Great Debates: Should Otolaryngology Be the New Primary Sleep Specialty?

PROGRAM DESCRIPTION: Obstructive sleep apnea (OSA) is a disease caused by repetitive episodes of nocturnal upper airway obstruction. During these episodes, there is disruption of sleep and activation of the sympathetic nervous system. The disease impacts a significant proportion of our population and puts the patient at risk for cardiovascular sequela and symptoms impacting their quality of life.

As we further our understanding of the pathophysiology of OSA, disease phenotypes, and develop new diagnostic and therapeutic options, we are able to provide care directed at the individual patient’s disease. The one size fits all approach to OSA needs to transition to a personalized, patient centric model.

The personalized care model allows for assessment of factors contributing to the individual patient's disease, relevant comorbidities, review of treatment options and patient goals of therapy, and recommendations for treatment. In order to truly provide personalized care, a physician must either have the expertise to adequately understand the disease process and offer multimodal therapy or have easy access to a variety of consultants.

As Otolaryngologists, we possess the expertise necessary to understand the physiologic mechanisms leading to obstructive sleep apnea, are armed with the ability to understand associated sleep comorbidities, and have the ability to provide both surgical and non-surgical treatment. Much of this is incorporated into our general residency training and board certification. In addition, many Otolaryngologists already possess a secondary certificates in Sleep Medicine and more residents are seeking additional training through hybrid Sleep Medicine/Surgery fellowships.

With this lecture, we will review the assessment and management of OSA and relevant sleep related comorbidities, discuss treatment protocols which allow for patient centric care and can improve patient retention, and show how this can all be done through the Otolaryngology office creating a "one stop shop" for the complete management of patients with OSA.

OUTCOME OBJECTIVE 1: Understand the pertinent anatomy and physiology of obstructive sleep apnea and the relevant sleep related comorbidities which may impact treatment outcomes and patient satisfaction.

OUTCOME OBJECTIVE 2: Understand medical management options which can be readily utilized by the otolaryngologist.

OUTCOME OBJECTIVE 3: Understand surgical management options which can be readily utilized by the otolaryngologist.

BACKGROUND STATEMENT: Otolaryngology residency provides a knowledge base of the disease and management options for sleep apnea. Because of sleep training incorporated into Otolaryngology training we possess the skill set to manage the majority of patients. Are we the sleep medicine specialty of the future?