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

Abstract 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...

Full description

Saved in:
Bibliographic Details
Main Authors: Ming-Chin Lan, Stanley Yung-Chuan Liu, Ming-Ying Lan, Yun-Chen Huang, Tung-Tsun Huang, Yen-Bin Hsu
Format: Article
Language:English
Published: SAGE Publishing 2020-12-01
Series:Journal of Otolaryngology - Head and Neck Surgery
Subjects:
Online Access:https://doi.org/10.1186/s40463-020-00478-7
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1832544207888187392
author Ming-Chin Lan
Stanley Yung-Chuan Liu
Ming-Ying Lan
Yun-Chen Huang
Tung-Tsun Huang
Yen-Bin Hsu
author_facet Ming-Chin Lan
Stanley Yung-Chuan Liu
Ming-Ying Lan
Yun-Chen Huang
Tung-Tsun Huang
Yen-Bin Hsu
author_sort Ming-Chin Lan
collection DOAJ
description Abstract 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
format Article
id doaj-art-82741896f8e9488f8ac417a1b6b0b17b
institution Kabale University
issn 1916-0216
language English
publishDate 2020-12-01
publisher SAGE Publishing
record_format Article
series Journal of Otolaryngology - Head and Neck Surgery
spelling doaj-art-82741896f8e9488f8ac417a1b6b0b17b2025-02-03T10:53:56ZengSAGE PublishingJournal of Otolaryngology - Head and Neck Surgery1916-02162020-12-014911710.1186/s40463-020-00478-7Role of drug-induced sleep endoscopy in evaluation of positional vs non-positional OSAMing-Chin Lan0Stanley Yung-Chuan Liu1Ming-Ying Lan2Yun-Chen Huang3Tung-Tsun Huang4Yen-Bin Hsu5Department of Otolaryngology-Head & Neck Surgery, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical FoundationDivision of Sleep Surgery, Department of Otolaryngology, Stanford University School of MedicineDepartment of Otolaryngology-Head & Neck Surgery, Taipei Veterans General HospitalDepartment of Otolaryngology-Head & Neck Surgery, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical FoundationDepartment of Otolaryngology-Head & Neck Surgery, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical FoundationDepartment of Otolaryngology-Head & Neck Surgery, Taipei Veterans General HospitalAbstract 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 abstracthttps://doi.org/10.1186/s40463-020-00478-7Obstructive sleep apneaPositional OSANon-positional OSASleep positionPositional dependencyNon-positional dependency
spellingShingle Ming-Chin Lan
Stanley Yung-Chuan Liu
Ming-Ying Lan
Yun-Chen Huang
Tung-Tsun Huang
Yen-Bin Hsu
Role of drug-induced sleep endoscopy in evaluation of positional vs non-positional OSA
Journal of Otolaryngology - Head and Neck Surgery
Obstructive sleep apnea
Positional OSA
Non-positional OSA
Sleep position
Positional dependency
Non-positional dependency
title Role of drug-induced sleep endoscopy in evaluation of positional vs non-positional OSA
title_full Role of drug-induced sleep endoscopy in evaluation of positional vs non-positional OSA
title_fullStr Role of drug-induced sleep endoscopy in evaluation of positional vs non-positional OSA
title_full_unstemmed Role of drug-induced sleep endoscopy in evaluation of positional vs non-positional OSA
title_short Role of drug-induced sleep endoscopy in evaluation of positional vs non-positional OSA
title_sort role of drug induced sleep endoscopy in evaluation of positional vs non positional osa
topic Obstructive sleep apnea
Positional OSA
Non-positional OSA
Sleep position
Positional dependency
Non-positional dependency
url https://doi.org/10.1186/s40463-020-00478-7
work_keys_str_mv AT mingchinlan roleofdruginducedsleependoscopyinevaluationofpositionalvsnonpositionalosa
AT stanleyyungchuanliu roleofdruginducedsleependoscopyinevaluationofpositionalvsnonpositionalosa
AT mingyinglan roleofdruginducedsleependoscopyinevaluationofpositionalvsnonpositionalosa
AT yunchenhuang roleofdruginducedsleependoscopyinevaluationofpositionalvsnonpositionalosa
AT tungtsunhuang roleofdruginducedsleependoscopyinevaluationofpositionalvsnonpositionalosa
AT yenbinhsu roleofdruginducedsleependoscopyinevaluationofpositionalvsnonpositionalosa