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Sleep Apnea

Sleep Apnea

Sleep apnea is a condition where breathing stops intermittently during sleep, often leading to significant health issues. Each episode can last from 10 to 20 seconds or more and is frequently accompanied by a brief arousal from sleep. This disturbance, largely unnoticed by the individual, can lead to severe daytime fatigue. Commonly, individuals seek help after being informed by their partners about loud snoring and noticeable breathing pauses during sleep.
The condition is more prevalent among...

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Drug-Induced Sleep Endoscopy DISE with Target Controlled Infusion TCI and Bispectral Analysis in Obstructive Sleep Apnea

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International expert consensus statement: surgical failure in obstructive sleep apnea.

Giannicola Iannella¹, Annalisa Pace², Giuseppe Magliulo²

¹Department of 'Organi Di Senso', University "Sapienza", Viale Università 33, 00185, Rome, Italy. giannicola.iannella@uniroma1.it.

Sleep & Breathing = Schlaf & Atmung

|September 22, 2024

Summary

This consensus statement addresses surgical failures in obstructive sleep apnea (OSA) treatment. Experts agreed on definitions, predictive factors, and management strategies for OSA surgery outcomes.

Keywords:

Clinical guidelines Delphi method Expert consensus Obstructive sleep apnea Sleep disorder management

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Area of Science:

Sleep Medicine
Otolaryngology
Surgical Oncology

Background:

Upper airway (UA) surgery is a common treatment for obstructive sleep apnea (OSA).
Surgical failures in OSA treatment can stem from complex pathophysiology, varied collapse patterns, and individual patient factors.
Standardized approaches to managing surgical failure are needed.

Purpose of the Study:

To establish international expert consensus on defining and managing surgical failure in OSA treatment.
To identify key predictive factors for surgical success and failure in OSA patients.
To provide guidance on diagnostic workup and treatment strategies for OSA surgical failures.

Main Methods:

A clinical consensus statement (CCS) was developed using the Delphi method with 35 international experts.
A systematic literature review adhering to PRISMA guidelines was conducted.
A 60-statement survey was administered to experts over two Delphi rounds.

Main Results:

Consensus was reached on 36 out of 60 statements after two Delphi rounds.
Agreement was achieved on the definition of surgical success/failure, predictive factors, and diagnostic workup for OSA surgery.
Consensus was also reached on treatment strategies for cases of surgical failure in OSA.

Conclusions:

Managing OSA after surgical failure is a significant clinical challenge.
This CCS offers valuable guidance for defining, preventing, and addressing surgical failures in OSA treatment.
The consensus provides a framework for improving patient outcomes in OSA surgery.