Andrea De Vito

1. How did you get engaged in sleep surgery? What inspired you to focus on surgical approaches for OSA, and how has your perspective evolved over time?

My first experience and involvement in sleep surgery began under the guidance of my former director, Prof. Claudio Vicini, in the late 1990s. Thanks to him, I developed my surgical proficiency and academic scientific foundation. Prof. Vicini was one of the first and few ENT specialists to take an interest in the diagnosis and treatment of patients affected by OSA. I came to understand the importance of sleep-disordered breathing from a medical point of view—its epidemiology, its underestimation—and I have continued to follow this area of our specialization ever since.

2. How is surgery for sleep-disordered breathing currently positioned in Italy? Is it recognized as a well-established field, or do you see gaps in diagnosis, treatment availability, or public awareness?

Unfortunately, in Italy, OSA remains an underdiagnosed disease, despite its known role as a risk factor for cardiovascular diseases and road accidents related to daytime sleepiness—a typical symptom of OSA. Furthermore, there are significant regional disparities in terms of access to dedicated clinics and specific care pathways for patients with OSA. However, in recent years, we have seen an increase in the number of sleep centers, both in the public and private health sectors.

3. Are all therapeutic options for OSA reimbursed by public insurance in Italy?

All therapeutic options, except for hypoglossal nerve stimulation (HNS), are covered by the public health system, including robotic surgery.

4. What are the most challenging issues you face as the head of the Department of Otorhinolaryngology?

In the field of OSA diagnosis and treatment, my main challenge as the Director of the ENT Unit is building a multidisciplinary team focused on this condition, along with establishing a truly multimodal treatment scheme.

5. How do you see the collaboration between surgical and non-surgical practices evolving in the future?

In the past year, I’ve noticed a growing interest in sleep-disordered breathing, including from the media. As a result, I hope for greater collaboration among all experts in this field.

6. What impact do you foresee from new technologies like wearables and AI in sleep medicine?

I am sure that new technologies will have a significant impact on our daily practice. For example, artificial intelligence could improve the automatic interpretation of polysomnography and help analyze comprehensive medical data (symptoms, clinical examinations, anthropometric data, polysomnographic results, etc.) to enable more personalized treatments.