Drug-Induced Sleep Endoscopy Findings in Supine vs Nonsupine Body Positions in Positional and Nonpositional Obstructive Sleep Apnea

Yalamanchili, Ronica; Mack, Wendy J.; Kezirian, Eric J.

doi:10.1001/jamaoto.2018.3692

Cited by 18 publications

(17 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Further study is needed with the DISE results. Third, although body position has been found to have a definite effect on upper airway collapsibility 7,27,28 , this study has a limitation that the effect of body position was not taken into account. This is because PM was measured during natural whole-night sleep and includes all body positions such as supine, right lateral, left lateral and prone, whereas DISF was evaluated only in the supine position during drug-induced sleep.…”

Section: Discussionmentioning

confidence: 96%

Correlation between short-time and whole-night obstruction level tests for patients with obstructive sleep apnea

Kim

Ahn

Choi

et al. 2021

Sci Rep

View full text Add to dashboard Cite

Identification of obstructive level is crucial for successful surgical outcomes in patients with obstructive sleep apnea (OSA). Unfortunately, most of the dynamic airway evaluations are performed for a short duration under drug-induced sleep; therefore, it is uncertain whether they represent airway events that occur during a whole night of sleep. This study was aimed to evaluate the correlation between obstructive levels that were identified by a short-time and a whole-night test in patients with OSA. Total 101 patients with OSA underwent drug-induced sleep fluoroscopy (DISF) and pressure manometry (PM). For DISF, the obstructive pattern was classified into one of three groups: soft palate, tongue-based, and a combined obstruction. PM was used to measure the proportion of retroglossal events out of total whole-night obstructive events in each patient. The mean age of the patients was 43.8 years. The obstructive pattern was identified as soft palate in 56 patients, combined in 38 patients, and tongue-based in 7 patients following DISF. Results from PM showed that the mean percentage of retroglossal obstructive events was 31.2 ± 30.7%. The average proportion of retroglossal obstructive events that were identified by PM in patients with soft palate, combined, and tongue-based obstruction was 27.2%, 32.1%, and 59.0%, respectively (p = 0.033). There are limitations of evaluating obstructive events that occur during a whole night with short-time tests. Surgeons should be aware the possibility of disagreement in the obstructive level between short-time and whole-night tests.

show abstract

Section: Discussionmentioning

confidence: 96%

Correlation between short-time and whole-night obstruction level tests for patients with obstructive sleep apnea

Kim

Ahn

Choi

et al. 2021

Sci Rep

View full text Add to dashboard Cite

show abstract

“…Patients with an AHI of 15-30 exhibited less severe lateral pharyngeal wall obstruction in the lateral position, but the obstruction increased in those with an AHI exceeding 30. Yalamanchili, et al 23) found that the oropharyngeal wall was the principal obstruction site in OSA patients, especially when sleeping in the lateral position. Thus, changes in sleep position may affect the principal upper airway obstruction site.…”

Section: Discussionmentioning

confidence: 99%

Snoring Sound Intensity and Formant Frequencies by Sleep Position in Patients with Positional Obstructive Sleep Apnea

Koh¹,

Kwon²,

Koo³

et al. 2020

Korean J Otorhinolaryngol-Head Neck Surg

View full text Add to dashboard Cite

Background and Objectives Snoring is the most common symptom of obstructive sleep apnea (OSA) and is caused by turbulent airflow due to narrowing of the upper airways. In patients with positional OSA, a change in sleep posture from supine to lateral is known to reduce snoring and sleep apnea. This study was performed to compare changes in snoring sound intensity and formant frequencies according to sleep position.Subjects and Method A total of 19 patients (male: 18; female: 1) diagnosed with positional OSA by polysomnography (PSG) were enrolled in this study. The snoring sounds recorded during PSG were analyzed acoustically and compared according to sleep position (i.e., supine vs. lateral).Results Snoring disappeared on changing sleep position in five patients, all of whom had Apnea-Hypopnea Index (AHI) <15. In other patients, the snoring sounds tended to decrease with posture change, and the degree of decrease was inversely proportional to AHI (p=0.015) and respiratory disturbance index (RDI) (p=0.013). Formant frequencies 1, 3, and 4 (F1, F3, and F4, respectively) decreased when sleeping in the lateral position (p=0.02, 0.03, and 0.01, respectively).Conclusion In patients with positional OSA, a change in sleep posture from supine to lateral during sleep reduced the intensity and frequency of snoring sound.

show abstract

“…In a population of mostly nonobese adults, Yalamanchili et al have showed a greater likelihood of anteroposterior airway narrowing (velum, tongue base, and epiglottis) in the supine position in both positional and non-positional OSA. In non-positional OSA, there was a higher degree of oropharyngeal lateral wall collapse in the lateral position [ 18 ]. In the study of Lee et al, they have found that oropharyngeal lateral wall collapse did not show significant improvement after position change (70.6% in supine vs. 60.0% in lateral).…”

Section: Discussionmentioning

confidence: 99%

Role of drug-induced sleep endoscopy in evaluation of positional vs non-positional OSA

Lan

Liu

Lan

et al. 2020

J of Otolaryngol - Head & Neck Surg

View full text Add to dashboard Cite

Background The study aimed to evaluate the anatomical differences between positional and non-positional OSA, and to identify the potential predictors for distinguishing between these two types of OSA. Methods A cross-sectional study of 230 consecutive patients with OSA undergoing DISE (Drug-induced Sleep Endoscopy) was carried out at a tertiary academic medical center. The factors correlating with positional and non-positional OSA were analyzed, including clinical characteristics, polysomnography data, and DISE findings. Results Univariate analysis revealed that non-positional dependency was correlated with a higher BMI (p < 0.001), neck circumference (p < 0.001), modified Mallampati score (p = 0.003), AHI (p < 0.001), degree of velum concentric collapse (p = 0.004), degree of oropharyngeal lateral wall collapse (p < 0.001), and degree of tongue base anteroposterior collapse (p = 0.004). Multivariate analysis revealed that oropharyngeal lateral wall collapse (OR = 1.90, p = 0.027) was the only anatomical factor significantly predicted non-positional dependency in OSA patients. AHI (OR = 1.04, p < 0.001), although significant, made only a marginal contribution to the prediction of non-positional dependency. Conclusions Oropharyngeal lateral wall collapse was identified as the only anatomical predictor for non-positional dependency in OSA patients. Therefore, further treatment modalities should address the distinct anatomical trait between positional and non-positional OSA. Graphical abstract

show abstract

Drug-Induced Sleep Endoscopy Findings in Supine vs Nonsupine Body Positions in Positional and Nonpositional Obstructive Sleep Apnea

Cited by 18 publications

References 14 publications

Correlation between short-time and whole-night obstruction level tests for patients with obstructive sleep apnea

Correlation between short-time and whole-night obstruction level tests for patients with obstructive sleep apnea

Snoring Sound Intensity and Formant Frequencies by Sleep Position in Patients with Positional Obstructive Sleep Apnea

Role of drug-induced sleep endoscopy in evaluation of positional vs non-positional OSA

Contact Info

Product

Resources

About