Propofol‐induced sleep: Polysomnographic evaluation of patients with obstructive sleep apnea and controls

Rabelo, Fábio Augusto Winckler; Braga, Adriano H.; Küpper, Daniel; Oliveira, José Antônio Apparecido de; Lopes, Fabrício Martins; Mattos, Pedro Luiz Vaz de Lima; Barreto, Shirley G.; Sander, Heidi H.; Fernandes, Regina Maria França; Valera, Fabiana Cardoso Pereira

doi:10.1016/j.otohns.2009.11.002

Cited by 132 publications

(97 citation statements)

References 17 publications

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“…The effect of the heterogenous methods of sedation (propofol and midazolam, bolus, and slow gradual titration) on the anatomic pattern of obstruction may be 19 The same conclusions were drawn in a study examining the effects of diazepam. 20 When using sedatives, the degree of anesthetic depth is trivial.…”

Section: Discussionmentioning

confidence: 68%

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

2011

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Section: Discussionmentioning

confidence: 68%

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

2011

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“…Therefore, we believe the choice of amplitude setting in this manner is reasonable. Regarding the reliability of DISE compared to natural sleep, a study of respiratory events in non-OSA controls and OSA patients undergoing PSG during propofol sedation and diurnal sleep did not find significant differences in apnoea severity [33]; thus, to some extent, DISE may be an approximation of upper-airway function with sedation. Variability during DISE assessment may occur due to differences in sedation depth during the procedure or between patients, which may influence collapsibility.…”

Section: Limitationsmentioning

confidence: 98%

Effect of upper-airway stimulation for obstructive sleep apnoea on airway dimensions

et al. 2014

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Upper-airway stimulation (UAS) using a unilateral implantable neurostimulator for the hypoglossal nerve is an effective therapy for obstructive sleep apnoea patients with continuous positive airway pressure intolerance. This study evaluated stimulation effects on retropalatal and retrolingual dimensions during drug-induced sedation compared with wakefulness to assess mechanistic relationships in response to UAS.Patients with an implanted stimulator underwent nasal video endoscopy while awake and/or during drug-induced sedation in the supine position. The cross-sectional area, anterior-posterior and lateral dimensions of the retropalatal and retrolingual regions were measured during baseline and stimulation.15 patients underwent endoscopy while awake and 12 underwent drug-induced sedation endoscopy. Increased levels of stimulation were associated with increased area of both the retropalatal and retrolingual regions. During wakefulness, a therapeutic level of stimulation increased the retropalatal area by 56.4% ( p=0.002) and retrolingual area by 184.1% ( p=0.006). During stimulation, the retropalatal area enlarged in the anterior-posterior dimension while retrolingual area enlarged in both anterior-posterior and lateral dimensions. During drug-induced sedation endoscopy, the same stimulation increased the retropalatal area by 180.0% ( p=0.002) and retrolingual area by 130.1% ( p=0.008). Therapy responders had larger retropalatal enlargement with stimulation than nonresponders.UAS increases both the retropalatal and retrolingual areas. This multilevel enlargement may explain reductions of the apnoea-hypopnoea index in selected patients receiving this therapy. @ERSpublications Upper-airway stimulation for OSA increases airway dimensions at both the tongue base and the palate

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“…Although DISE is performed widely, research is limited. Previous studies have demonstrated its validity [2][3][4][5][6] and reliability [7,8].…”

Section: Introductionmentioning

confidence: 99%

Drug-induced sleep endoscopy: the VOTE classification

Kezirian

Hohenhorst²,

Vries

2011

Eur Arch Otorhinolaryngol

546

413

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The surgical evaluation of obstructive sleep apnea is designed to characterize the pattern of upper airway obstruction in order to develop an effective treatment plan for an individual patient. Drug-induced sleep endoscopy (DISE) is one evaluation technique that involves assessment of individuals under pharmacologic sedation designed to simulate natural sleep, utilizing fiberoptic endoscopy to examine the upper airway. Developed in multiple centers throughout Europe, DISE was first described in 1991 and is performed widely around the world. Although multiple studies support a potential role for DISE in evaluation for treatment with surgery and mandibular repositioning appliances, important clinical questions remain unanswered. A major limitation in advancing our understanding of drug-induced sleep endoscopy has been the multiplicity and, in many cases, the complexity of classification systems that prevent the comparison of results across the studies and centers. We present the VOTE classification, a method for characterizing DISE findings that focuses on its core feature, the specific structures that contribute to obstruction.

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Propofol‐induced sleep: Polysomnographic evaluation of patients with obstructive sleep apnea and controls

Cited by 132 publications

References 17 publications

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

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

Effect of upper-airway stimulation for obstructive sleep apnoea on airway dimensions

Drug-induced sleep endoscopy: the VOTE classification

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