A Novel Method to Classify the Responses of Genioglossus to Negative Pressure in OSA Patients

Objective. This study aims to develop a novel method to classify different genioglossus (GG) responses to upper airway (UA) negative pressure in obstructive sleep apnea (OSA) patients.Study Design. A single-center, prospective, cohort study.Setting. Sleep Medical Center.Methods. Patients with OSA underwent drug-induced sleep endoscopy with synchronous genioglossus electromyography (ggEMG) and UA pressure monitoring. In spontaneous obstructive apnea events, the value of epiglottis negative pressure at the end of inspiration (P-epi) and corresponding peak phasic ggEMG were recorded as pairing data for linear regression analysis to classify GG response modes: peak phasic ggEMG-P-epi linear mode (P < .05) were classified as group 1; others (P = .05) were classified as group 2. Using nasopharyngeal tube (NPT) to reopen the palatopharyngeal cavity for comparing the improvement between the OSA patients with different GG response modes.Results. Sixty subjects were analyzed for GG response modes: 22 patients were in group 1 (r(2) = 0.233-0.867), and 38 patients were in group 2. The proportion of partial (63.16% vs 59.09%) or complete (36.84% vs 22.73%) collapse rate of the tongue base in group 2 was significantly higher (?(2) = 7.823, P = .020). The improvement of the apnea-hypopnea index after NPT placement in group 2 was significantly lower than in group 1 (59.09% vs 31.58%, ?(2) = 4.339, P = .037).Conclusion. This novel method is advantageous for distinguishing OSA patients with different GG response abilities to UA negative pressure, whose GG responses conforming to peak phasic ggEMG-P-epi linear mode might be more suitable for palatopharyngeal surgery.

Automated summary

This study aims to classify different genioglossus responses to upper airway negative pressure in obstructive sleep apnea patients. The method involves drug-induced sleep endoscopy with synchronous genioglossus electromyography and upper airway pressure monitoring. The results show that OSA patients with different genioglossus response modes have different outcomes in terms of tongue base collapse rate and improvement after nasopharyngeal tube placement. This novel method is useful for identifying suitable candidates for palatopharyngeal surgery.