About Complex Sleep Apnea
The Complex Sleep Apnea Program at Rady Children’s Hospital provides advanced evaluation and treatment for children with complex health issues who continue to have difficulty breathing during sleep, even after traditional treatment for obstructive sleep apnea.
To help these children, the program uses the latest diagnostic tools and therapies, along with a coordinated care approach by sleep specialists from Respiratory Medicine (sleep medicine), Otolaryngology (sleep surgery) and Plastic Surgery (craniofacial surgery), while also including the fields of Pediatric Dentistry and Orthodontics. This multidisciplinary model ensures each child receives a personalized sleep apnea treatment plan based on their unique anatomy and medical needs.
Daniel Lesser, M.D. (Respiratory Medicine), Rakesh Bhattacharjee, M.D. (Respiratory Medicine/Sleep Medicine), Javan Nation, M.D. (Otolaryngology) and Samuel Lance, M.D. (Plastic Craniofacial Surgery) collaborate to create a management plan that considers the specific features of each child’s sleep disorder. Drs. Lesser and Bhattacharjee interpret sleep study results, evaluate candidacy for positive airway pressure (PAP) therapy, and determine if additional testing or treatment of associated conditions is needed.
Dr. Nation provides expertise in anatomic assessment of the upper airway soft tissues using in-office laryngoscopy, sleep endoscopy and cine-airway MRI. Dr. Lance evaluates the mid-face, mandible and oral cavity bony structures to identify craniofacial factors that may contribute to airway narrowing. Both Drs. Nation and Lance have special expertise in advanced surgical procedures that improve sleep-related breathing disorders and have been successfully used in patients within this program.
Drs. Jacy Stauffer, D.M.D. (Pediatric Dentistry) and George Abichaker, M.S., D.D.S. (Orthodontics) assess the dental arches and bite to identify dental and orthodontic issues that may worsen obstructive sleep apnea. They can provide interceptive treatments, including specialized dental appliances designed to help improve the airway. Working together, the dental and medical teams develop coordinated treatment plans tailored to each child.
Conditions Treated
- Obstructive sleep apnea
- Complex sleep apnea
- Residual obstructive sleep apnea after tonsillectomy and adenoidectomy
- Upper airway obstruction
- Obstructive hypoventilation
- Sleep-disordered breathing
Multidisciplinary Team
Physicians
Daniel Lesser, M.D. – Respiratory Medicine
Rakesh Bhattacharjee, M.D. – Respiratory Medicine / Sleep Medicine
Javan Nation, M.D. – Otolaryngology
Samuel Lance, M.D. – Plastic Craniofacial Surgery
Jacy Stauffer, D.M.D. – Pediatric Dentistry
George Abichaker, M.S., D.D.S. – Orthodontics
Physician Assistant
Anita Lazar, PA-C
Nurse
Carrie Arii, R.N.
Care Coordination and Scheduling
Sylvia Sandoval
*Appointments are by referral only.