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Current Techniques and Role of Drug-Induced Sleep Endoscopy for Obstructive Sleep Apnea

  • Sleep and Otolaryngology (H Gouveris, Section Editor)
  • Published:
Current Sleep Medicine Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

Drug-induced sleep endoscopy (DISE) was developed for dynamic evaluation of the airway collapse under simulated sleep conditions. DISE has been extensively studied in the last 25 years to standardize the procedures and classification as well as its role in non-surgical and surgical management. The goal of this study is to determine current techniques and recommendations regarding DISE.

Recent Findings

Current research suggests that standardization with target-controlled infusion and bispectral analysis may be safer and more reproducible. The velum, oropharyngeal, tongue base, epiglottis classification remains the most commonly used to describe the obstruction. While DISE changes surgical management in 50% of patients, there are few studies to evaluate differences in surgical outcomes with and without DISE. Emerging evidence suggests complete collapse of the velum and hypopharyngeal obstruction are associated with poor surgical outcomes.

Summary

Going forward, more information is required to determine how well DISE mimics natural sleep and its role in decision-making for patients seeking alternatives to continuous positive airway pressure.

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Abbreviations

AHI:

Apnea-hypopnea index

A-P:

Anterior-posterior

BIS:

Bispectral index

BMI:

Body mass index

CCC:

Complete concentric collapse

DISE:

Drug-induced sleep endoscopy

LAUP:

Laser-assisted uvulopalatopharyngoplasty

MM:

Müller’s maneuver

ODI:

Oxygen desaturation index

OSA:

Obstructive sleep apnea

PSG:

Polysomnography

TCI:

Target-controlled infusion

UPPP:

Uvulopalatopharyngoplasty

VOTE:

Velum, oropharyngeal, tongue base, epiglottis

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Authors and Affiliations

  1. Department of Otolaryngology, Emory University School of Medicine, Atlanta, GA, USA

    Melissa S. Oh & Raj C. Dedhia

  2. Emory Sleep Center, Emory Healthcare, Atlanta, GA, USA

    Raj C. Dedhia

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  1. Melissa S. Oh
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  2. Raj C. Dedhia
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Correspondence to Raj C. Dedhia.

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Melissa S. Oh and Raj C. Dedhia each declare no potential conflicts of interest.

Human and Animal Rights and Informed Consent

All reported studies with human or animal subjects performed by the authors have been previously published and complied with all applicable ethical standards (including the Helsinki declaration and its amendments, institutional/national research committee standards, and international/national/institutional guidelines).

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This article is part of the Topical Collection on Sleep and Otolaryngology

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Oh, M.S., Dedhia, R.C. Current Techniques and Role of Drug-Induced Sleep Endoscopy for Obstructive Sleep Apnea. Curr Sleep Medicine Rep 3, 152–163 (2017). https://doi.org/10.1007/s40675-017-0082-3

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