Raj C Dedhia, MD, MSCR

Raj C Dedhia, MD, MSCR

As treatment options for obstructive sleep apnea (OSA) continue to evolve, questions remain about their effectiveness. Dr. Raj C Dedhia, recruited from Emory University in 2019, currently serves as Director of the Sleep Surgery Division. He spends 50% of his time as a sleep researcher, studying better ways to predict response to OSA surgery and the effects current therapies may have on patient health. The Division’s current and past projects have been funded by the National Institutes of Health, American Heart Association, American Academy of Sleep Medicine, Triological Society, and industry sponsors including Inspire Medical Systems, Inc and Nyxoah S.A.

List of Completed Peer-Reviewed Work by Dr. Dedhia

Video Lectures by Dr. Dedhia

Media Segments with Dr. Dedhia

Podcasts with Dr. Dedhia

     

Sleep Surgery Research Team

Everett Seay, BS, RPSGT
Research Program Manager

Akshay Tangutur, MS
Research Coordinator

Kendra Troske, BA
Research Coordinator

Active Research Projects

Characterizing Mechanisms of Upper Airway Obstruction During Drug-Induced Sleep Endoscopy

Drug-induced sleep endoscopy (DISE) is a procedure used by Otolaryngologists to evaluate upper airway collapse site(s) of patients with obstructive sleep apnea. Our National Institutes of Health (NIH) sponsored study aims to characterize specific causes of upper airway obstruction during DISE. Our approach involves measuring airway pressures, pharyngeal patency, airflow, and responses to tongue muscle stimulation during DISE. Our goal is to develop personalized solutions that address the pathogenic mechanisms of airway collapse and airflow obstruction during sleep.

Raj Dedhia, MD, MSCR and Alan Schwartz, MD are joint Principal Investigators on this project.

DISE-CAD

This research study is being done to see what role tongue muscle movement plays in keeping the airway open during sleep. If you agree to join the study, you will be asked to complete the following research procedures:
1. Have a standard overnight sleep study in our sleep lab.
2. Have an MRI scan of your head and neck.
3. Have 1-2 upper airway exams (called Drug-Induced Sleep Endoscopy or DISE). You will be given medicine to sedate (relax) you during DISE.
    a. Have measurements of the changes in your breathing and airway collapse at different levels of airway pressure.
    b. Have your tongue muscles stimulated and the effects on air flow and airway collapse measured.
4. Have video and ultrasound images of your tongue and throat.

Subject Population: Adults who have Obstructive Sleep Apnea

Duration of Subject Participation: 1 overnight and 2-3 mornings or afternoons

Contact: Everett Seay: (215) 615-8777 | Everett.Seay@pennmedicine.upenn.edu

 

DISE-PhOP

This research study is being done to better understand how and why the airway collapses during sleep. We would like to find out what types of things (for example, air flow, air pressure, or face shape) affect if someone’s throat closes up during sleep and how well they do after sleep surgery. If you agree to join the study, you will be asked to complete the following research procedures during your planned drug-induced sleep endoscopy (DISE) exam:
1. 2 thin tubes will be passed through your nostrils into your throat to take air pressure measurements. They will be removed at the end of the ~30 minute DISE.
2. You will have an ultrasound scan of your throat/airway.
The information we collect from these research procedures will not be used to make decisions about your medical care.

Subject Population: Adults whose doctor has recommended that they have Drug-Induced Sleep Endoscopy (DISE) to test their breathing during sleep

Duration of Subject Participation: 1 day

Contact: Everett Seay: (215) 615-8777 | Everett.Seay@pennmedicine.upenn.edu


Hypoglossal Nerve Stimulation on Cardiovascular Outcomes

https://clinicaltrials.gov/ct2/show/NCT03359096?term=dedhia&rank=2

A new, well-tolerated treatment known as tongue stimulation is a device which opens the airway during sleep and can provide treatment for patients unable to use the mask and hose treatment. This study will evaluate the effect of this new treatment on blood pressure and heart-related measures to observe if it lowers patients’ risk of heart problems. To learn more about the methods, please read this publication by Dr. Dedhia’s team: https://www.ncbi.nlm.nih.gov/pubmed/30194765

CARDIOSA-12

This research study is being done to look at the effect of tongue stimulation on blood pressure and heart-related measures in people who have obstructive sleep apnea. If you agree to join the study, you will be asked to complete the following research procedures:
•2 in-lab cardiovascular testing sessions (5 visits to our office/lab in total)
•2 at-home blood pressure and sleep testing sessions
•2 weeks of no Inspire® device use
•1 month of regular Inspire® use
•1 month of very low level Inspire® use

Subject Population: Adults who have obstructive sleep apnea and an Inspire® nerve stimulator implant

Duration of Subject Participation: About 2 and a half months

Contact: Akshay Tangutur, MS: (215) 615-8777 | Akshay.Tangutur@pennmedicine.upenn.edu

 

A Multicenter Study to Assess the Safety and Effectiveness of the Genio™ Dual-sided Hypoglossal Nerve Stimulation System for the Treatment of Obstructive Sleep Apnea in Adult Subjects

DREAM

The research study is being done to find better treatment for Obstructive Sleep Apnea (OSA). An implantable device, Genio™ system can help reduce your OSA. This study is designed to evaluate the Genio™ device’s safety and effectiveness in adult subjects with moderate to severe OSA and who did not tolerate, failed, or refused positive airway pressure (PAP). The study compares your OSA status after 12 months of study treatment using the study device with your initial OSA status.

Contact: Akshay Tangutur, MS: (215) 615-8777 | Akshay.Tangutur@pennmedicine.upenn.edu


Adherence and Outcome of Upper Airway Stimulation (UAS) for OSA International Registry

ADHERE Registry

The purpose of this research registry is to gather information on how the Inspire® Upper Airway Stimulation (UAS) System is used and performs for patients in the commercial setting. In addition, the information collected will continue to educate physicians who treat obstructive sleep apnea (OSA). If you agree to join the study, certain information from your past, current and future medical records will be collected and entered into the registry database. Data will be collected at four time points during your Inspire care:
1. Prior to receiving Inspire therapy;
2. During the procedure to implant the system and your recovery from the surgery;
3. Once your Inspire therapy has been programmed to your ideal settings; and
4. After one year of therapy use

Subject Population: Adults who have received or plan to receive an Inspire® Upper Airway Stimulation (UAS) System for treatment of obstructive sleep apnea

Duration of Subject Participation: About 1 year

Contact: Everett Seay: (215) 615-8777 | Everett.Seay@pennmedicine.upenn.edu 


Surgical Therapy for Obstructive Sleep Apnea on Blood Pressure and Peripheral Arterial Tonometry

This study will evaluate the effects of upper airway surgery on cardiovascular function as measured by changes in blood pressure and peripheral arterial tonometry before and after treatment.

SAP

The research study is being done to look at the effect of sleep apnea surgery on different measures of
cardiovascular (heart) function in people with obstructive sleep apnea. If you agree to join the study, you will be asked to complete the following research procedures:
1. Have an at-home sleep test.
2. Wear a blood pressure monitor for a full day, before and after your surgery.
3. Answer questions about your sleep, before and after your surgery.
4. Let the researchers collect information from your medical record.

Subject Population: Adults who are planning to have surgery for sleep apnea

Duration of Subject Participation: About 8 months

Contact: Akshay Tangutur, MS: (215) 615-8777 | Akshay.Tangutur@pennmedicine.upenn.edu

 


Mentored Projects under Dr. Dedhia

“The Accuracy and Reliability of Visually Assessed Pharyngeal Opening Pressures During Drug-Induced Sleep Endoscopy.” https://pubmed.ncbi.nlm.nih.gov/36040822/

“The Role of Craniofacial Maldevelopment in the Modern OSA Epidemic: A Scoping Review.” https://pubmed.ncbi.nlm.nih.gov/34984972/

“Influence of Apnea vs. Hypopnea Predominance in Predicting Mean Therapeutic Positive Airway Pressures Among Patients with Obstructive Sleep Apnea.” https://pubmed.ncbi.nlm.nih.gov/34666884/

Lead Author: Jason Yu, MD


Evaluation of Therapeutic Positive Airway Pressure as a Hypoglossal Nerve Stimulation Predictor in Patients With Obstructive Sleep Apnea.”
https://jamanetwork.com/journals/jamaotolaryngology/article-abstract/2766714

“Clinical Radiographic Predictors of Response to Hypoglossal Nerve Stimulation for Obstructive Sleep Apnea.” https://pubmed.ncbi.nlm.nih.gov/33048610/

“Transoral Versus Endoscopic Examination in Predicting Outcomes of Hypoglossal Nerve Stimulation for Obstructive Sleep Apnea.” https://pubmed.ncbi.nlm.nih.gov/32533788/

“Therapeutic Positive Airway Pressure Level Predicts Response to Hypoglossal Nerve Stimulation for Obstructive Sleep Apnea.” https://www.ncbi.nlm.nih.gov/pubmed/31482839

Lead Author: Clara Lee, MD


Evaluation of Therapeutic Positive Airway Pressure as a Hypoglossal Nerve Stimulation Predictor in Patients With Obstructive Sleep Apnea.”
https://jamanetwork.com/journals/jamaotolaryngology/article-abstract/2766714

“Upper airway surgery to rescue the “untitratable” patient with OSA and obesity.” https://www.ncbi.nlm.nih.gov/pubmed/31957643/

Lead Author: Everett Seay, BS, RPSGT


“Success of Hypoglossal Nerve Stimulation Using Mandibular Advancement During Sleep Endoscopy.” https://onlinelibrary.wiley.com/doi/full/10.1002/lary.28589

Lead Author: Graeme Mulholland, MD, FRCSC


“Obstructive sleep apnea, sleep symptoms, and their association with cardiovascular disease.” https://www.ncbi.nlm.nih.gov/pubmed/31532856

Lead Author: Melissa Oh, MD


“Hypoglossal Nerve Stimulation Therapy on Peripheral Arterial Tonometry In Obstructive Sleep Apnea: A Pilot Study.” https://www.ncbi.nlm.nih.gov/pubmed/?term=29926395

Lead Author: Allison Ikeda, MD


“Practice Patterns of Sleep Otolaryngologists at Training Institutions in the United States.” https://www.ncbi.nlm.nih.gov/pubmed/27677599

“Validated Measures of Insomnia, Function, Sleepiness, and Nasal Obstruction in a CPAP Alternatives Clinic Population.” https://www.ncbi.nlm.nih.gov/pubmed/28633723

Lead Author: Austin Lam, MD


“Surgical Treatment of OSA on Cardiovascular Outcomes: A Systematic Review.” https://www.ncbi.nlm.nih.gov/pubmed/28923761

Lead Author: Tyler Halle, MD


“Sedative Choice In Drug-Induced Sleep Endoscopy: A Neuropharmacology-Based Review.” https://www.ncbi.nlm.nih.gov/pubmed/27363604

Lead Author: Jack “Will” Shteamer, MD