Cheong Crystal Sj, Loke Weiqiang, Thong Mark Kim Thye, Toh Song Tar, Lee Chi-Hang
Department of Otolaryngology-Head and Neck Surgery, National University Hospital, Singapore.
Faculty of Dentistry, National University of Singapore, Singapore.
Clin Exp Otorhinolaryngol. 2021 May;14(2):149-158. doi: 10.21053/ceo.2020.01704. Epub 2020 Oct 16.
Obstructive sleep apnea is a prevalent sleep disorder characterized by partial or complete obstruction of the upper airway. Continuous positive airway pressure is the first-line therapy for most patients, but adherence is often poor. Alternative treatment options such as mandibular advancement devices, positional therapy, and surgical interventions including upper airway stimulation target different levels and patterns of obstruction with varying degrees of success. Drug-induced sleep endoscopy enables the visualization of upper airway obstruction under conditions mimicking sleep. In the era of precision medicine, this additional information may facilitate better decision-making when prescribing alternative treatment modalities, with the hope of achieving better adherence and/or success rates. This review discusses the current knowledge and evidence on the role of drug-induced sleep endoscopy in the non-positive airway pressure management of obstructive sleep apnea.
阻塞性睡眠呼吸暂停是一种常见的睡眠障碍,其特征是上呼吸道部分或完全阻塞。持续气道正压通气是大多数患者的一线治疗方法,但依从性往往较差。其他治疗选择,如下颌前移装置、体位治疗以及包括上气道刺激在内的外科干预措施,针对不同程度和模式的阻塞,取得了不同程度的成功。药物诱导睡眠内镜检查能够在模拟睡眠的条件下对上气道阻塞进行可视化观察。在精准医学时代,这些额外信息可能有助于在开具替代治疗方式时做出更好的决策,以期获得更高的依从性和/或成功率。本综述讨论了关于药物诱导睡眠内镜检查在阻塞性睡眠呼吸暂停非气道正压治疗管理中的作用的现有知识和证据。