Surgery is not recommended as a frontline sleep apnea treatment for many reasons. One of them is that it’s hard to figure out how much of various tissues need to be removed to open up the airway. For this planning stage, surgeons typically induce sleep apnea, but this can be risky. Now a new procedure seems to help make inducing sleep apnea faster and safer.
Drug-Induced Sleep Endoscopy
The new technique, developed by researchers at the University of Pennsylvania, is called drug-induced sleep endoscopy (DISE). Doctors use fast-acting anesthetic propofol to quickly bring patients to a sleep apnea state, but they use two important techniques to reduce the risk of overdose. First, they have a new proprietary computer algorithm that takes many factors into account when determining dosage. Second, they deliver anesthesia in a controlled, uniform fashion with constant monitoring.
Benefits of the New Approach
This new approach makes it easier, faster, and safer for patients to be gauged for sleep apnea surgery. Because the technique allows sleep apnea to be induced, it doesn’t require a sleep lab–it can be done in the doctor’s office.
The study is also faster to induce sleep apnea. Other approaches typically take about 6.2 minutes to induce sleep apnea, but this new procedure is nearly two and a half minutes faster at 3.8 minutes.
And with the shorter time for induction, the new procedure improves oxygen saturation, which makes it safer. Other studies can cause oxygen saturation to dip as low as 80%, but in DISE trials, oxygen saturation stayed at a relatively high 91%.
This makes it an improvement over previous procedures, which forced doctors to choose between a safer procedure and a faster one.
Just how safe does this make DISE overall? In a pilot study of 97 patients, there were no adverse effects.
Surgery is still not a frontline treatment option for sleep apnea, but we know that many people do not tolerate CPAP, and some of them may not benefit from oral appliances. It’s important that we have surgery as another option and that we make it as safe as possible.