Abstract

BACKGROUND: The study aimed to evaluate the anatomical differences between positional and non-positional OSA, and to identify the potential predictors for distinguishing between these two types of OSA.METHODS: A cross-sectional study of 230 consecutive patients with OSA undergoing DISE (Drug-induced Sleep Endoscopy) was carried out at a tertiary academic medical center. The factors correlating with positional and non-positional OSA were analyzed, including clinical characteristics, polysomnography data, and DISE findings.RESULTS: Univariate analysis revealed that non-positional dependency was correlated with a higher BMI (p<0.001), neck circumference (p<0.001), modified Mallampati score (p=0.003), AHI (p<0.001), degree of velum concentric collapse (p=0.004), degree of oropharyngeal lateral wall collapse (p<0.001), and degree of tongue base anteroposterior collapse (p=0.004). Multivariate analysis revealed that oropharyngeal lateral wall collapse (OR=1.90, p=0.027) was the only anatomical factor significantly predicted non-positional dependency in OSA patients. AHI (OR=1.04, p<0.001), although significant, made only a marginal contribution to the prediction of non-positional dependency.CONCLUSIONS: Oropharyngeal lateral wall collapse was identified as the only anatomical predictor for non-positional dependency in OSA patients. Therefore, further treatment modalities should address the distinct anatomical trait between positional and non-positional OSA.

View details for DOI 10.1186/s40463-020-00478-7

View details for PubMedID 33317645