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Characteristic Pressure Waveforms Can Distinguish Airway Collapse Patterns in Sleep Apnea Patients: A Pilot Study
Ravi R Shah1, Ahmad F Mahmoud2, Raj C Dedhia3
1Department of Otolaryngology-Head and Neck Surgery Henry Ford Health + Michigan State University Detroit Michigan USA.
OTO Open
|July 8, 2024
Summary
Pharyngeal pressure recordings can identify upper airway collapse patterns in obstructive sleep apnea (OSA). This method shows promise for assessing candidacy for hypoglossal nerve stimulator (HGNS) implantation.
Area of Science:
- Sleep Medicine
- Otolaryngology
- Medical Devices
Background:
- Obstructive sleep apnea (OSA) is a common sleep disorder characterized by recurrent upper airway collapse.
- Current diagnostic methods like DISE can be invasive and may not fully capture dynamic airway changes.
- Identifying specific collapse patterns is crucial for tailoring treatment, including hypoglossal nerve stimulation.
Purpose of the Study:
- To determine if pharyngeal pressure recordings can differentiate various upper airway collapse patterns in OSA patients.
- To evaluate the correlation between pharyngeal pressure recordings and suitability for hypoglossal nerve stimulator (HGNS) implantation.
Main Methods:
- A prospective case series involving 25 OSA patients.
- Simultaneous drug-induced sleep endoscopy (DISE) and transnasal pharyngeal pressure recording.
- Classification of collapse patterns by site, extent, and direction, and pressure waveform characteristics (shape, amplitude, slope).
Main Results:
- Nasopharyngeal waveform shape correlated with palatal collapse extent (P=.001).
- Oropharyngeal waveform shape linked to collapse site (P<.001) and direction (P=.019).
- Pressure waveform characteristics were associated with collapse extent and favorable patterns for HGNS candidacy (P=.043, P=.004).
Conclusions:
- Distinct pharyngeal pressure waveforms are associated with specific upper airway collapse patterns in OSA.
- Pharyngeal pressure measurement is a valuable tool, potentially augmenting DISE in evaluating sleep surgery candidacy, particularly for HGNS.
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