The Role of Drug-Induced Sleep Endoscopy with Positive Airway Pressure Titration in the Individualized Treatment of Obstructive Sleep Apnea: A Report of Three Illustrative Cases.

PURPOSE

Drug-induced sleep endoscopy with positive airway pressure titration (DISE-PAPT) can assess the effect of varying positive pressure levels on upper airway collapse in patients with obstructive sleep apnea (OSA) under simulated sleep condition. But it remains unclear whether DISE-PAPT can facilitate the development of personalized therapeutic interventions for OSA and further improve the therapeutic efficacy.

PATIENTS AND METHODS

We present three adult patients with severe OSA exhibiting distinct clinical profiles: one case of continuous positive airway pressure (CPAP) treatment failure, one case of intolerance to high CPAP, and one case of psychological resistance to CPAP therapy.

RESULTS

According to the DISE-PAPT evaluation findings, CPAP combined with positional therapy was administered in Case 1. CPAP with surgical management was performed in Case 2, resulting in significant therapeutic improvements. Additionally, real-time DISE-PAPT visualization of CPAP-mediated upper airway patency restoration enhanced CPAP adherence in Case 3.

CONCLUSION

The personalized treatment strategies based on the DISE-PAPT technique hold promise for improving the overall therapeutic efficacy and adherence among patients with OSA.