Abstract
Objective: The purpose of this study is to evaluate the location, configuration, and degree of differences in upper airway obstruction between the Mueller Maneuver (MM) and Drug-induced sleep endoscopy (DISE), thus acquiring a better diagnostic value for SDB patients.
 Methods: A cross-sectional and analytical descriptive study using retrospective secondary data to evaluate the location, configuration and degree of upper airway obstruction in SDB subjects using the Mueller Maneuver and DISE. Polysomnography (PSG) type 2 was used to determine the SDB degree.
 Results: Subjects with SDB non-Obstructive sleep apnea (OSA) and OSA show a multilevel obstruction with a different location and configuration due to the various risk factors, such as nasal congestion, laryngopharyngeal reflux, obesity and menopause.
 Conclusion: Statistical differences in upper airway obstruction configuration between MM and DISE were found in the level of the velum (p=0,036), oropharynx (p<0,001) and epiglottis (p=0,036) and were also found in the obstruction degree of the velum, oropharynx, tongue base and epiglottis with p=0,002; p<0,001; p<0,001 and p<0,001. No statistical difference was found on the lowest oxygen saturation between PSG and DISE (p=0,055).
Highlights
Sleep-disordered breathing (SDB) is a spectrum of abnormalities in breathing during sleep
Druginduced sleep endoscopy (DISE) is an actual observation that can assess the dynamics of the upper airway obstruction that occur during sleep
A cross-sectional and analytical descriptive study using retrospective secondary data from the Bronchoesophagology Division of the ORL-HNS Department FMUI/CMGH was performed to evaluate the difference in the location, configuration and degree of upper airway obstruction in SDB subjects using the Mueller Maneuver (MM) and DISE on 46 subjects
Summary
Sleep-disordered breathing (SDB) is a spectrum of abnormalities in breathing during sleep. The characteristic of SDB is the presence of a partial or total upper airway obstruction resulting in intermittent pauses in breathing in the form of apnea (total), hypopnea (partial), or just airflow limitation. Various questionnaires demonstrate a history of sleep complaints, such as the Epsworth Sleepiness Scale (ESS) and the STOP-BANG questionnaire explore the risk factors for sleep disorders. Mueller's Maneuver (MM) examines the active muscle control tone; this maneuver is not representative of the patient’s sleeping condition. Polysomnography (PSG) is a gold standard for assessing breathing pattern abnormalities during sleep with many parameters conducted in this study. Druginduced sleep endoscopy (DISE) is an actual observation that can assess the dynamics of the upper airway obstruction that occur during sleep. DISE can determined the location, configuration and degree of obstruction at the velum, oropharynx, tongue base or epiglottis (VOTE) or at a combination of these
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