Impact of drug-induced sleep endoscopy on the apnea-hypopnea-index during polysomnography

Introduction Polysomnography (PSG) and drug-induced sleep endoscopy (DISE) are often used to assess surgical therapy options in patients with obstructive sleep apnea (OSA). DISE and PSG complement each other regarding treatment recommendations. Because during DISE sedatives are administered and rostral fluid-shift may be influenced, we hypothesize that the exact timepoint of DISE has an impact on pharyngeal collapsibility during sleep and, therefore, on PSG results. Methods Out of 604 DISE patients between Jan 1 st 2017 and June 20 th 2020 we enrolled 101 adult OSA-patients with complete data into this retrospective study. We analyzed a previous PSG (PSG1) and the PSG during our diagnostic assessment (PSG2). Primary endpoint was the change of apnea-hypopnea-index (AHI) from PSG1 to PSG2. In the study group (SG) DISE was performed the same day as PSG2 (n=53) whereas it was performed on a different day in the control group (KG, n=58). Results From PSG1 to PSG2, mean and medium AHI changed by -4,77 +/- 18,92/h and -3,80/h in the SG versus -1,70 +/- 13,77/h and -0,25/h in the KG, respectively. Statistical significance was only found in the subgroup having all PSG in our institution (p=0,0189). In this cohort mean and median AHI remained unchanged in the KG, whereas it dropped relevantly in the SG (mean: SG -7,62+/- 20,47, KG 0,38 +/- 11,53; median: SG -6,65, KG 0,20). Conclusion Performing DISE the day of PSG may lead to a reduced AHI and influence therapy recommendation, in particular if certain AHI limits have to be respected. Therefore, DISE and PSG should be scheduled on different days. Poster-PDF A-1532.PDF Publication History Publication Date: 13 May 2021 (online) © . Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany