Tongue peak pressure: a tool to aid in the identification of obstruction sites in patients with obstructive sleep apnea/hypopnea syndrome

AbstractPurpose of this study was to evaluate whether tongue peak pressure measured using the Iowa Oral Performance Instrument is correlated with the topographic site of obstruction in patients with obstructive sleep apnea/hypopnea syndrome observed during drug-induced sleep endoscopy. Thirty-five consecutive adult patients (29 men, 6 women) were prospectively enrolled after having been diagnosed with severe obstructive sleep apnea/hypopnea syndrome by polysomnography. An apnea –hypopnea index>  30 was confirmed, and age, gender, and body mass index were recorded by Epworth Sleepiness Scale questionnaire, and a thorough evaluation of the upper airway by video-flexible endoscopy. Twenty healthy controls according to age and sex were chosen for IOPI measurements. After drug-induced sleep e ndoscopy, a topographic diagnosis was done using the VOTE classification. Tongue and lip peak pressures were both measured using the Iowa Oral Performance Instrument in all patients and in 20 healthy controls. Main outcomes and measures: the correlations between office findings, Iowa Oral Performanc e Instrument measures, and the VOTE tongue classification during drug-induced sleep endoscopy (T0, T1, T2) were then investigated.ResultsThe average Iowa Oral Performance Instrument tongue and lip pressure were 44.02  ± 12.29 and 15.03 ± 3.71 kPa, respectively. The Iowa Oral Performance Instrument scores were both significantly lower t...
Source: Sleep and Breathing - Category: Respiratory Medicine Source Type: research

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FCP Abstract PURPOSE: The present study evaluated the upper airway pattern of obstruction in individuals undergoing drug-induced sleep endoscopy (DISE) exam with positive airway pressure (PAP), and compared this effect through a nasal or oronasal mask. METHODS: Prospective study. Patients requiring PAP due to obstructive sleep apnea (OSA) were evaluated through DISE at three different moments: (1) a baseline condition (without PAP); (2) PAP treatment with a nasal mask; and (3) PAP with an oronasal mask at the same pressure. The conditions were compared intra-individually, following VOTE classification. A TOTA...
Source: Sleep and Breathing - Category: Sleep Medicine Authors: Tags: Sleep Breath Source Type: research
AbstractPurposeThe present study evaluated the upper airway pattern of obstruction in individuals undergoing drug-induced sleep endoscopy (DISE) exam with positive airway pressure (PAP), and compared this effect through a nasal or oronasal mask.MethodsProspective study. Patients requiring PAP due to obstructive sleep apnea (OSA) were evaluated through DISE at three different moments: (1) a baseline condition (without PAP); (2) PAP treatment with a nasal mask; and (3) PAP with an oronasal mask at the same pressure. The conditions were compared intra-individually, following VOTE classification. A TOTAL VOTE score (the sum of...
Source: Sleep and Breathing - Category: Respiratory Medicine Source Type: research
Abstract Purpose of this study was to evaluate whether tongue peak pressure measured using the Iowa Oral Performance Instrument is correlated with the topographic site of obstruction in patients with obstructive sleep apnea/hypopnea syndrome observed during drug-induced sleep endoscopy. Thirty-five consecutive adult patients (29 men, 6 women) were prospectively enrolled after having been diagnosed with severe obstructive sleep apnea/hypopnea syndrome by polysomnography. An apnea-hypopnea index> 30 was confirmed, and age, gender, and body mass index were recorded by Epworth Sleepiness Scale questionnaire,...
Source: Sleep and Breathing - Category: Sleep Medicine Authors: Tags: Sleep Breath Source Type: research
ConclusionLwPTL seems a simple and straightforward staging system for classifying drug-induced sleep endoscopy, distinguishing the important upper retopalatal obstruction and the primary and secondary laryngeal collapses, providing more information for appropriate treatment selection.ResumoIntroduçãoNão há consenso sobre um sistema único de classificação para os achados obstrutivos da endoscopia do sono induzido por drogas. Os sistemas de classificação anteriores negligenciaram a abordagem da obstrução retropalatal superior, a divisão segme...
Source: Brazilian Journal of Otorhinolaryngology - Category: ENT & OMF Source Type: research
CONCLUSIONS: Use of remifentanil during DISE reduces the target concentration of propofol required for patient sedation to perform DISE without respiratory depression. PMID: 30324545 [PubMed - as supplied by publisher]
Source: Sleep and Breathing - Category: Sleep Medicine Authors: Tags: Sleep Breath Source Type: research
ConclusionsUse of remifentanil during DISE reduces the target concentration of propofol required for patient sedation to perform DISE without respiratory depression.
Source: Sleep and Breathing - Category: Respiratory Medicine Source Type: research
ConclusionElderly patients showed a higher incidence of total collapse in the velum and a lower incidence in the oropharyngeal lateral wall compared to younger patients.
Source: European Archives of Oto-Rhino-Laryngology - Category: ENT & OMF Source Type: research
Authors: Hasselbacher K, Bruchhage KL, Abrams N, Steffen A Abstract INTRODUCTION: First-line treatment for patients with obstructive sleep apnea (OSA) is continuous positive airway pressure (CPAP) therapy. However, many patients cannot use CPAP sufficiently. With drug-induced endoscopy (DISE), it is possible to assess the collapse pattern in the upper airway. The aim of this work was to evaluate a collective of patients with CPAP usage problems using DISE, in order to evaluate their usage problems and therapy recommendations. METHODS: Over a period of 5 years, all patients with an apnea-hypopnea ...
Source: HNO - Category: ENT & OMF Tags: HNO Source Type: research
Abstract PURPOSE: To compare patient characteristics, upper airway (UA) collapse patterns and treatment outcome in obstructive sleep apnea (OSA) patients, including non-positional OSA patients (NPP) and positional OSA patients (PP), and non-OSA. METHODS: Cohort study of patients screened for OSA in 2012. Polysomnography was performed and UA was evaluated using the VOTE classification during drug-induced sleep endoscopy (DISE). Treatment outcome of MAD and UA surgery was evaluated. RESULTS: Eight hundred sixty patients were included. Higher BMI, larger neck circumference, and greater age were independent ...
Source: Sleep and Breathing - Category: Sleep Medicine Authors: Tags: Sleep Breath Source Type: research
AbstractPurposeTo compare patient characteristics, upper airway (UA) collapse patterns and treatment outcome in obstructive sleep apnea (OSA) patients, including non-positional OSA patients (NPP) and positional OSA patients (PP), and non-OSA.MethodsCohort study of patients screened for OSA in 2012. Polysomnography was performed and UA was evaluated using the VOTE classification during drug-induced sleep endoscopy (DISE). Treatment outcome of MAD and UA surgery was evaluated.ResultsEight hundred sixty patients were included. Higher BMI, larger neck circumference, and greater age were independent significant predictors for O...
Source: Sleep and Breathing - Category: Respiratory Medicine Source Type: research
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