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. 2016 Oct 20:6:35849.
doi: 10.1038/srep35849.

Dynamic Drug-Induced Sleep Computed Tomography in Adults With Obstructive Sleep Apnea

Hsueh-Yu Li  1   2   3 , Yu-Lun Lo  2   4   5 , Chao-Jan Wang  2   6 , Li-Jen Hsin  1   2 , Wan-Ni Lin  1   2 , Tuan-Jen Fang  1   2 , Li-Ang Lee  1   2
Affiliations

Dynamic Drug-Induced Sleep Computed Tomography in Adults With Obstructive Sleep Apnea

Hsueh-Yu Li et al. Sci Rep. .

Abstract

Surgical success for obstructive sleep apnea (OSA) depends on identifying sites of obstruction in the upper airway. In this study, we investigated sites of obstruction by evaluating dynamic changes in the upper airway using drug-induced sleep computed tomography (DI-SCT) in patients with OSA. Thirty-five adult patients with OSA were prospectively enrolled. Sleep was induced with propofol under light sedation (bispectral index 70-75), and low-dose 320-detector row CT was performed for 10 seconds over a span of 2-3 respiratory cycles with supporting a continuous positive airway pressure model. Most (89%) of the patients had multi-level obstructions. Total obstruction most commonly occurred in the velum (86%), followed by the tongue (57%), oropharyngeal lateral wall (49%), and epiglottis (26%). There were two types of anterior-posterior obstruction of the soft palate, uvular (94%) and velar (6%), and three types of tongue obstruction, upper (30%), lower (37%), and upper plus lower obstruction (33%). DI-SCT is a fast and safe tool to identify simulated sleep airway obstruction in patients with OSA. It provides data on dynamic airway movement in the sagittal view which can be used to differentiate palate and tongue obstructions, and this can be helpful when planning surgery for patients with OSA.

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Figures

Figure 1
Figure 1. Correlation between levels of total obstruction and apnea-hypopnea index (AHI).
The levels of total obstruction were significantly associated with AHI (r = 0.40, p = 0.02).
Figure 2
Figure 2. Setting of drug-induced sleep computed tomography (DI-SCT).
(A) DI-SCT facility. (B) A diagram showing the relative position of monitors for vital signs, sedation depth, and continuous positive airway pressure during DI-SCT.
Figure 3
Figure 3. A representative case of severe obstructive sleep apnea.
Raw data were reconstructed and transferred to a workstation for post-processing, including mid-sagittal and three-dimensional, and dynamic display in wakefulness (A) and drug-induced sleep (B).
Figure 4
Figure 4. Types of anterior-posterior palatal obstruction.
Two types (uvular and velar) of anterior-posterior palatal obstruction were classified in drug-induced sleep computed tomography.
Figure 5
Figure 5. Types of tongue obstruction.
Upper, lower and upper/lower types of tongue obstruction were noted in drug-induced sleep computed tomography.
See this image and copyright information in PMC

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References

    1. Strollo P. J. Jr. & Rogers R. M. Obstructive sleep apnea. N. Engl. J. Med. 334, 99–104 (1996). - PubMed
    1. Peppard P. E. et al.. Prospective study of the association between sleep-disordered breathing and hypertension. N. Engl. J. Med. 342, 1378–1384 (2000). - PubMed
    1. Yaggi H. K. et al.. Obstructive sleep apnea as a risk factor for stroke and death. N. Engl. J. Med. 353, 2034–2041 (2005). - PubMed
    1. Kushida C. et al.. American Academy of Sleep Medicine. Practice parameters for the use of continuous and bilevel positive airway pressure devices to treat adult patients with sleep-related breathing disorders. Sleep. 29, 375–380 (2006). - PubMed
    1. Chen N. H. et al.. Airway assessment by volumetric computed tomography in snorers and subjects with obstructive sleep apnea in a Far-East Asian population (Chinese). Laryngoscope. 112, 721–726 (2002). - PubMed

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