Full-night measurement of level of obstruction in sleep apnea utilizing continuous manometry.

OBJECTIVES/HYPOTHESIS: To determine the average proportion of retropalatal or retroglossal obstruction occurring during a whole night in single patients with obstructive sleep apnea.

STUDY DESIGN: Retrospective analysis.

METHODS: Patients who underwent full-night polysomnography and upper airway pressure manometry at the same time were retrospectively enrolled. Airway obstruction levels were categorized into retropalatal or retroglossal obstruction according to the pressure change shown during pressure manometry. The proportion of retropalatal/retroglossal obstruction was calculated for each patient. Independent factors associated with the proportion were assessed.

RESULTS: A total of 218 patients (198 men) with obstructive sleep apnea were included in the study (mean age, 46.8 ± 1.6 years; body mass index, 26.7 ± 3.1 kg/m2 ). The average proportion of retroglossal and retropalatal obstruction in individuals was 36.2% and 63.8%, respectively. The apnea-hypopnea index was not significantly correlated with the proportion of retroglossal obstruction (P = .219) after adjustment for age, sex, and body mass index. Meanwhile, the proportion of retroglossal obstruction was significantly correlated with oxygen desaturation index (P = .036), average oxygen saturation (P = .006), lowest oxygen saturation (P = .028), and time below 90% oxygen saturation (P = .021).

CONCLUSIONS: To our knowledge, this is the first study showing the average proportions of retropalatal/retroglossal obstruction occurring in single individuals with obstructive sleep apnea during a whole night. The proportion of upper airway obstruction site was significantly associated with oxygen desaturation.

LEVEL OF EVIDENCE: 4. Laryngoscope, 127:2897-2902, 2017.