[Sleep endoscopy and complete concentric collapse in CPAP failure].

INTRODUCTION

First-line treatment for patients with obstructive sleep apnea (OSA) is continuous positive airway pressure (CPAP) therapy. However, many patients cannot use CPAP sufficiently. With drug-induced endoscopy (DISE), it is possible to assess the collapse pattern in the upper airway. The aim of this work was to evaluate a collective of patients with CPAP usage problems using DISE, in order to evaluate their usage problems and therapy recommendations.

METHODS

Over a period of 5 years, all patients with an apnea-hypopnea index (AHI) of at least 15/h were retrospectively evaluated using DISE. The recommended treatment options were then analyzed.

RESULTS

Data analysis of 210 patients showed that about two thirds reported mask problems as the cause of non-adherence to CPAP. A complete concentric collapse (CCC) could be excluded in 75%. These patients had a lower AHI and more frequent tonsillectomy (TE) than patients with CCC. Double the number of patients with a body mass index (BMI) > 35 kg/m had a CCC compared to those with a BMI < 35 kg/m. Among patients with similar BMI and AHI, CCC was twice as likely to be found in patients without TE.

CONCLUSION

The course of treatment recommended for OSA often differs, depending on CCC, BMI > 35 kg/m, and previous TE.