Tomasz J. Kuzniar, M.D., Ph.D.

Tomasz J. Kuzniar, M.D., Ph.D.

Tomasz J. Kuzniar, M.D., Ph.D.

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Conditions & Procedures

Conditions

Asthma, Central Sleep Apnea, Chronic Obstructive Pulmonary Disease (COPD), Lung Cancer, Lung Disease, Lung Nodule, Obstructive Sleep Apnea (Adult/Pediatric), Sleep Apnea, Sleep Disorder Breathing in Cardiac Disease, Sleep Disorders

Procedures

Bronchoscopy, Correlation of Sleep Apnea and Cardiac Disease, Sleep Study, Thoracentesis

General Information

Gender

Male

Affiliation

NorthShore Medical Group

Expertise

Sleep Medicine, Pulmonary/Critical Care

Academic Rank

Senior Clinician Educator

Languages

English, French, Polish

Board Certified

Critical Care Medicine, Internal Medicine, Pulmonary Disease, Sleep Medicine

Clinical Service

Education, Training & Fellowships

Medical School

Wroclaw Medical University, 1994

Internship

State Hospital No. 5, Wroclaw, Poland, 1995

Residency

Wroclaw Medical University, 1999
NorthShore University HealthSystem, 2002

Fellowship

Mayo Clinic
Northwestern Feinberg School of Medicine, 2005

Locations

A

NorthShore Medical Group

2150 Pfingsten Rd.
Suite 3000
Glenview, IL 60026
847.570.2714 847.733.5109 fax This location is wheelchair accessible.
B

NorthShore Medical Group

1000 Central St.
Suite 800
Evanston, IL 60201
847.570.2714 847.733.5109 fax This location is wheelchair accessible.
C

NorthShore Medical Group

2180 Pfingsten Rd.
Suite 2000
Glenview, IL 60026
847.570.2714 847.733.5109 fax This location is wheelchair accessible.

Insurance

Commercial Plans
  • Aetna Choice POS (Open Access) and POS II (Open Access)
  • Aetna Elect Choice EPO and EPO Open Access
  • Aetna Health Network Options
  • Aetna HMO (including Open Access)
  • Aetna Managed Choice (Open Access)
  • Aetna Managed Choice POS
  • Aetna Open Access Aetna Select (Aetna HealthFund)
  • Aetna Open Access Elect Choice EPO (Aetna HealthFund)
  • Aetna Open Access Managed Choice POS (Aetna HealthFund)
  • Aetna Open Choice PPO
  • Aetna Open Choice PPO (Aetna HealthFund)
  • Aetna Premier Care Network
  • Aetna QPOS
  • Aetna Select
  • Aetna Select (Open Access)
  • Beechstreet PPO Network
  • Blue Cross Blue Shield - PPO Products
    Not Contracted Blue Cross Blue Shield Blue Choice PPO
  • Blue Cross Blue Shield Blue Advantage
    Verify PCP Participation
  • Blue Cross Blue Shield HMOI
  • Cigna HMO
  • Cigna LocalPlus
  • Cigna Open Access Plus (OAP)
  • Cigna Open Access Plus with CareLink (OAPC)
  • Cigna POS
  • Cigna PPO
  • Cofinity PPO (an Aetna Company)
  • Coventry Health Care Elect Choice EPO
  • Coventry Health Care First Health PPO
  • Galaxy Health PPO Network
  • Great West PPO/POS
  • Healthcare's Finest Network (HFN)
  • Humana - All Commercial Plans (including Choice Care)
  • Humana - NorthShore Complete Care
  • Humana/ChoiceCare Network PPO
  • Medicare
  • Multiplan and PHCS PPO Network (Including PHCS Savility)
  • NorthShore Employee Network
  • Preferred Plan PPO
  • Three Rivers Provider PPO Network (TRPN)
  • Tricare
  • Unicare
  • United Healthcare - All Commercial Plans
    Not Contracted United Healthcare Core
    Not Contracted United Healthcare Navigate
Exchange Plans
  • Not Contracted Aetna
  • Blue Cross Blue Shield - PPO Products
    Not Contracted Blue Cross Blue Shield Blue Choice PPO
  • Blue Cross Blue Shield Blue Precision
    Verify PCP Participation
  • Not Contracted Coventry
  • Humana National
  • Land of Lincoln - All Products
  • Not Contracted United Healthcare Compass
Medicaid
  • Illinois Department of Public Aid (IDPA)
  • Illinicare ICP
  • Community Care Partners
Medicare Advantage Plans
  • Aetna Medicare (SM) Plan (HMO/Open Access HMO)
  • Aetna Medicare (SM) Plan (PPO)
  • Blue Cross Blue Shield Medicare Advantage PPO Plan
  • Cigna-HealthSpring Advantage HMO
  • Cigna-HealthSpring Premier HMO-POS
  • Cigna-HealthSpring Primary HMO
  • Humana Gold Plus HMO
  • Humana Gold Plus PFFS
  • HumanaChoice PPO
  • United Healthcare - All Medicare Plans
Medicare Medicaid Alignment Initiative (MMAI) Plans
  • Blue Cross Blue Shield Community
  • HealthSpring
  • Humana
  • Illinicare Health Plan
  • Meridian Complete

Publications

  • Treatment-emergent central sleep apnea at high altitude.

    Sleep medicine 2015 Mar

    Authors: Morgenthaler TI,
    Abstract
    Prior studies show that adaptive servoventilation (ASV) is initially more effective than continuous positive airway pressure (CPAP) for patients with complex sleep apnea syndrome (CompSAS), but choosing therapies has been controversial because residual central breathing events may resolve over time in many patients receiving chronic CPAP therapy. We conducted a multicenter, randomized, prospective trial comparing clinical and polysomnographic outcomes over prolonged treatment of patients with CompSAS, with CPAP versus ASV.
    Qualifying participants meeting criteria for CompSAS were randomized to optimized CPAP or ASV treatment. Clinical and polysomnographic data were obtained at baseline and after 90 days of therapy.
    We randomized 66 participants (33 to each treatment). At baseline, the diagnostic apnea-hypopnea index (AHI) was 37.7 ± 27.8 (central apnea index [CAI] = 3.2 ± 5.8) and best CPAP AHI was 37.0 ± 24.9 (CAI 29.7 ± 25.0). After second-night treatment titration, the AHI was 4.7 ± 8.1 (CAI = 1.1 ± 3.7) on ASV and 14.1 ± 20.7 (CAI = 8.8 ± 16.3) on CPAP (P ≤ 0.0003). At 90 days, the ASV versus CPAP AHI was 4.4 ± 9.6 versus 9.9 ± 11.1 (P = 0.0024) and CAI was 0.7 ± 3.4 versus 4.8 ± 6.4 (P < 0.0001), respectively. In the intention-to-treat analysis, success (AHI < 10) at 90 days of therapy was achieved in 89.7% versus 64.5% of participants treated with ASV and CPAP, respectively (P = 0.0214). Compliance and changes in Epworth Sleepiness Scale and Sleep Apnea Quality of Life Index were not significantly different between treatment groups.
    Adaptive servoventilation (ASV) was more reliably effective than CPAP in relieving complex sleep apnea syndrome. While two thirds of participants experienced success with CPAP, approximately 90% experienced success with ASV. Because both methods produced similar symptomatic changes, it is unclear if this polysomnographic effectiveness may translate into other desired outcomes.
    Clinicaltrials.Gov NCT00915499.
    PMID: 25465532 [PubMed - as supplied by publisher]
  • The complexities of complex sleep apnea.

    Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine 2013

    Authors: Kuźniar TJ,
    Abstract
    The definition of complex sleep apnea (CompSAS) encompasses patients with obstructive sleep apnea (OSA) who develop central apnea activity upon restitution of airway patency. Presence of arterial hypertension (HTN), coronary artery disease (CAD) and heart failure (HF) have been proposed as risk factors for CompSAS among OSA patients. Using our database of patients with CompSAS, we examined the prevalence of these risk factors and defined other clinical characteristics of patients with CompSAS.
    Through retrospective search of the database, we examined the medical and clinical characteristics of consecutive patients diagnosed with CompSAS between 11/1/2006 and 6/30/2011 at NorthShore University HealthSystem.
    One hundred and fifty patients with CompSAS were identified. Among patients included in the study, 97 (64.7 %) had at least one risk factor for CompSAS, while 53 (35.3 %) did not have any of them. Prevalence of low left ventricular ejection fraction and hypocapnia were low. Therapeutic interventions consisted of several positive airway pressure therapies, mainly adaptive servo ventilation. A hundred and ten patients (73.3 %) complied with recommended therapy and improved clinically.
    Although most patients with CompSAS have cardiac comorbidities, about one third of patients do not have any risk factors of CompSAS prior to sleep testing. Further research on factors involved in development of CompSAS will allow for better tailoring of therapy to pathophysiology involved in an individual case.
    PMID: 24235902 [PubMed - as supplied by publisher]
  • Pulmonary nocardiosis in a patient with chronic obstructive pulmonary disease--case report and literature review.

    Pneumonologia i alergologia polska 2012

    Authors: Anderson M,
    Abstract
    Nocardiosis is an infrequent but potentially serious pulmonary infection that typically affects patients with immune suppression or structural lung disease. We report a case of a 70-year-old patient with chronic obstructive pulmonary disease (COPD) treated with inhaled steroids, theophylline, short-acting beta-agonists and anticholinergics, and long-term oxygen therapy, who presented with non-resolving pneumonia. Following a diagnosis of nocardiosis, made based on sputum culture, the patient was treated with trimethoprim/sulphamethoxazole and then, due to treatment side effects, with minocycline. We review the literature data on nocardiosis in COPD patients.
    PMID: 23109210 [PubMed - as supplied by publisher]
  • Treatment of complex sleep apnea syndrome.

    Chest 2012 Oct

    Authors: Kuźniar TJ,
    Abstract
    Complex sleep apnea syndrome (CompSAS) describes the coexistence or appearance and persistence of central apneas or hypopneas in patients with obstructive sleep apnea upon successful restoration of airway patency. We review data on treatment of CompSAS with CPAP, bilevel positive airway pressure, and adaptive servoventilation and discuss evidence for the addition of medications (analgesics, hypnotics, acetazolamide) and gases (oxygen, CO2) to positive airway pressure therapy. Future research should focus on defining outcomes in patients with CompSAS and allow for more accurate tailoring of therapy to the pathophysiology present in the individual patient.
    PMID: 23032455 [PubMed - as supplied by publisher]
  • The emergence of central sleep apnea after surgical relief of nasal obstruction in obstructive sleep apnea.

    Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine 2012 Jun 15

    Authors: Goldstein C,
    Abstract
    By the current definition, complex sleep apnea (CompSA) refers to the emergence of central sleep apnea (CSA) during the treatment of obstructive sleep apnea (OSA) with continuous positive airway pressure (CPAP). However, new-onset CSA has been described with use of other treatments for OSA, including tracheostomy, maxillofacial surgery, and mandibular advancement device. We present a patient with CSA beginning after endoscopic sinus and nasal surgery for nasal obstruction in the setting of mild OSA. This case highlights the importance of non-PAP mechanisms in the pathogenesis of CompSA.
    PMID: 22701391 [PubMed - as supplied by publisher]
  • Trials of bilevel positive airway pressure - spontaneous in patients with complex sleep apnoea.

    Pneumonologia i alergologia polska 2012

    Authors: Kuźniar TJ,
    Abstract
    Patients with complex sleep apnoea (CompSAS) have obstructive sleep apnoea and experience persistent central apnoeas when exposed to positive airway pressure. Elevated loop gain is one of the postulated mechanisms of CompSAS. We speculated that bilevel positive airway pressure - spontaneous (BPAP-S), by producing relative hyperventilation, may more readily produce CompSAS activity than continuous positive airway pressure (CPAP). If found to do so, a trial of BPAP-S might be a simple way of identifying patients with elevated loop gain who are at risk for CompSAS.
    Thirty-nine patients with complex sleep apnoea were included in the study. Segments of NREM sleep on CPAP and BPAP-S matched for body position and expiratory airway pressure (comparison pressure) were retrospectively analysed. Correlations between clinical and demographic variables and polysomnographic response to CPAP and BPAP-S were sought.
    There was no difference in any of the polysomnographic indices on CPAP and BPAP-S. In 19 patients the use of CPAP was associated with lower AHI at the comparison pressure; in 20 patients the opposite was true. No clinical variables correlated to the differential response to CPAP vs. BPAP-S.
    BPAP-S was not more effective than CPAP in stimulating complex sleep apnoea activity.
    PMID: 22562273 [PubMed - as supplied by publisher]
  • Parotid abscess in a patient with obstructive sleep apnea treated with continuous positive airway pressure therapy.

    Sleep & breathing = Schlaf & Atmung 2012 Sep

    Authors:
    Abstract
    PMID: 21960462 [PubMed - as supplied by publisher]
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