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How Does Epiglottic Collapse Affect OSA Severity?

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A new study in the Journal of Clinical Sleep Medicine examined how different structural issues affect the severity and treatability of Obstructive Sleep Apnea in adults.   The study compared adults with and without epiglottic collapse and looked at obesity, the severity of apnea, and response to treatment.   

What Makes OSA Caused by Epiglottic Collapse Special?

Compared to other adults, the patients with epiglottic collapse were:

  • Less likely to be obese and had less severe sleep apnea overall.   
  • More prone to collapse of the tongue base than other patients, but were unlikely to have soft palate collapse or collapse in the wall of the throat.   
  • More responsive to oral appliance therapy and to orofacial myofunctional therapy.

This study shows how important it is to find the root cause of a patient's OSA when evaluating and treating them.  The underlying anatomy affects both the AHI index and the appropriate treatment. Targeting treatment to each patient can increase the effectiveness of treatment.  When patients have a treatment plan that helps them, they’re more likely to stick with it and see the long-term health benefits that come from treating sleep apnea.

Patients who suffer from epiglottic collapse don’t always respond to CPAP treatment.  While some doctors recommend surgery as a first-line intervention for this condition, oral appliance therapy represents a safe, non-invasive option.

How is Epiglottic Collapse Diagnosed?

Currently, epiglottic collapse is diagnosed mainly via Drug-Induced Sleep Endoscopy (DISE), an imaging technique in which the patient is put to sleep while footage is taken of the inside of the throat using a fiberoptic camera.  This gives an accurate image of what's going on while a patient sleeps.  Recently, a multinational team of researchers has also explored using sleep breathing patterns to identify epiglottic collapse without the need for an invasive procedure.  This means that in the near future it may be possible to identify epiglottic collapse as part of a normal sleep study and to tailor treatments effectively.

When you see a patient who says that they have been diagnosed with sleep apnea, do you ask them if they know the underlying cause?  Part of helping our patients is getting a full picture of their diagnosis so we can make sure that they get a treatment plan that they can comply with, and that will change their lives.