Many of my patients are told that they don’t have obstructive sleep apnea based on formal sleep studies. However, they still keep waking up choking and gasping, or never feel refreshed after sleeping for 10 hours.
Here’s a recent publication (by me and others) looking at drug induced sleep endoscopy (DISE) in patients with upper airway resistance syndrome (UARS). By definition, these patients have an AHI level less than 5, but are still severely symptomatic.
DISE is a simple procedure performed in the operating room where you’re placed in deep sleep using an intravenous solution of propofol. This procedure can be performed alone, or in combination with other surgical procedures. Once we reach a state of deep sleep with vigorous breathing, we record the images in the upper airway. The bottom line is that we see significant multilevel obstruction in most patients. Take a look at the videos. By definition, they don’t officially have sleep apnea.
Hopefully, this study will create more awareness of the possibility of significant obstructed breathing even if your sleep study is completely normal.