Evaluation of Obstructive Sleep Apnea by Drug Induced Sleep Endoscopy in Pateints Presenting with Stroke or Transient Ischemic Attack

对出现卒中或短暂性脑缺血发作的患者进行药物诱导睡眠内镜检查以评估阻塞性睡眠呼吸暂停

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Abstract

Background: Obstructive Sleep Apnea Hypopnea (OSAHS) Syndrome is defined by repetitive episodes of apneas or hypopneas, excessive daytime somnolence; waking up during sleep with gasping, choking, or breath holding; or witnessed reports of apneas, loud snoring, or both. The current gold standard diagnostic test for OSAS is polysomnography. Material and Methods: A total of 30 patients diagnosed with stroke and OSA at tertiary care hospital were included in this study. They underwent clinical evaluation and investigations including polysomnography. They were then subjected to drug induced sleep endoscopy and findings were noted according to VOTE classification. Result: Patients belonged to age groups ranging from 3 to 8 decade of life. Mean BMI was found to be 33.02 (+/-8.37) where 73.33% patients were overweight and obese category. Multilevel obstruction was present in 96.67% of patients Oropharynx was most common site of obstruction in our study. Velum(86.6%) was 2nd most common site of obstruction. This was the most common type of obstruction in our study was multilevel collapse (46.67%) including all 4 sites i.e. velum, oropharynx, tongue base and epiglottis. BMI in this study was found to have insignificant correlation with multi-level severe obstruction (p = 0.306). Conclusion: Obstructive sleep apnoea is a common finding in majority of patients suffering from chronic lifestyle diseases. In our study, we found that DISE is easy to perform, safe and reliable tool for evaluation of OSA with CVA patients as the majority of these patients have multi-level obstruction. The procedure also provides important information about dynamic changes in upper airway during sleep. Multilevel obstruction is the most common obstruction. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s12070-024-04758-w.

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