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. 2024 Dec 2;29(1):38.
doi: 10.1007/s11325-024-03222-x.

The potential impact of new remodelling intrapharynegal OSA surgery on sleep architecture: a preliminary investigation

Antonio Moffa  1   2 , Lucrezia Giorgi  3   4 , Domiziana Nardelli  5   3 , Francesco Iafrati  3 , Giannicola Iannella  6 , Rodolfo Lugo  7 , Peter M Baptista  8 , Claudio Vicini  9   10 , Manuele Casale  5   3
Affiliations

The potential impact of new remodelling intrapharynegal OSA surgery on sleep architecture: a preliminary investigation

Antonio Moffa et al. Sleep Breath. .

Abstract

Purpose: Patients with Obstructive Sleep Apnea (OSA) often experience poor sleep quality and excessive daytime sleepiness, which significantly affect their daily lives. Among the therapeutic options, Barbed Pharyngoplasty (BP) is widely used, showing an overall improvement in the primary efficacy parameters. However, the impact of this surgical intervention on sleep architecture remains unclear. The purpose of this study is to assess potential changes in sleep architecture in patients with moderate to severe OSA who have successfully undergone BP.

Methods: Adult patients affected by moderate-severe OSA who underwent Alianza BP were enrolled. Each patient underwent polysomnography preoperatively and six months postoperatively, using the WatchPAT device for consistent data acquisition.

Results: This study enrolled 27 patients. Although not statistically significant, improvements were observed in Total Sleep Time (TST), Sleep Efficiency, REM, light, and deep sleep, significant improvements were noted in the Apnea-Hypopnea Index (AHI), Oxygen Desaturation Index (ODI), Respiratory Disturbance Index (RDI), and Epworth Sleepiness Scale (ESS). Positive correlations were found between AHI improvement and changes in light sleep and negative correlations with deep sleep. ODI and RDI improvement correlated positively with light sleep and negatively with deep and REM sleep. No correlations were found between these indices and TST and sleep efficiency.

Conclusion: A noteworthy correlation was found between AHI improvement and changes in sleep stages. Increased AHI gain and surgical success were associated with improved deep sleep and reduced light sleep, even though REM sleep remained relatively unchanged. Indeed, BP could be a valid surgical option for improving sleep architecture, by promoting better sleep quality.

Keywords: Barbed Pharyngoplasty; Obstructive Sleep Apnea; Polysomnography; Sleep Architecture; Sleep Efficiency.

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Conflict of interest statement

Declarations. Ethical approval: All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. Conflict of interest: The authors declare that they have no conflict of interest. Informed consent: Informed consent was obtained from all individual participants included in the study.

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