(1307) Comparative Analysis of Drug-Induced Sleep Endoscopy-PAP and Therapeutic CPAP in the Treatment of Obstructive Sleep Apnea

Introduction: Drug-induced sleep endoscopy with positive airway pressure (DISE-PAP) has become an important tool in the field of sleep medicine/surgery to help improve patient selection for various surgical interventions. While the accessibility of CPAP during DISE remains limited across clinical settings, CPAP therapeutic pressure may be more readily available. Whether the two pressures are similar however is not fully understood. This study aims to assess the relationship between DISE-PAP opening pressure and CPAP therapeutic pressure.

Methods: A retrospective cohort study of patients at a single institution with OSA who underwent DISE-PAP and had data available from their home CPAP device. DISE-PAP opening pressure was defined as the CPAP pressure at which the airway was visually open at all levels. CPAP therapeutic pressure was collected from the patients' data download from their home CPAP devices. Patients were excluded if they had residual AHI > 10 on CPAP data download. The 2 values were compared for equivalence.

Results: In total, 18 patients were included (average AHI = 29; average DISE-PAP pressure = 9.3 cmH20; average CPAP therapeutic pressure = 10 cmH20). DISE-PAP pressure was within 3.5 cmH20 of CPAP therapeutic pressure in 15 patients (83%) and within 2 cmH20 in 8 patients (44%). However, based on equivalence testing for means in all patients, DISE-PAP pressure was not statistically similar to CPAP therapeutic pressure. This held true when patients were stratified by AHI and BMI.

Conclusions: Our study suggests that DISE-PAP pressures do not correlate with CPAP therapeutic pressures, although they appear to be similar for a subset of patients. There remains a need to further evaluate the relationship between treatment success, DISE-PAP pressures, and CPAP therapeutic pressures.