{"id":2616,"date":"2018-12-13T10:54:26","date_gmt":"2018-12-13T18:54:26","guid":{"rendered":"https:\/\/keck.usc.edu\/news\/sleep-doctor\/"},"modified":"2025-10-23T13:32:54","modified_gmt":"2025-10-23T20:32:54","slug":"sleep-doctor","status":"publish","type":"post","link":"https:\/\/keck.usc.edu\/news\/sleep-doctor\/","title":{"rendered":"Sleep Doctor"},"content":{"rendered":"\n \n \n\n\n\n\n\n\n\n
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Sleep Doctor<\/h1>\n\n\n<\/div>\n \n \n
\n \n December 13, 2018<\/span>\n <\/div>\n \n \n
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\"\"If you doze off during a consultation with Eric Kezirian, MD, MPH, he won\u2019t take offense. As the head of Sleep Surgery in the USC Caruso Department of Otolaryngology \u2013 Head and Neck Surgery, it\u2019s his job to help patients sleep better. Kezirian uses the latest techniques \u2014 and is helping pioneer new ones \u2014 to treat snoring and obstructive sleep apnea.<\/p>\n

Snoring can be a major issue for patients as well as anyone who is trying to sleep nearby. Snoring is generally considered a nuisance, but it can be a sign of something more serious: obstructive sleep apnea.<\/p>\n

Sleep apnea is the blockage of breathing that can wake us up and disrupts the body\u2019s oxygen flow. Its ramifications range from fatigue, headaches and difficulty concentrating to increased risks of stroke, heart failure and, possibly, even cancer. The condition is on the rise, affecting up to billion people worldwide \u2014 10 times more than the World Health Organization estimated in 2007.<\/p>\n

\u201cMany risk factors for sleep apnea are becoming more common,\u201d Kezirian says of the growing prevalence. These include an aging population and increasing rates of obesity. \u201cBy age 60, approximately 40 percent of people have moderate to severe sleep apnea,\u201d he explains.<\/p>\n

The key to Kezirian\u2019s clinical approach \u2014 and his research \u2014 is determining what is likely to work best for each individual. \u201cYou don\u2019t treat everybody the same way because that just does not work,\u201d he says.<\/p>\n

When it comes to planning for surgery, this might require a trip to the operating room for an evaluation called drug-induced sleep endoscopy. \u201cYou sedate patients in a careful way that is close to natural sleep,\u201d he says. \u201cThen I look with a telescope inside their throat to see what is causing their sleep apnea so that we can come up with a focused but effective treatment.\u201d<\/p>\n

Kezirian is considered an international leader in drug-induced sleep endoscopy and personalized medicine approaches to sleep apnea and snoring. He recently led a global study examining how drug-induced sleep endoscopy can be used to guide the selection of surgical procedures and predict the results of surgery. With 275 patients and 14 centers around the world, the project is the largest in the field to date.<\/p>\n

\u201cThe study had a couple of key findings,\u201d he says. \u201cWe confirmed something that we have suspected but never properly studied \u2013 that surgery does not work well if the sides of the patient\u2019s throat are collapsing. And if the tongue is falling back to block breathing \u2014 which it commonly does \u2014 the results are better when you treat that instead of ignoring it.\u201d<\/p>\n

With his focus on sleep surgery, Kezirian uses a wide range of procedures to treat patients, whether by removing, tightening or repositioning tissue. He also works with companies in their research to understand the benefits of new approaches. One of these is Inspire Medical\u2019s Upper Airway Stimulation (UAS) System that is implanted in the body with a surgical procedure. UAS keeps the space for breathing in the throat open by mildly stimulating the nerve that controls tongue movement. \u201cIt\u2019s somewhat similar to a tongue pacemaker,\u201d Kezirian says. UAS is a relatively new technology, gaining FDA approval in 2014, and Kezirian also is serving as investigator in a multi-center study of its effectiveness.<\/p>\n

The most common treatment for sleep apnea, though, remains continuous positive airway pressure (CPAP), a machine that is worn at night to help with breathing. \u201cIt is low-risk and still the first-line option for people with significant sleep apnea,\u201d Kezirian says.<\/p>\n

Some patients find the CPAP mask uncomfortable, and studies have shown that about 30 percent of patients cannot sleep well while wearing CPAP. \u201cIt does not work well for everybody,\u201d Kezirian admits. \u201cSo that is when you think about other options.\u201d<\/p>\n

Those options include surgery and customized oral appliances like the mandibular advancement device, which holds the lower jaw slightly forward during the night to keep the airway open.<\/p>\n

\u201cOften, we combine methods,\u201d he notes. \u201cSurgery with an oral appliance is a common approach to get the results the we want.\u201d<\/p>\n

As a specialist at a leading academic medical center, Kezirian takes on the most challenging cases \u2014 including patients who have not responded to previous surgery and other treatments. \u201cSend your most difficult cases,\u201d he says with a chuckle. \u201cI will be honest with them, explaining whether additional surgery might work well or finding another way.\u201d<\/p>\n

Of course, not all restless nights are due to sleep apnea. For people who snore but don\u2019t have sleep apnea, surgery is typically a good option. However, Kezirian may first recommend \u201cweight loss, sleeping on your side, avoiding alcohol within three hours of bedtime and other things that are healthy for anybody.\u201d<\/p>\n

Kezirian is as dedicated to educating the public about snoring and sleep apnea as he is to ensuring peaceful dreams for his patients. He even blogs and produces Youtube videos featuring tips and research information.<\/p>\n

To make a gift to the Caruso Department of Otolaryngology \u2013 Head and Neck Surgery, click\u00a0here<\/a>.<\/p>\n\n\n\n<\/div>\n <\/div>\n\n\n <\/div><\/div>\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":168,"featured_media":2618,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"advgb_blocks_editor_width":"","advgb_blocks_columns_visual_guide":"","footnotes":"","_links_to":"","_links_to_target":""},"categories":[6],"tags":[16],"class_list":["post-2616","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-press-release","tag-otolaryngology"],"acf":[],"yoast_head":"\nSleep Doctor<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/keck.usc.edu\/news\/sleep-doctor\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" 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