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Tomasz J. Kuzniar, M.D.

Tomasz J. Kuzniar, M.D.

Tomasz J. Kuzniar, M.D.

Sleep Medicine, Pulmonary/Critical Care
  • Locations

    Endeavor Health Medical Group

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

    Endeavor Health Medical Group

    1000 Central St.
    Suite 615
    Evanston, IL 60201
    847.570.2714 847.733.5109 fax
    View Map: Google
    This location is wheelchair accessible.

    Endeavor Health Medical Group

    2150 Pfingsten Rd.
    Suite 3000
    Glenview, IL 60026
    847.570.2714 847.733.5109 fax
    View Map: Google
    This location is wheelchair accessible.

    Endeavor Health Medical Group

    9669 Kenton Ave.
    Suite 602
    Skokie, IL 60076
    847.570.2714 847.236.9637 fax
    View Map: Google
    This location is wheelchair accessible.
  • Publications
    • International Consensus Statement on Obstructive Sleep Apnea.

      International forum of allergy & rhinology 2023 Jul

      Authors: Chang JL
      Evaluation and interpretation of the literature on obstructive sleep apnea (OSA) allows for consolidation and determination of the key factors important for clinical management of the adult OSA patient. Toward this goal, an international collaborative of multidisciplinary experts in sleep apnea evaluation and treatment have produced the International Consensus statement on Obstructive Sleep Apnea (ICS:OSA).
      Using previously defined methodology, focal topics in OSA were assigned as literature review (LR), evidence-based review (EBR), or evidence-based review with recommendations (EBR-R) formats. Each topic incorporated the available and relevant evidence which was summarized and graded on study quality. Each topic and section underwent iterative review and the ICS:OSA was created and reviewed by all authors for consensus.
      The ICS:OSA addresses OSA syndrome definitions, pathophysiology, epidemiology, risk factors for disease, screening methods, diagnostic testing types, multiple treatment modalities, and effects of OSA treatment on multiple OSA-associated comorbidities. Specific focus on outcomes with positive airway pressure (PAP) and surgical treatments were evaluated.
      This review of the literature consolidates the available knowledge and identifies the limitations of the current evidence on OSA. This effort aims to create a resource for OSA evidence-based practice and identify future research needs. Knowledge gaps and research opportunities include improving the metrics of OSA disease, determining the optimal OSA screening paradigms, developing strategies for PAP adherence and longitudinal care, enhancing selection of PAP alternatives and surgery, understanding health risk outcomes, and translating evidence into individualized approaches to therapy.
      PMID: 36068685 [PubMed - as supplied by publisher]
    • CPAP Adherence, Mortality, and Progression-Free Survival in Interstitial Lung Disease and OSA.

      Chest 2020 Oct

      Authors: Adegunsoye A, Neborak JM, Zhu D, Cantrill B, Garcia N, Oldham JM, Noth I, Vij R, Kuzniar TJ, Bellam SK, Strek ME, Mokhlesi B
      OSA, a common comorbidity in interstitial lung disease (ILD), could contribute to a worsened course if untreated. It is unclear if adherence to CPAP therapy improves outcomes.
      Does adherence to CPAP therapy improve outcomes in patients with concurrent interstitial lung disease and OSA?
      We conducted a 10-year retrospective observational multicenter cohort study, assessing adult patients with ILD who had undergone polysomnography. Subjects were categorized based on OSA severity into no/mild OSA (apnea-hypopnea index score < 15) or moderate/severe OSA (apnea-hypopnea index score ≥ 15). All subjects prescribed and adherent to CPAP were deemed to have treated OSA. Cox regression models were used to examine the association of OSA severity and CPAP adherence with all-cause mortality risk and progression-free survival (PFS).
      Of 160 subjects that met inclusion criteria, 131 had OSA and were prescribed CPAP. Sixty-six patients (41%) had no/mild untreated OSA, 51 (32%) had moderate/severe untreated OSA, and 43 (27%) had treated OSA. Subjects with no/mild untreated OSA did not differ from those with moderate/severe untreated OSA in mean survival time (127 ± 56 vs 138 ± 93 months, respectively; P = .61) and crude mortality rate (2.9 per 100 person-years vs 2.9 per 100 person-years, respectively; P = .60). Adherence to CPAP was not associated with improvement in all-cause mortality risk (hazard ratio [HR], 1.1; 95% CI, 0.4-2.9; P = .79) or PFS (HR, 0.9; 95% CI, 0.5-1.5; P = .66) compared with those that were nonadherent or untreated. Among subjects requiring supplemental oxygen, those adherent to CPAP had improved PFS (HR, 0.3; 95% CI, 0.1-0.9; P = .03) compared with nonadherent or untreated subjects.
      Neither OSA severity nor adherence to CPAP was associated with improved outcomes in patients with ILD except those requiring supplemental oxygen.
      PMID: 32450237 [PubMed - as supplied by publisher]
    • New Approaches to Positive Airway Pressure Treatment in Obstructive Sleep Apnea.

      Sleep medicine clinics 2016 Jun

      Authors: Kuźniar TJ
      Continuous positive airway pressure (CPAP) is a mainstay of therapy in patients with obstructive sleep apnea (OSA). This technology has gone through tremendous changes that resulted in devices that can recognize and differentiate sleep-disordered breathing events, adjust their output to these events, monitor usage, and communicate with the treatment team. This article discusses recent developments in treatment of OSA with PAP.
      PMID: 27236053 [PubMed - as supplied by publisher]
    • Treatment-emergent central sleep apnea at high altitude.

      Sleep medicine 2015 Mar

      Authors: Kuźniar TJ
      PMID: 25465532 [PubMed - as supplied by publisher]
    • Sleep apnea, continuous positive airway pressure, and renal health.

      American journal of respiratory and critical care medicine 2014 Sep 01

      Authors: Kuźniar TJ, Klinger M
      PMID: 25171309 [PubMed - as supplied by publisher]
    • The complex sleep apnea resolution study: a prospective randomized controlled trial of continuous positive airway pressure versus adaptive servoventilation therapy.

      Sleep 2014 May 01

      Authors: Morgenthaler TI, Kuzniar TJ, Wolfe LF, Willes L, McLain WC
      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: 24790271 [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 Nov 15

      Authors: Kuźniar TJ
      PMID: 24235902 [PubMed - as supplied by publisher]
    • Clinical heterogeneity of patients with complex sleep apnea syndrome.

      Sleep & breathing = Schlaf & Atmung 2013 Dec

      Authors: Kuźniar TJ, Kasibowska-Kuźniar K, Ray DW, Freedom T
      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: 23436008 [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, Kuźniar TJ
      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, Morgenthaler TI
      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]