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Updated: Jul 25, 2025
07:54
Drug-Induced Sleep Endoscopy DISE with Target Controlled Infusion TCI and Bispectral Analysis in Obstructive Sleep Apnea
Published on: December 6, 2016
19.8K
Multilevel Airway Obstruction Phenotypes in Adult OSA
Bartholomew Bacak1, Lee Porterfield1, Sveta Karelsky1
1University of Rochester Medical Center Rochester New York USA.
OTO Open
|June 26, 2023
Summary
Three distinct airway obstruction phenotypes were identified using drug-induced sleep endoscopy (DISE) in adults. These multilevel phenotypes suggest different collapse patterns and may guide future treatment strategies for sleep apnea.
Area of Science:
- Sleep Medicine
- Otolaryngology
- Respiratory Physiology
Background:
- Airway obstruction during sleep is a key factor in obstructive sleep apnea.
- Drug-induced sleep endoscopy (DISE) is a valuable tool for visualizing airway collapse.
- Understanding multilevel airway obstruction phenotypes is crucial for effective treatment.
Purpose of the Study:
- To describe multilevel phenotypes of airway obstruction identified via DISE in adults.
- To correlate these phenotypes with demographic and polysomnographic data.
Main Methods:
- Retrospective chart review of DISE video recordings from adult patients.
- Cross-correlation matrix analysis to identify significant correlations between anatomical subsites.
- Calculation of mean differences and confidence intervals for phenotype comparisons.
Main Results:
- Three distinct phenotypes were identified: T2-E2 (tongue base/epiglottis collapse), V2C-O2LPW (velum/oropharynx collapse), and V0/1-O2T (velum/tonsillar hypertrophy).
- Phenotype 1 (T2-E2) associated with older age, lower BMI, and smaller neck circumference.
- Phenotype 2 (V2C-O2LPW) associated with higher BMI, larger neck circumference, and higher apnea-hypopnea index.
- Phenotype 3 (V0/1-O2T) associated with younger age.
Conclusions:
- Three distinct multilevel airway obstruction phenotypes were identified using DISE.
- These phenotypes represent different patterns of anatomical collapse.
- The identification of these phenotypes may impact understanding of pathophysiology and treatment selection.
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