Dıagnostıc Methods For Snorıng And Obstructıve Sleep Apnea

Sleep Endoscopy

Have you ever wondered what happens in your throat when you snore or experience apnea (difficulty breathing) during sleep? Sleep endoscopy is a method designed to answer this question. This medical procedure allows doctors to observe how the airway behaves during sleep, helping to diagnose and treat issues like snoring and sleep apnea.

What is Sleep Endoscopy?

Sleep endoscopy, also known as drug-induced sleep endoscopy (DISE), is like a guided tour of your throat while you sleep. During the procedure, an anesthesiologist administers a mild sedative to mimic the relaxation that naturally occurs during sleep. In this semi-sleep state, a small camera is inserted through your nose to observe the lower part of the airway behind the nose.

The procedure identifies areas where blockages or collapses occur. Common sites of obstruction include:

• Soft Palate and Uvula
• Pharynx, Tonsils, Tongue Base

Since each individual’s airway behaves differently, this personalized information is highly valuable.

Why Do Doctors Use It?

Since my training in Pittsburgh in 2013, I have consistently used sleep endoscopy for patients with complaints of snoring and sleep apnea while planning treatment. This method helps pinpoint the exact location of the blockage in cases where the problem cannot be fully identified during an upright examination. Preoperative sleep endoscopy plays a crucial role as a guide to improving treatment success.

Sleep endoscopy is essential for diagnosing and treating breathing problems. Knowing where the obstruction occurs helps doctors choose the most appropriate treatment, whether it’s a CPAP device, an oral appliance, or surgery. If you’ve had surgery before, sleep endoscopy can show whether the treatment was effective and what may still be required.

Who Needs Sleep Endoscopy?

Your doctor may recommend this procedure if:

• Other tests cannot fully explain your symptoms.
• You do not respond to standard treatments like CPAP.
• Surgery is being considered for sleep apnea.
• Your airway anatomy is complex or unusual.

What is the Patient Experience Like?

Don’t worry—sleep endoscopy is a simple and safe procedure. The sedative makes you feel relaxed, and the camera does not cause pain. The procedure is completed in under an hour, and you can go home the same day.

What Are Its Drawbacks?

While sleep endoscopy is highly beneficial, it is not without limitations:

• Cost: It can be expensive and may not be widely available.
• Sedative Drug Effects: Though mild, sedatives may slightly alter airway behavior compared to natural sleep.
• Expertise Required: Interpreting results accurately requires skill.

What is Polysomnography?

Polysomnography is a comprehensive test that measures various body functions during sleep. It is typically performed in a sleep lab and monitors the following parameters:

• Brain Activity: Records electrical activity in the brain using EEG.
• Eye Movements: Determines REM (rapid eye movement) and sleep stages.
• Muscle Activity: Measures muscle tone and movements using EMG.
• Heart Rate and Breathing: Monitored with EKG and respiratory sensors.
• Oxygen Levels: Tracks blood oxygen saturation.

Polysomnography is used to diagnose sleep disorders such as sleep apnea, narcolepsy, and restless leg syndrome.

Polysomnography vs. Sleep Endoscopy: What Are the Differences?

Polysomnography and sleep endoscopy are two key methods used in diagnosing sleep disorders, each serving different purposes and being conducted differently. Here are the main differences between the two:

Main Differences

Purpose:

• Polysomnography: Analyzes sleep stages and general physiological parameters.
• Sleep Endoscopy: Examines the anatomical and dynamic features of the airway.

Application Field:

• Polysomnography: General diagnosis of sleep disorders.
• Sleep Endoscopy: Surgical planning for sleep apnea or evaluation of treatment success.

Application Method:

• Polysomnography: Conducted overnight in a lab setting using multiple devices.
• Sleep Endoscopy: A short procedure performed under sedation in an operating room.

Use of Results:

• Polysomnography: Determines the type of sleep disorder.
• Sleep Endoscopy: Guides treatment or decision-making for surgical intervention.