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Updated: Sep 5, 2026

Drug-Induced Sleep Endoscopy (DISE) with Target Controlled Infusion (TCI) and Bispectral Analysis in Obstructive Sleep Apnea
Published on: December 6, 2016
Obstructive sleep apnea and twins
Giannicola Iannella1, Andrea Collettini1, Antonella Polimeni2
1Department of 'Organi di Senso', University "Sapienza", Rome, Italy.
Purpose:
Present an intriguing case of a man suffering of OSA who has a homozygous monochorionic twin. Made a systematic review of the literature to summarize existing data and the reported incidence of OSA in twins.
Methods:
Case presentation and systematic literature review, according to the PRISMA guidelines about twins and Obstructive sleep Apnea.
Results:
Our patient had a severe OSA condition with an Apnea Hypopnea index (AHI) of 57.6. This patient had a twin who did not suffer from sleep apnea and presented different oropharyngeal and endoscopic anatomical characteristics. Six eligible studies were identified investigating OSA or OSA-related traits in twins. All studies demonstrated higher concordance among monozygotic than dizygotic twins and substantial heritability estimates (40%-83%), particularly for AHI and ODI. However, non-shared environmental and anatomical factors accounted for considerable phenotypic variability.
Conclusion:
Despite the genetic factors related to the sleep apnea, differences in anatomical features and lifestyle could contributed to the different expression of OSA.
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