Drug-inducedsleependoscopy(DISE), also known assleepnasendoscopy (SNE), is a minimally invasive surgical procedure. It is a diagnostic tool used for studying theairwayin a sleeping (sedated) patient with obstructivesleep apnea(OSA).
What is obstructive sleep apnea (OSA)?
Obstructivesleep apnea(OSA) is a sleep disorder that causes the patient’sbreathingto stop and start repeatedly during sleep.
The most characteristic feature of OSA issnoring. It happens due to intermittent relaxation of the throat muscles that block the airway while the patient is asleep.
Due to troubled breathing, OSA leads to a gradual fall in oxygen concentration. As a result, the patient gets choking spells that awaken them and disturbs their sleep.
Initial treatment for OSA includes the following devices:
- A device that uses positive pressure to keep the airway open while the patient is asleep.
- A mouthpiece to thrust the patient’s lower jaw forward during sleep.
这些设备只在管理协会的帮助toms of OSA. If the patient does not want to use these devices for a lifetime, they can consider corrective surgery for OSA.
What are the advantages of the DISE procedure?
Drug-induced sleep endoscopy (DISE) is a powerful tool for studying the airway in a sleeping patient in real-time. It helps the doctor identify the level and pattern of airway obstruction in a patient with obstructive sleep apnea (OSA). This allows them to tailor the treatment plan for each patient. This can improve the results of the surgery and/or minimize the extent of the planned surgery.
DISE may also provide information that will eliminate the need for surgery for patients with OSA.
How is the DISE procedure performed?
The patient is sedated in a way that is similar to natural sleep. The medication given for sedation is propofol. Sedation allows the surgeons to look inside the throat using a long, thin tube-like camera known as a flexible fiberoptic laryngoscope or an endoscope.
Once the anesthesiologist confirms that the patient is sedated and breathing, the surgeons place the laryngoscope through one of the nostrils and into the throat to examine the airway and nearby possible regions that can cause obstructive sleep apnea (OSA).
Who can undergo the DISE procedure?
Any patient who has documented obstructive sleep apnea (OSA) can be considered for drug-induced sleep endoscopy (DISE) through propofol.
The ideal patient should have
- Documented OSA.
- An airway that is considered manageable by the anesthesiologist and surgeon.
- A patent nasal airway that can allow the easy passage of a fiberoptic laryngoscope.
Who will not be considered for the DISE procedure?
Not all patients with obstructive sleep apnea (OSA) are fit to undergo drug-induced sleep endoscopy (DISE). Following patients are not fit for DISE:
- Pregnantwomen
- Patients with propofolallergy
- Patients with a significant nasal obstruction that obstructs the passage of a laryngoscope
- Patients with an airway deemed unsafe by the doctor
- Patients with a history of aspiration (breathing in a foreign object such as sucking food into the airway)
- Patients withallergiesto propofol components (such as egg lecithin or soybean oil)
What are the risks of the DISE procedure?
Drug-induced sleep endoscopy (DISE) is a relatively safe surgical procedure compared with other surgeries. Possible complications include:
- Epistaxis (nose bleeding from the injury due to the laryngoscope)
- Laryngospasm (muscle spasmof the vocal cords), which can cause difficulty in breathing and speaking
- Aspiration
Sharifian MR, et al. Drug induced sleep endoscopy in obstructive sleep apnea. Tanaffos. 2018;17(2):122-126.
Top What Is a DISE Procedure? Related Articles
Sleep Disorders: Myths and Facts About Obstructive Sleep Apnea
Is it just snoring, or is it something more serious? We set the record straight on some myths and facts surrounding obstructive sleep apnea.
Sleep Disorders
A number of vital tasks carried out during sleep help maintain good health and enable people to function at their best. Sleep needs vary from individual to individual and change throughout your life. The National Institutes of Health recommend about 7-9 hours of sleep each night for older, school-aged children, teens, and most average adults; 10-12 for preschool-aged children; and 16-18 hours for newborns. There are two stages of sleep: 1) REM sleep (rapid-eye movement), and 2) NREM sleep (non-rapid-eye movement).
Sleep Apnea
Sleep apnea is defined as a reduction or cessation of breathing during sleep. The three types of sleep apnea are central apnea, obstructive apnea (OSA), and a mixture of central and obstructive apnea. Central sleep apnea is caused by a failure of the brain to activate the muscles of breathing during sleep. OSA is caused by the collapse of the airway during sleep. OSA is diagnosed and evaluated through patient history, physical examination and polysomnography. There are many complications related to obstructive sleep apnea. Treatments are surgical and non-surgical.
Sleep Disorders: Insomnia, Sleep Apnea, and More
了解不同类型的睡眠/唤醒disorders such as insomnia, narcolepsy, and sleep apnea. Explore the symptoms, causes, tests and treatments of sleep disorders.
What Are the Three Types of Sleep Apnea?
Sleep apnea is a sleep disorder that can potentially lead to serious health complications. In sleep apnea, the person may stop breathing for some time during sleep. The three kinds of sleep apnea are obstructive sleep apnea, central sleep apnea, and mixed sleep apnea.What Are the Four Warning Signs of Sleep Apnea?
Sleep apnea is a sleep disorder that can potentially lead to serious systemic health complications. It is a condition that causes a person to intermittently stop breathing during sleep. Warning signs of sleep apnea include snoring, nighttime gasping, intermittent pauses during sleep, and daytime sleepiness.