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Current Sleep Medicine Reports

, Volume 3, Issue 3, pp 152–163 | Cite as

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

  • Melissa S. Oh
  • Raj C. Dedhia
Sleep and Otolaryngology (H Gouveris, Section Editor)
  • 82 Downloads
Part of the following topical collections:
  1. Topical Collection on Sleep and Otolaryngology

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.

Keywords

Drug-induced sleep endoscopy Obstructive sleep apnea Bispectral analysis Müller’s maneuver 

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

Notes

Compliance with Ethical Standards

Conflict of Interest

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).

References

Papers of particular interest, published recently have been highlighted as: • Of importance. •• Of major importance

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Copyright information

© Springer International Publishing AG 2017

Authors and Affiliations

  1. 1.Department of OtolaryngologyEmory University School of MedicineAtlantaUSA
  2. 2.Emory Sleep Center, Emory HealthcareAtlantaUSA

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