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Understanding Correlation of Polysomnography Parameters with Drug Induced Sleep Endoscopy in Obstructive Sleep Apnea

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Abstract

The aim of this study was to analyze drug-induced sleep endoscopy (DISE) findings performed in 64 patients and to evaluate the association of DISE findings with PSG parameters. This retrospective, single center, observational study included patients with obstructive sleep apnoea (OSA) who have undergone DISE as part of surgical planning. DISE was performed using dexmedetomidine infusion. The data were documented as per VOTE (velum, oropharynx, tongue base and epiglottis) classification. The patient characteristics and level 2 Polysomnography (PSG) findings were analyzed with DISE findings. Among 62 patients, mean AHI and lowest oxygen saturation levels were 39.68 ± 27.59 and 78.36 ± 9.38, respectively. Mean ESS, SSS and PSQI levels were 10.74 ±  − 4.96, 7.73 ±  − 1.52, and 8.92 +/− 4.99, respectively. A Single level of obstruction was observed in 4.8% patients, followed by 40.3%, 43.5%, and 11.3% were found to have 2, 3, and 4 levels of obstruction, respectively. All patients had palatal involvement, followed by the oropharyngeal (88.7%), the tongue base (59.7%), and the epiglottis (12.9%) obstruction. There was no significant correlation between partial collapse at velopharynx with AHI. However, complete collapse at the level of the oropharynx (p < 0.05) and the tongue base (p < 0.001) showed a statistically significant association with AHI. Also, a significant correlation was observed between the number of sites and AHI Grade (p < 0.0001). The study helps to understand the association of different patterns and degrees of anatomical obstruction in OSA with different PSG parameters. PSG and DISE findings are complimentary to each other in treatment planning and selection of surgical procedures.

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References

  1. Croft CB, Pringle M (1991) Sleep nasendoscopy: a technique of assessment in snoring and obstructive sleep apnoea. Clin Otolaryngol Allied Sci 16(5):504–509

    Article  CAS  PubMed  Google Scholar 

  2. Moon IJ, Han DH, Kim JW, Rhee CS, Sung MW et al (2010) Sleep magnetic resonance imaging as a new diagnostic method in obstructive sleep apnoea syndrome. Laryngoscope 120(12):2546–2554

    Article  PubMed  Google Scholar 

  3. Kezirian EJ, Hohenhorst W, De Vries N (2011) Drug-induced sleep endoscopy: the VOTE classification. Eur Arch Otorhinolaryngol 268(8):1233–1236

    Article  PubMed  Google Scholar 

  4. Lim PVH, Curry AR (1999) A new method for evaluating and reporting the severity of snoring. J Laryngol Otol 113:336–340

    Article  CAS  PubMed  Google Scholar 

  5. Buysse DJ, Reynolds CF III, Monk TH, Berman SR, Kupfer DJ (1989) The pittsburgh sleep quality index: a new instrument for psychiatric practice and research. Psychiatry Res 28(2):193–213

    Article  CAS  PubMed  Google Scholar 

  6. Kumar HV, Schroeder JW Jr, Gang Z, Sheldon SH (2014) Mallampati score and pediatric obstructive sleep apnoea. J Clin Sleep Med 10(9):985–990

    Article  PubMed  PubMed Central  Google Scholar 

  7. Singh J, Badr MS, Diebert W, Epstein L, Hwang D, Karres V et al (2015) American academy of sleep medicine (AASM) position paper for the use of telemedicine for the diagnosis and treatment of sleep disorders: an American academy of sleep medicine position paper. J Clin Sleep Med 11(10):1187–1198

    Article  PubMed  PubMed Central  Google Scholar 

  8. Osman AM, Carter SG, Carberry JC, Eckert DJ (2018) Obstructive sleep apnoea: current perspectives. Nat Sci Sleep 23(10):21–34. https://doi.org/10.2147/NSS.S124657.PMID:29416383;PMCID:PMC5789079

    Article  Google Scholar 

  9. Randerath W, Bassetti CL, Bonsignore MR, Farre R, Ferini-Strambi L et al (2018) Challenges and perspectives in obstructive sleep apnoea. Eur Respir J 52(3):1702616. https://doi.org/10.1183/13993003.02616-2017

    Article  PubMed  Google Scholar 

  10. Yoon BW, Hong JM, Hong SL, Koo SK, Roh HJ, Cho KS (2016) A comparison of dexmedetomidine versus propofol during drug-induced sleep endoscopy in sleep apnoea patients. Laryngoscope 126(3):763–767

    Article  CAS  PubMed  Google Scholar 

  11. Fernandez-Julian E, Garcia-Perez MA, Garcia-Callejo J, Ferrer F, Marti F, Marco J (2014) Surgical planning after sleep versus awake techniques in patients with obstructive sleep apnoea. Laryngoscope 124(8):1970–1974

    Article  PubMed  Google Scholar 

  12. Campanini A, Canzi P, De Vito A, Dallan I, Montevecchi F, Vicini C (2010) Awake versus sleep endoscopy: personal experience in 250 OSAHS patients. Acta Otorhinolaryngol Ital 30(2):73–77

    CAS  PubMed  PubMed Central  Google Scholar 

  13. Soares D, Folbe AJ, Yoo G, Badr MS, Rowley JA, Lin HS (2013) Drug-induced sleep endoscopy vs awake Müller’s maneuver in the diagnosis of severe upper airway obstruction. Otolaryngol Head Neck Surg 148(1):151–156

    Article  PubMed  Google Scholar 

  14. Ravesloot MJ, de Vries N (2011) One hundred consecutive patients undergoing drug-induced sleep endoscopy: results and evaluation. Laryngoscope 121(12):2710–2716

    Article  PubMed  Google Scholar 

  15. De Corso E, Fiorita A, Rizzotto G et al (2013) The role of drug-induced sleep endoscopy in the diagnosis and management of obstructive sleep apnoea syndrome: our personal experience. Acta Otorhinolaryngol Ital 33(6):405–413

    PubMed  Google Scholar 

  16. Certal VF, Pratas R, Guimaraes L, Lugo R, Tsou Y, Camacho M et al (2016) Awake examination versus DISE for surgical decision making in patients with OSA: a systematic review. Laryngoscope 126(3):768–774

    Article  PubMed  Google Scholar 

  17. Johal A, Battagel JM, Kotecha BT (2005) Sleep nasendoscopy: a diagnostic tool for predicting treatment success with mandibular advancement splints in obstructive sleep apnoea. Eur J Orthod 27:607–614

    Article  PubMed  Google Scholar 

  18. Sanabria J, Arrieta JJ, Pondal SG, Casas CC, Troncoso F, Rodriguez P et al (2019) Using individualized mandibular advancement device to avoid confusing jaw maneuvers during DISE in 114 consecutive sleep-apnea patients. Eur Respir J 54(63):4174

    Google Scholar 

  19. Strollo PJ Jr, Soose RJ, Maurer JT, De Vries N, Cornelius J, Froymovich O et al (2014) Upper-airway stimulation for obstructive sleep apnoea. N Engl J Med 370(2):139–149

    Article  CAS  PubMed  Google Scholar 

  20. De Corso E, Bastanza G, Della Marca G, Grippaudo C, Rizzotto G, Marchese MR et al (2015) Drug-induced sleep endoscopy as a selection tool for mandibular advancement therapy by oral device in patients with mild to moderate obstructive sleep apnoea. Acta Otorhinolaryngol Ital 35(6):426–432

    PubMed  Google Scholar 

  21. Kotecha B, De Vito A (2018) Drug induced sleep endoscopy: its role in evaluation of the upper airway obstruction and patient selection for surgical and non-surgical treatment. J Thorac Dis 10(1):40

    Article  Google Scholar 

  22. Vanderveken OM, Maurer JT, Hohenhorst W, Hamans E, Lin HS, Vroegop AV et al (2013) Evaluation of drug-induced sleep endoscopy as a patient selection tool for implanted upper airway stimulation for obstructive sleep apnoea. J Clin Sleep Med 9(5):433–438

    Article  PubMed  PubMed Central  Google Scholar 

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Authors and Affiliations

  1. Medicover Hospitals, Hyderabad, India

    Sampurna Ghosh

  2. AIG Hospitals, Hyderabad, India

    Srinivas Kishore

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  1. Sampurna Ghosh
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  2. Srinivas Kishore
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Correspondence to Sampurna Ghosh.

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Ghosh, S., Kishore, S. Understanding Correlation of Polysomnography Parameters with Drug Induced Sleep Endoscopy in Obstructive Sleep Apnea. Indian J Otolaryngol Head Neck Surg 76, 30–35 (2024). https://doi.org/10.1007/s12070-023-04052-1

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