title: Pharyngo-laryngoscopic video-recording in obstructive sleep apnea during natural N2 sleep. A case report of a non-complete obstructive mechanism.
abstract: OBJECTIVE
  This is a video case report of a 58-year-old male patient with severe obstructive sleep apnea (OSA) who underwent a pharyngo-laryngoscopy during non-drug-induced sleep.
  
  
  METHODS
  The pharyngo-laryngoscopy was performed transnasally during a 30-minute nap, in the afternoon, with a flexible endoscope in supine position. During the procedure, the patient was monitored with polysomnography.
  
  
  RESULTS
  The patient slept for 20 minutes in supine position, reaching N2 sleep stage. During the sleep, 15 respiratory events (apneas or hypopneas) were recorded. The video-recording showed that, during apneas, the obstruction at the pharyngeal level was never complete, although the nasal sensor showed a total stop in the nasal airflow.
  
  
  CONCLUSIONS
  This case highlights that OSA could not be as obstructive as generally thought, at least during N2 sleep; moreover, it suggests that apneic episodes are not a totally passive and monomorphic phenomenon, but a rather complex event.
authors: Sleep Unit and Clinical Neurophysiology Section, Clinica Universidad de Navarra, Pamplona, Spain. jiriarte@unav.es
authors: Jorge
authors: J
authors: Iriarte
authors: Jose-Alberto
authors: JA
authors: Palma
authors: Secundino
authors: S
authors: Fernandez
authors: Elena
authors: E
authors: Urrestarazu
authors: Manuel
authors: M
authors: Alegre
authors: Julio
authors: J
authors: Artieda
authors: Peter
authors: P
authors: Baptista
mesh_terms: D004724:Endoscopy; D006801:Humans; D007828:Laryngoscopy; D007830:Larynx / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D010614:Pharynx / Q000503:physiopathology*; D017286:Polysomnography; D012123:Pulmonary Ventilation / Q000502:physiology; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis* / Q000503:physiopathology*; D012894:Sleep Stages / Q000502:physiology*; D014741:Video Recording