Sleep endoscopy and complete concentric collapse in CPAP failure

HNO
Katrin HasselbacherA Steffen

Abstract

First-line treatment for patients with obstructive sleep apnea (OSA) is continuous positive airway pressure (CPAP) therapy. However, many patients cannot use CPAP sufficiently. With drug-induced endoscopy (DISE), it is possible to assess the collapse pattern in the upper airway. The aim of this work was to evaluate a collective of patients with CPAP usage problems using DISE, in order to evaluate their usage problems and therapy recommendations. Over a period of 5 years, all patients with an apnea-hypopnea index (AHI) of at least 15/h were retrospectively evaluated using DISE. The recommended treatment options were then analyzed. Data analysis of 210 patients showed that about two thirds reported mask problems as the cause of non-adherence to CPAP. A complete concentric collapse (CCC) could be excluded in 75%. These patients had a lower AHI and more frequent tonsillectomy (TE) than patients with CCC. Double the number of patients with a body mass index (BMI) > 35 kg/m2 had a CCC compared to those with a BMI < 35 kg/m2. Among patients with similar BMI and AHI, CCC was twice as likely to be found in patients without TE. The course of treatment recommended for OSA often differs, depending on CCC, BMI > 35 kg/m2, and previous TE.

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Citations

Feb 29, 2020·The Laryngoscope·Stanley Yung-Chuan LiuRobson Capasso
Sep 6, 2019·Sleep & Breathing = Schlaf & Atmung·Armin SteffenClemens Heiser
Sep 1, 2020·The Laryngoscope·Armin SteffenKatrin Hasselbacher
Apr 28, 2020·Laryngoscope Investigative Otolaryngology·Armin SteffenClemens Heiser
May 8, 2020·Sleep & Breathing = Schlaf & Atmung·E DielemanM P Copper

Dec 15, 2020·Laryngo- rhino- otologie·Armin SteffenWinfried Randerath
Jun 7, 2021·Sleep & Breathing = Schlaf & Atmung·Markus WirthClemens Heiser
Jun 22, 2021·European Archives of Oto-rhino-laryngology : Official Journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : Affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery·Armin SteffenWinfried Randerath
Jul 3, 2021·Neuromodulation : Journal of the International Neuromodulation Society·Armin SteffenInke R König
Jul 20, 2021·Journal of Clinical Sleep Medicine : JCSM : Official Publication of the American Academy of Sleep Medicine·Maria V SuurnaStacey L Ishman

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