title: Drug-induced sleep endoscopy in sleep-disordered breathing: report on 1,249 cases.
abstract: OBJECTIVE
  To describe upper airway (UA) collapse patterns during drug-induced sleep endoscopy (DISE) in a large cohort of patients with sleep-disordered breathing (SDB) and to assess associations with anthropometric and polysomnographic parameters.
  
  
  METHODS
  Observational study.
  
  
  METHODS
  A total of 1,249 patients [age 47 ± 10 y; apnea-hypopnea index (AHI) 18.9 ± 15.3/h; body mass index (BMI) 27.2 ± 3.7 kg/m(2)] underwent polysomnography and DISE. DISE findings were categorized to the following UA levels: palate, oropharynx, tongue base, and hypopharynx. The degree of collapse was reported as complete, partial, or none. The pattern of the obstruction was described as anteroposterior, lateral, or concentric. Associations between DISE findings and anthropometric and polysomnographic parameters were analyzed.
  
  
  RESULTS
  Palatal collapse was seen most frequently (81%). Multilevel collapse was noted in 68.2% of all patients. The most frequently observed multilevel collapse pattern was a combination of palatal and tongue base collapse (25.5%). Palatal collapse was seen most frequently (81%). The prevalence of complete collapse, multilevel collapse, and hypopharyngeal collapse increased with increasing severity of obstructive sleep apnea (OSA). Multilevel and complete collapse were more prevalent in obese patients and in those with more severe OSA. Both higher BMI and AHI values were associated with a higher probability of complete concentric palatal collapse.
  
  
  CONCLUSIONS
  The current study provides an overview of UA collapse patterns in a large cohort of SDB patients who underwent DISE. The associations found in this study may indicate that UA collapse patterns observed during DISE cannot be fully explained by selected baseline polysomnographic and anthropometric characteristics.
authors.affiliation: Department of ENT, Head and Neck Surgery, Antwerp University Hospital, Edegem, Belgium; Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.
authors.forename: Anneclaire V
authors.initials: AV
authors.lastname: Vroegop
authors.forename: Olivier M
authors.initials: OM
authors.lastname: Vanderveken
authors.forename: An N
authors.initials: AN
authors.lastname: Boudewyns
authors.forename: Joost
authors.initials: J
authors.lastname: Scholman
authors.forename: Vera
authors.initials: V
authors.lastname: Saldien
authors.forename: Kristien
authors.initials: K
authors.lastname: Wouters
authors.forename: Marc J
authors.initials: MJ
authors.lastname: Braem
authors.forename: Paul H
authors.initials: PH
authors.lastname: Van de Heyning
authors.forename: Evert
authors.initials: E
authors.lastname: Hamans
mesh_terms: D000328:Adult; D000367:Age Factors; D000402:Airway Obstruction / Q000209:etiology / Q000503:physiopathology*; D000886:Anthropometry; D015992:Body Mass Index; D002983:Clinical Competence; D015331:Cohort Studies; D004724:Endoscopy / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage*; D007262:Infusions, Intravenous; D016015:Logistic Models; D008297:Male; D008874:Midazolam / Q000008:administration & dosage; D008875:Middle Aged; D016017:Odds Ratio; D009960:Oropharynx / Q000187:drug effects / Q000503:physiopathology; D010159:Palate / Q000187:drug effects / Q000503:physiopathology; D017286:Polysomnography / Q000379:methods; D015742:Propofol / Q000008:administration & dosage; D018570:Risk Assessment; D012737:Sex Factors; D012890:Sleep / Q000187:drug effects; D012891:Sleep Apnea Syndromes / Q000175:diagnosis* / Q000628:therapy; D018709:Statistics, Nonparametric
chemical_list: D006993:Hypnotics and Sedatives; D008874:Midazolam; D015742:Propofol
keywords: Drug-induced sleep endoscopy; obstructive sleep apnea; polysomnography; sleep-disordered breathing