0500 Impact of positive airway pressure on drug-induced sleep endoscopy to deliver precision medicine

Abstract Introduction Sleep endoscopy during natural sleep will be ideal, to evaluate the upper airway episodes of obstructive apnea, but quite difficult achieve. Drug-induced is an alternative standard care document level and severity collapse airway. It especially benefit for patients who are intolerant positive pressure used as a part work-up therapy treating apnea. Using propofol infusion Bi-spectral index 50-70, monitor depth sedation, can determined with endoscopy, conducted initially without CPAP then ranging from 10 cmH2O 20 cm H2O in failed PAP therapy. Methods (DISE) was carried out bronchoscopy suite by same Pulmonologist anesthesiologist manage sedation using Propofol. Adequate confirmed presence snoring, BIS. The patient underwent entire procedure while supine. obstructions followed velum/oropharynx/tongue base/epiglottis recorded patent/partial/complete. obstruction pattern classified into circumferential, anteroposterior, or lateral. Tongue base identified when tongue pushed epiglottis causing lumen obstruction. DISE CPAP. Results Out total 80 patients, upon application CPAP, 3 (4%) had patent velum tongue. partial complete One (1%) persistent anterior-posterior lateral wall velum, patent. 68 (85%) improved anteroposterior collapse. Five (6%) continued have circumferential velum. Conclusion performed combination various pressures allows real-time visualization impact these on us provide treatment options sooner than later. Support (if any)