Anthropometric Predictors in Drug-Induced Sleep Endoscopy With Positive Airway Pressure.

Area of Science:

• Sleep Medicine
• Otolaryngology
• Surgical Outcomes

Background:

• Anthropometric measurements are established risk factors for obstructive sleep apnea (OSA).
• The predictive value of these measurements for surgical outcomes in continuous positive airway pressure (CPAP)-intolerant OSA patients is not well understood.
• Drug-induced sleep endoscopy with positive airway pressure (DISE-PAP) assesses airway collapse patterns.

Purpose of the Study:

• To investigate the association between neck, waist, and hip circumferences and airway collapse patterns during DISE-PAP.
• To explore the relationship between these anthropometric measures and pharyngeal opening pressures (PhOPs).
• To determine the utility of anthropometric data in predicting surgical outcomes for CPAP-intolerant OSA patients.

Main Methods:

• Retrospective cohort study at a single tertiary care center.
• Included 73 CPAP-intolerant OSA patients who underwent DISE-PAP.
• Analyzed demographics, anthropometrics, and DISE findings using Spearman's correlations, with sub-analysis of body roundness index (BRI) vs. body mass index (BMI).

Main Results:

• Complete velum collapse correlated with BMI, BRI, neck, waist, hip circumferences, and waist:height ratio.
• Complete lateral oropharyngeal wall collapse associated with BMI, neck, and waist circumferences.
• Neck circumference ≥42 cm significantly increased lateral wall collapse risk in males (OR 5.37). PhOP correlated with hip, neck, and waist circumferences.

Conclusions:

• Neck, waist, and hip circumferences are significant predictors of airway collapse during DISE-PAP.
• Central adiposity, indicated by these measurements, plays a crucial role in airway resistance.
• Findings support incorporating these anthropometric measures into preoperative assessments for surgical planning in CPAP-intolerant OSA patients.