Outcome of drug-induced sedation endoscopy in adults with obstructive sleep apnoea or snoring.

Abstract

Introduction: First-line treatment for obstructive sleep apnoea (OSA) is continuous positive airway pressure (CPAP). However, adherence to CPAP is poor. Non-adherent patients may benefit from other treatment modalities. Drug-induced sedation endoscopy (DISE) is a validated tool to suggest individualised treatment options. This study aimed to investigate the outcome of DISE in patients with OSA or severe snoring.

Methods: Patients with OSA and/or snoring who had poor compliance with CPAP were included in a database from May 2020 to October 2022. The inclusion criteria were BMI less-than 35 kg/m2, age 18-65 years and no contraindications to propofol infusion. DISE was performed, and anatomic collapse during DISE was evaluated using the velum-oropharynx-tongue-base-epiglottis classification. Treatment suggestions were registered.

Results: The database included 190 referred patients, and 109 patients underwent DISE. Among these, 34 had mild OSA or snoring (Apnea-Hypopnea Index (AHI) less-than 15 events/hour)) and 75 had moderate-severe OSA (AHI ≥ 15 events/hour). A total of 51% of patients were recommended sleep surgery, the most frequent being tonsillectomy. Surgery was recommended more among patients with AHI ≥ 15 events/hour.

Conclusions: DISE suggests a personalised treatment for eligible patients with OSA or severe snoring. When the DISE findings were considered, half of the patients were recommended for sleep surgery. The value of DISE in planning such surgery in this cohort needs to be determined.

Funding: None.

Trial registration: The study was approved by the Institutional Review Board and the Scientific Ethical Committee of the Central Denmark Region (no: 1-10-72-228-17).