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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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Published on: December 6, 2016

Oxygen-based endotypes of Obstructive Sleep Apnea.

Andrew Wellman¹, Ludovico Messineo¹, Ali Azarbarzin¹

¹Division of Sleep and Circadian Disorders, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.

Medrxiv : the Preprint Server for Health Sciences

|June 12, 2026

Summary

A new method using pulse oximetry successfully identified oxygen-based Obstructive Sleep Apnea (OSA) endotypes in 95% of participants. This approach shows promise for aiding therapeutic decisions in OSA management.

Keywords:

Endotypes Obstructive Sleep Apnea Oxygen saturation

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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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Published on: December 6, 2016

A Model to Simulate Clinically Relevant Hypoxia in Humans

A Model to Simulate Clinically Relevant Hypoxia in Humans

Published on: December 22, 2016

Area of Science:

Sleep Medicine
Respiratory Physiology
Biomedical Engineering

Background:

Obstructive Sleep Apnea (OSA) is a complex condition with multiple contributing endotypes.
Measuring these OSA endotypes has been a significant challenge in clinical practice and research.
Existing methods for endotyping OSA are limited in their ability to capture key physiological parameters.

Purpose of the Study:

To introduce and validate a novel method for measuring oxygen-based endotypes in Obstructive Sleep Apnea (OSA).
To assess the feasibility of using pulse oximetry signals for OSA endotyping.
To explore the utility of identified endotypes in reflecting positional and sleep state variations.

Main Methods:

Analysis of data from the Sleep Heart Health Study (SHHS).
Identification and graphical modeling of two oxygen-based endotypes: steady-state SpO2 and SpO2 arousal threshold.
Validation of endotypes by assessing their response to positional (supine vs. non-supine) and sleep state (REM vs. NREM) changes.

Main Results:

The proposed method for measuring oxygen-based endotypes was feasible in 95% of SHHS participants.
Steady-state SpO2 was significantly lower in supine versus non-supine sleep and during REM versus NREM sleep.
The SpO2 arousal threshold showed expected changes in 3 out of 4 tested conditions, indicating responsiveness to physiological variations.

Conclusions:

Endotyping Obstructive Sleep Apnea (OSA) using pulse oximetry signals is feasible.
Oxygen-based endotypes derived from pulse oximetry show potential for clinical application.
This novel approach may assist in guiding therapeutic decisions for OSA patients.