The Role of Drug-Induced Sleep Endoscopy with Positive Airway Pressure Titration in the Individualized Treatment of Obstructive Sleep Apnea: A Report of Three Illustrative Cases.

Abstract

Purpose: Drug-induced sleep endoscopy with positive airway pressure titration (DISE-PAPT) can assess the effect of varying positive pressure levels on upper airway collapse in patients with obstructive sleep apnea (OSA) under simulated sleep condition. But it remains unclear whether DISE-PAPT can facilitate the development of personalized therapeutic interventions for OSA and further improve the therapeutic efficacy.

Patients and methods: We present three adult patients with severe OSA exhibiting distinct clinical profiles: one case of continuous positive airway pressure (CPAP) treatment failure, one case of intolerance to high CPAP, and one case of psychological resistance to CPAP therapy.

Results: According to the DISE-PAPT evaluation findings, CPAP combined with positional therapy was administered in Case 1. CPAP with surgical management was performed in Case 2, resulting in significant therapeutic improvements. Additionally, real-time DISE-PAPT visualization of CPAP-mediated upper airway patency restoration enhanced CPAP adherence in Case 3.

Conclusion: The personalized treatment strategies based on the DISE-PAPT technique hold promise for improving the overall therapeutic efficacy and adherence among patients with OSA.