Epiglottis Collapse in Individuals With Obstructive Sleep Apnea

Obstructive sleep apnea (OSA) is a common sleep disorder characterized by repeated upper airway collapse during sleep. The epiglottis, often overlooked in conventional assessments, has emerged as a site of significant obstruction in OSA. This review aims to highlight current knowledge of the epidemiology, pathophysiology, diagnosis, and treatment of epiglottic collapse in adults with OSA.

PubMed, Embase, Web of Science, and Cochrane literature search.

We conducted a detailed review of publications related to epiglottic collapse, specifically on study design, sample size, assessment methods, treatment approaches, and outcomes.

Epiglottic collapse prevalence in OSA varies widely (11.5%-73.5%) due to inconsistent diagnostic criteria, with drug-induced sleep endoscopy (DISE) establishing itself as the gold standard by revealing higher incidence rates than traditional methods, while emerging artificial intelligence analytics and noninvasive aerodynamic assessments demonstrate diagnostic promise, and surgical interventions prove effective alternatives for CPAP-resistant cases.

Epiglottic collapse is a critical, under-recognized component of upper airway obstruction in OSA. Accurate diagnosis using DISE and other innovative tools is helpful for optimal management. Although surgical treatments have shown promise in effectively managing OSA with epiglottic collapse, there is a need for standardized diagnostic criteria and treatment protocols. Future research should focus on developing and validating these standards to improve outcomes in individuals with OSA and epiglottic collapse.