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KMID : 0361020220650120781
Korean Journal of Otolaryngology - Head and Neck Surgery
2022 Volume.65 No. 12 p.781 ~ p.786
Effect of Body Mass Index on Upper Airway Obstruction as Revealed by Drug-Induced Sleep Endoscopy in Patients With Sleep-Disordered Breathing
Woo Joo-Young

Koo Soo-Kweon
Koh Tae-Kyung
Ji Chang-Lok
Abstract
Background and Objectives Drug-induced sleep endoscopy (DISE) usefully determinesthe sites of airway obstruction in patients with sleep-disordered breathing. It is widely acceptedthat obesity increases obstructive sleep apnea. However, no study has explored how andwhere obesity causes obstructions. In this study, we described the patterns of upper airway obstructionrevealed by DISE in patients of various body mass indices (BMIs) with sleep-disorderedbreathing.

Subjects and Method All subjects had sleep-disordered breathing and underwent DISE.
Endoscopic findings at the retropalatal (upper lateral, upper anteroposterior [AP]) and retrolingual(lower lateral, lower AP) levels were graded; obstruction was complete (2), partial (1),or none (0). Subjects with BMI <25 (<25 group), 25¡ÂBMI<30 (25<30 group), and ¡Ã30 kg/m2(>30 group) were compared using a dummy variable; to this end, we employed R ver. 4.0.5.

Results For the total of 153 patients reviewed, the mean age was 43.1¡¾12.2 years and themean BMI was 26.0¡¾3.4 kg/m2.
At the retropalatal AP level, the DISE grade was significantlyhigher in the 25<30 group than in the <25 group (p=0.029) but not in the >30 group (p=0.248).
At the retropalatal lateral level, significant increases were evident in both of the higher BMIgroups (p=0.06 and p=0.024, respectively). No significant relationship was found at the retrolinguallevel.

Conclusion In terms of the retropalatal AP and lateral diameters, a higher BMI is associatedwith a greater incidence of more severe obstruction.
KEYWORD
Body mass index, Drug-induced sleep endoscopy, Obstructive sleep apnea, Sleep disordered breathing
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