I am interested in knowing physiological classification systems/parameters for classifying the severity of sleep apnoea during drug induced sleep endoscopy. For example, how is blood oxygen level used to classify sleep apnea during drug induced sleep endoscopy?
As far as I know sleep apnoea should be classified as mild, moderate or severe according to AHI index, (AASM rules). During DISE nor apnoea or hyponoea could be identified because the proper sensors ( flow and Thermistor) to do so are not used. O2 saturation is not a criteria to identify apnoea but should be used to classify Hipopnoea ( in children we must have a 3% desaturation to classify an Hipoponea )
DISE , I think is very useful to see where the level of obstruction of the upper airway exists, although sleep induced by propofol or other sedating drugs doesn´t induce REM sleep which is a sleep phase where the obstruction events are more frequent.
If this is for research purposes, i would think a subject would have to undergo full polysomnography during the procedure, to accurately measure the AHI index. This includes EEG, ECG, Nasal flow measurement, Pulse oximetry, and respiratory inductance plethysmography.
In some cases pulse oximetry can be used in clinical practice, but it has clear limitations and is not an accurate surrogate for AHI. Pulse oximetry can imply OSA by measuring the frequency of 4% cyclical desaturations that occur per hour of sleep. However, as the previous comment has stated, not all respiratory events that occur in sleep apnoea are associated with a desaturation, and hence pulse oxiemtry alone understimates AHI.
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