The Use of Middle Latency Auditory Evoked Potentials (MLAEP) as Methodology for Evaluating Sedation Level in Propofol-Drug Induced Sleep Endoscopy (DISE) Procedure

Abstract

To analyze the middle latency auditory evoked potential index (MLAEPi), compared to the standard bispectral index (BIS), as a method for evaluating the sedation level in drug-induced sleep endoscopy (DISE). In this controlled clinical study on a sample of 99 obstructive sleep apnea (OSA) or snoring patients, we compared the MLAEPi with the BIS after propofol infusion during the standard DISE technique in order to define the MLAEPi values within the observational window of the procedure. The DISE procedure was divided into eight steps, and we collected both MLAEPi and BIS data values from the same patient in every step. The MLAEPi showed a faster response than the BIS after propofol infusion during DISE. Therefore, the clinical use of the MLAEPi in evaluating the sedation level seems to be a good alternative to the current technological standards.

Machine Learning (ML) Models to Enhance the Berlin Questionnaire (BQ) Detection of Obstructive Sleep Apnea (OSA) at-Risk Patients

“…Despite an increase in research and medical attention towards OSA in recent years, it remains a condition that is frequently not diagnosed. This underdiagnosis can be attributed to the lack of biomarkers for identifying the disease [10][11][12][13][14].…”

“…Recent advancements in software technologies and Machine Learning (ML) methods have significantly enhanced the development of effective predictive and diagnostic tools, becoming increasingly prevalent in various fields of medical research and applications, including for OSA [12,13,[21][22][23][24][25][26][27][28]. The prediction models described in existing research primarily utilize clinical data, such as demographic information (age and gender), comorbid conditions, anthropometric measures (Body Mass Index (BMI), waist and neck circumferences), symptoms of OSA, and physiological parameters (blood pressure, overnight pulse oximetry, and lung function tests).…”

Obstructive Sleep Apnea Syndrome: From Symptoms to Treatment

“…It consists in an upper airway evaluation during a pharmacologically simulated sleep. Yu Lin et al [ 15 ] and other literature evidence [ 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 ] has stated that DISE is superior to the wake-up endoscopy in identifying obstructions sites and types of collapses in the hypopharyngeal and base of the tongue regions. Recently, the use of a middle latency auditory evoked potentials (MLAEP) has been proposed as a good methodology to evaluate the correct level of sedation for patients during DISE procedures [ 16 , 17 ].…”