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Dr. Ryan J. Soose

  • Dr. Denise GilmanDirector, UPMC Division of Sleep Surgery Assistant Professor, UPMC Department of Otolaryngology
  • Specialty: Sleep medicine and sleep surgery
  • Practice Name: University ENT Specialists
  • Fellowship: UPMC Sleep Medicine Center
  • Residency: UPMC Department of Otolarynglogy – Head and Neck Surgery
  • Medical School: University of Pittsburgh School of Medicine
  • Undergraduate: University of Notre Dame Years
  • In Practice: Five Years

Why did you choose your specialty?
Snoring, sleep apnea, and other sleep problems are extremely common and often have a huge impact on a person's quality of life as well as that of the spouse or other family members. I feel that this growing population deserves a higher level of care – a comprehensive, compassionate, cutting-edge practice that employs the best in diagnostic evaluation and all available treatment options, both medical and surgical.

What symptoms do patients ignore most?
Most people are aware that sleep apnea and other sleep disorders can lead to daytime fatigue and being physically tired. Many don't realize, however, that being mentally tired is just as common. Difficulty with focus, attention, concentration, and memory are common in people with sleep problems but are often overlooked.

What advice do you wish patients would take seriously?
Get more sleep. The most common reason for daytime sleepiness is not really a specific sleep disorder but rather just an insufficient amount of sleep. With our busy 24-hour schedules and electronic devices, the importance of sleep is often overlooked. Studies suggest that the average person needs 7-8 hours of sleep to optimize daytime function.

What question do patients most often ask?
How do I lose weight? Excess weight is one of the key factors contributing to sleep apnea in many patients. They often tell me they are cutting calories and exercising more but still are not losing weight. Many people don't realize that poor sleep affects the body's metabolism and makes it very difficult to lose weight. Once the sleep is improved, the weight often starts to come off.

Tell us about your most compelling case?
Every case is compelling! Every patient has a unique story. That's what makes my job so interesting. In sleep apnea, for example, the presenting symptoms, the way it affects their health and quality of life, the airway anatomy, the goals of treatment, and the most appropriate treatment options, all vary from one person to another. That's why a cookie-cutter approach just doesn't work. At the UPMC Division of Sleep Surgery, we consider all treatment options, both medical and surgical, and tailor a customized treatment plan to each individual.

What innovation has changed treatment in your specialty?
Sleep endoscopy has really provided a big breakthrough in improving surgical success rates for sleep apnea. Using a brief 'twilight' sedation, we can recreate conditions that mimic sleep. This allows us to better characterize the specific anatomical locations and pattern of obstruction, and therefore better predict the proper surgical treatment plan.

What is the biggest myth you deal with and what is the truth?
The biggest myth that I deal with is that positive pressure therapy (CPAP) is the only treatment option available to help patients with sleep apnea. Many patients undergo expensive sleep testing and receive CPAP equipment, but are unable to use it effectively, and then continue on untreated and symptomatic for years, without ever being educated about all of their options. Overall, CPAP has the most data of being the most effective treatment option for sleep apnea, however, the reality is that at least half of patients who are prescribed CPAP either refuse it, are unable to tolerate it, or are unable to achieve successful improvement in their symptoms with it. We must provide help to these patients too and we have the tools to do so.

Dental appliances, airway reconstructive surgery, hypoglossal nerve stimulation, weight loss, positional therapy, and adjunctive options, such smoking cessation, allergy management, and reflux therapy, can all provide effective relief, particularly when used in combination. Although we commonly employ CPAP and other forms of positive pressure for our patients, we consider all medical and surgical treatment options and continue to work until we've accomplished our goals in each patient.

Dr. Ryan Soose can be reached at University ENT Specialists, (412) 232-3687 or visit www.upmc.com/sleep

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