Comparison of conventional continuous positive airway pressure to continuous positive airway pressure titration performed with sleep endoscopy

Civelek, Senol; Emre, İsmet Emrah; Dizdar, Denizhan; Çuhadaroğlu, Çağlar; Ekşioğlu, Birsen; Eraslan, Algın Kayar; Turgut, Suat

doi:10.1002/lary.22494

Cited by 42 publications

(46 citation statements)

References 20 publications

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“…The reason is that collapse of the epiglottis is not usually seen when the patient is awake. Furthermore, laryngeal obstruction may be a reason for intolerance of CPAP and failure of OSA surgery [9]. The most common type of epiglottis pathology in our study group was closing door epiglottis, when the epiglottis collapsed on the posterior wall of the hypopharynx during inspiration (Figure 2).…”

Section: Discussionmentioning

confidence: 95%

“…Civelek et al demonstrated that the majority of adult OSA patients unable to tolerate CPAP have multilevel obstruction [9], and 15% had primary epiglottic obstruction in the hypopharynx. Primary epiglottic obstruction may not be amenable to CPAP, as positive pressure may further push a retroflexed epiglottis into the endolarynx [14].…”

Section: Discussionmentioning

confidence: 99%

“…However, many patients do not tolerate CPAP due to laryngeal collapse, which in many cases can be diagnosed only during DISE. Therefore, DISE with CPAP can be helpful in identifying the reason for CPAP intolerance in patients with OSA [9]. …”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Drug-Induced Sleep Endoscopy Changes the Treatment Concept in Patients with Obstructive Sleep Apnoea

Hybášková

Jor

Novák

et al. 2016

BioMed Research International

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The present study evaluated whether drug-induced sleep endoscopy (DISE) helps identify the site of obstruction in patients with obstructive sleep apnoea (OSA). A total of 51 consecutive patients with polysomnography-confirmed OSA were enrolled in this prospective study. The presumed site of obstruction was determined according to history, otorhinolaryngologic examination, and polysomnography and a therapeutic plan designed before DISE. In 11 patients with severe OSA and/or previously failed continuous positive airway pressure (CPAP) treatment, DISE with simultaneous CPAP was performed. Multilevel collapse was noted in 49 patients (96.1%). The most frequent multilevel collapse was palatal, oropharyngeal, and tongue base collapse (n = 17, 33.3%), followed by palatal and oropharyngeal collapse (n = 12, 23.5%). Pathology of the larynx (epiglottis) was observed in 16 patients (31.4%). The laryngeal obstruction as a reason for intolerance of CPAP was observed in 3/11 (27.3%) patients. After DISE, the surgical plan was changed in 31 patients (60.8%). The results indicate that DISE helps identify the site of obstruction in the upper airways in patients with OSA more accurately and that the larynx plays an important role in OSA.

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Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 99%

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Drug-Induced Sleep Endoscopy Changes the Treatment Concept in Patients with Obstructive Sleep Apnoea

Hybášková

Jor

Novák

et al. 2016

BioMed Research International

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“…We, therefore, embarked on the study to evaluate the differential effect of nasal CPAP (nCPAP) pressure settings on upper airway collapsibility of OSA patients as assessed during drug‐induced sleep endoscopy (DISE). DISE has been successfully used for CPAP titration, with the results comparable to the conventional manual CPAP titration in the sleep laboratory . It also plays an increasingly important role in evaluation of upper airway characteristics of OSA patients to tailor individual surgical treatment .…”

Section: Introductionmentioning

confidence: 99%

Impact of continuous positive airway pressure in patients with obstructive sleep apnea during drug‐induced sleep endoscopy

Torre

Liu

Kushida

et al. 2017

Clinical Otolaryngology

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The differential nCPAP effects observed in this study may help to understand some of the mechanisms responsible for inadequate patient response and poor nCPAP compliance. The use of DISE in combination with CPAP may serve as a first step in optimizing patients that failed to adapt to treatment with CPAP. This approach can help the physician identify patterns of airway collapse that may require varying pressures different from the one the patient is using, as well as anatomical factors that may be corrected to help with compliance.

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“…Increase in the number of DISE examinations is to be expected, not only because of the growing OSA awareness but, perhaps in the near future, also to cut healthcare system costs by means of CPAP titration during DISE instead of during a costly overnight in-hospital polysomnography [53].…”

Section: Discussionmentioning

confidence: 99%

The Utility of Sleep Endoscopy in Adults with Obstructive Sleep Apnea: A Review of the Literature

Maanen

Ravesloot

Safiruddin

et al. 2013

Curr Otorhinolaryngol Rep

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Since history and physical examination alone cannot reliably diagnose obstructive sleep apnea (OSA), the gold standard for the diagnosis of OSA is polysomnography. When an oral device or surgery is considered, it is of utmost importance to examine an individual's pattern, degree and site(s) of upper airway obstruction. This article tries to evaluate recent literature published on the use of (drug-induced) sleep endoscopy in evaluating the individually tailored treatment. Different techniques, interrater reliability, test-retest reliability and currently available data on the relationship with treatment outcome are reviewed.

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Comparison of conventional continuous positive airway pressure to continuous positive airway pressure titration performed with sleep endoscopy

Abstract: Results with conventional CPAP titration and endoscopy-assisted CPAP titration showed no statistically significant difference. Endoscopy-assisted CPAP is a cheaper and less time consuming alternative to conventional CPAP and has similar results.

Cited by 42 publications

References 20 publications

Drug-Induced Sleep Endoscopy Changes the Treatment Concept in Patients with Obstructive Sleep Apnoea

Drug-Induced Sleep Endoscopy Changes the Treatment Concept in Patients with Obstructive Sleep Apnoea

Impact of continuous positive airway pressure in patients with obstructive sleep apnea during drug‐induced sleep endoscopy

The Utility of Sleep Endoscopy in Adults with Obstructive Sleep Apnea: A Review of the Literature

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