Diagnostic work-up of socially unacceptable snoring

Abstract

In the diagnostic work-up of socially unacceptable snoring (SUS) with or without a history suggestive of obstructive sleep apnoea syndrome (OSAS), information on the severity of the pathology as well as on local and general causative factors is needed. In part I of this study, we reported on the findings recorded in 380 patients by means of sleep registration. In this part, our emphasis is on analysis of the local contributing factors. In 340 of the 380 patients sleep endoscopy was performed to establish the level(s) of obstruction as accurately as possible. Sleep endoscopy was performed following artificial induction of sleep with midazolam and consisted in endoscopy and flexible nasopharyngoscopy and laryngoscopy. Although obstruction at the oropharyngeal level was often present, obstructions at lower levels or at multiple levels were also frequently found. In many cases sleep endoscopy showed obstruction at different level(s) than had been suspected on the grounds of ear nose and throat (ENT) investigation only. An obstruction at only one level was recorded in 35% of the patients (119), while 65% of patients (221) had multiple-level obstruction. The level(s) of obstruction could be well established by sleep endoscopy. We conclude that a diagnostic work-up involving a combination of sleep registration, sleep endoscopy, and analysis of general factors is worthwhile. Combining the results of these tests makes it possible to give individually tailored advice on treatment.

Snore-GANs: Improving Automatic Snore Sound Classification With Synthesized Data

“…The database is strongly imbalanced with a comparatively low number of T and E samples. This is consistent with earlier medical research, which has found that respiratory disturbances occur more frequently at velopharyngeal and oropharyngeal level, compared to the hypopharyngeal level [50]. For more specific information about the database, the readers are referred to [10].…”

One hundred consecutive patients undergoing drug-induced sleep endoscopy: Results and evaluation

“…21 Various articles have described respective sedation methods, but there is no standardized protocol. [4][5][6][7][8]22 The ideal concentration differs per individual, depending on his or her susceptibility to the sedative effect of the drug. Slow stepwise induction is vital to avoid oversedation, yielding falsepositive results.…”

“…3,4 DISE, performed for decades in many leading centers in Europe as well as in selected centers in other parts of the world, is indicated when surgery or oral device therapy is being considered as a treatment option by the patient and physician. [5][6][7] Before DISE, polysomnography (PSG) must be performed to assess the severity of the OSA. The PSG results are compulsory and at the basis of performing DISE.…”

Plasma Radiofrequency Preceded by Pressure Recording Enhances Success for Treating Sleep‐Related Breathing Disorders

“…Anatomic narrowing of the upper airways is considered one of the reasons for patients developing SRBD. Still, surgical treatment for opening up the obstructed area has not gained popularity, mainly because of the poor outcomes 7 and undesirable side effects, including postoperative pain, scarring, fibrosis, and mouth dryness. 11 With the CAUP procedure, no such negative effects were observed.…”

“…Enhancing surgical outcomes within the SRBD population requires properly identifying the site of partial or total pharyngeal obstruction during sleep as well as using a surgical tool allowing for site-specific surgery. 7 To target the optimal surgical site in SRBD patients, we have used a system consisting of micropressure transducers mounted in a thin, soft, and flexible polyurethane catheter (Apnea-Graph, MRA-Medical Ltd, Gloucestershire, UK) for several years to measure pressure gradients in the upper airway and esophagus and to collect polygraphy information during sleep. We recently began using bipolar plasmamediated radiofrequency-based (coblation) instruments to perform UPPP procedures, allowing for treatment under local anesthesia on an outpatient basis.…”