Enhanced drug-induced sleep endoscopy: Distinguishing central from obstructive apnea

Crystal S Cheong; Raj C Dedhia; Everett G Seay; Sebastian M Jara; Jorge I Mora; Erica R Thaler; Alan R Schwartz

doi:10.1002/lary.30517

Enhanced drug-induced sleep endoscopy: Distinguishing central from obstructive apnea

Laryngoscope. 2023 Mar;133(3):706-708. doi: 10.1002/lary.30517. Epub 2022 Dec 14.

Authors

Crystal S Cheong^{1

2}, Raj C Dedhia^{1

2}, Everett G Seay¹, Sebastian M Jara^{1

2}, Jorge I Mora², Erica R Thaler¹, Alan R Schwartz¹

Affiliations

¹ Department of Otorhinolaryngology - Head and Neck Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
² Division of Sleep Medicine, Department of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.

Abstract

This case report describes a patient originally diagnosed with obstructive sleep apnea (OSA) who was later found to have central sleep apnea (CSA) during drug-induced sleep endoscopy, which was subsequently confirmed on an in-laboratory sleep study. The revised diagnosis resulted in a change in recommended therapy from hypoglossal nerve stimulation to phrenic nerve stimulation. This case report is a reminder that the sleep surgeon must be cognizant of the possibility of CSA being misclassified as OSA especially as home sleep studies become increasingly routine, and discusses ways to more easily distinguish between CSA and OSA. Laryngoscope, 133:706-708, 2023.

Keywords: central sleep apnea; drug-induced sleep endoscopy; obstructive sleep apnea; surgical treatment of obstructive sleep apnea.

Publication types

Case Reports
Research Support, N.I.H., Extramural

MeSH terms

Airway Obstruction*
Endoscopy / methods
Humans
Hypoglossal Nerve / surgery
Sleep
Sleep Apnea, Central* / diagnosis
Sleep Apnea, Obstructive* / therapy
Syndrome

Grants and funding

R01 HL144859/HL/NHLBI NIH HHS/United States