{"title":"药物诱导睡眠内窥镜检查时的家庭睡眠研究鼻气流模式和会厌塌陷。","authors":"Abhay Sharma, Jacob Noel, B Tucker Woodson","doi":"10.1007/s11325-025-03305-3","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>Obstructive sleep apnea (OSA) is characterized by collapse of various portions of the pharynx. Epiglottic collapse is difficult to diagnose and may affect treatment tolerance. Previous research shows a distinct nasal airflow pattern during epiglottic obstruction characterized by signal discontinuities. It was hypothesized that primary epiglottic collapse characterized during drug-induced sleep endoscopy (DISE) correlates with nasal airflow discontinuity signals seen on home sleep studies.</p><p><strong>Methods: </strong>Patients with clinical records of undergoing both DISE and home portable sleep studies with raw data available from December 2016 to August 2021 were screened for epiglottic collapse or no epiglottic collapse using the VOTE scoring system. Any patient with tongue base collapse was excluded. Characterization of nasal airflow signals as discontinuities was based on previously published data. Acute flow discontinuities were scored by two blinded observers (AS, JN) from home cardiorespiratory studies using nasal pressure cannulas (Apnea Link Plus). Breath statistics (total number of breaths and flow limited breaths) for each patient were captured by the home cardiorespiratory device. DISE was performed under propofol anesthesia to a Ramsay level 5. Epiglottic collapse was described by shape, direction (AP or lateral), and timing (prolonged or intermittent).</p><p><strong>Results: </strong>The home sleep studies and DISE of 18 patients being considered for surgical therapies were retrospectively analyzed. Patients included had either complete (n=11) or no epiglottic collapse (n=7). The mean AHI was 21.3 and 19.7, respectively. There was a significant difference between nonepiglottic and epiglottic collapse groups in the total discontinuity breaths (median 7 vs 29, p=0.002), discontinuity breaths/hour (median 0.91 vs 5.3, p=0.001), and fraction of discontinuity breaths over total flow limited breaths (0.5% vs 1.9%, p=0.001). Morphological changes in epiglottic collapse did not affect discontinuities.</p><p><strong>Conclusion: </strong>The data from this study demonstrates nasal airflow signals from home sleep studies correlate with DISE epiglottic collapse.</p>","PeriodicalId":21862,"journal":{"name":"Sleep and Breathing","volume":"29 2","pages":"142"},"PeriodicalIF":2.1000,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Home sleep study nasal airflow patterns and epiglottic collapse during drug induced sleep endoscopy.\",\"authors\":\"Abhay Sharma, Jacob Noel, B Tucker Woodson\",\"doi\":\"10.1007/s11325-025-03305-3\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>Obstructive sleep apnea (OSA) is characterized by collapse of various portions of the pharynx. Epiglottic collapse is difficult to diagnose and may affect treatment tolerance. Previous research shows a distinct nasal airflow pattern during epiglottic obstruction characterized by signal discontinuities. It was hypothesized that primary epiglottic collapse characterized during drug-induced sleep endoscopy (DISE) correlates with nasal airflow discontinuity signals seen on home sleep studies.</p><p><strong>Methods: </strong>Patients with clinical records of undergoing both DISE and home portable sleep studies with raw data available from December 2016 to August 2021 were screened for epiglottic collapse or no epiglottic collapse using the VOTE scoring system. Any patient with tongue base collapse was excluded. Characterization of nasal airflow signals as discontinuities was based on previously published data. Acute flow discontinuities were scored by two blinded observers (AS, JN) from home cardiorespiratory studies using nasal pressure cannulas (Apnea Link Plus). Breath statistics (total number of breaths and flow limited breaths) for each patient were captured by the home cardiorespiratory device. DISE was performed under propofol anesthesia to a Ramsay level 5. Epiglottic collapse was described by shape, direction (AP or lateral), and timing (prolonged or intermittent).</p><p><strong>Results: </strong>The home sleep studies and DISE of 18 patients being considered for surgical therapies were retrospectively analyzed. Patients included had either complete (n=11) or no epiglottic collapse (n=7). The mean AHI was 21.3 and 19.7, respectively. There was a significant difference between nonepiglottic and epiglottic collapse groups in the total discontinuity breaths (median 7 vs 29, p=0.002), discontinuity breaths/hour (median 0.91 vs 5.3, p=0.001), and fraction of discontinuity breaths over total flow limited breaths (0.5% vs 1.9%, p=0.001). Morphological changes in epiglottic collapse did not affect discontinuities.</p><p><strong>Conclusion: </strong>The data from this study demonstrates nasal airflow signals from home sleep studies correlate with DISE epiglottic collapse.</p>\",\"PeriodicalId\":21862,\"journal\":{\"name\":\"Sleep and Breathing\",\"volume\":\"29 2\",\"pages\":\"142\"},\"PeriodicalIF\":2.1000,\"publicationDate\":\"2025-03-28\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Sleep and Breathing\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s11325-025-03305-3\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Sleep and Breathing","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s11325-025-03305-3","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
Home sleep study nasal airflow patterns and epiglottic collapse during drug induced sleep endoscopy.
Purpose: Obstructive sleep apnea (OSA) is characterized by collapse of various portions of the pharynx. Epiglottic collapse is difficult to diagnose and may affect treatment tolerance. Previous research shows a distinct nasal airflow pattern during epiglottic obstruction characterized by signal discontinuities. It was hypothesized that primary epiglottic collapse characterized during drug-induced sleep endoscopy (DISE) correlates with nasal airflow discontinuity signals seen on home sleep studies.
Methods: Patients with clinical records of undergoing both DISE and home portable sleep studies with raw data available from December 2016 to August 2021 were screened for epiglottic collapse or no epiglottic collapse using the VOTE scoring system. Any patient with tongue base collapse was excluded. Characterization of nasal airflow signals as discontinuities was based on previously published data. Acute flow discontinuities were scored by two blinded observers (AS, JN) from home cardiorespiratory studies using nasal pressure cannulas (Apnea Link Plus). Breath statistics (total number of breaths and flow limited breaths) for each patient were captured by the home cardiorespiratory device. DISE was performed under propofol anesthesia to a Ramsay level 5. Epiglottic collapse was described by shape, direction (AP or lateral), and timing (prolonged or intermittent).
Results: The home sleep studies and DISE of 18 patients being considered for surgical therapies were retrospectively analyzed. Patients included had either complete (n=11) or no epiglottic collapse (n=7). The mean AHI was 21.3 and 19.7, respectively. There was a significant difference between nonepiglottic and epiglottic collapse groups in the total discontinuity breaths (median 7 vs 29, p=0.002), discontinuity breaths/hour (median 0.91 vs 5.3, p=0.001), and fraction of discontinuity breaths over total flow limited breaths (0.5% vs 1.9%, p=0.001). Morphological changes in epiglottic collapse did not affect discontinuities.
Conclusion: The data from this study demonstrates nasal airflow signals from home sleep studies correlate with DISE epiglottic collapse.
期刊介绍：
The journal Sleep and Breathing aims to reflect the state of the art in the international science and practice of sleep medicine. The journal is based on the recognition that management of sleep disorders requires a multi-disciplinary approach and diverse perspectives. The initial focus of Sleep and Breathing is on timely and original studies that collect, intervene, or otherwise inform all clinicians and scientists in medicine, dentistry and oral surgery, otolaryngology, and epidemiology on the management of the upper airway during sleep.
Furthermore, Sleep and Breathing endeavors to bring readers cutting edge information about all evolving aspects of common sleep disorders or disruptions, such as insomnia and shift work. The journal includes not only patient studies, but also studies that emphasize the principles of physiology and pathophysiology or illustrate potentially novel approaches to diagnosis and treatment. In addition, the journal features articles that describe patient-oriented and cost-benefit health outcomes research. Thus, with peer review by an international Editorial Board and prompt English-language publication, Sleep and Breathing provides rapid dissemination of clinical and clinically related scientific information. But it also does more: it is dedicated to making the most important developments in sleep disordered breathing easily accessible to clinicians who are treating sleep apnea by presenting well-chosen, well-written, and highly organized information that is useful for patient care.
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