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Sleep endoscopy


Sleep endoscopy is also known as sleep nasoendoscopy. It is a drug-induced sleep that acts as a powerful tool to study the dynamic airway in a patient while he is asleep. The information gained from the sleep endoscopy would help the surgeon while tailoring the operation. The condition for each patient could be different and sleep endoscopy offers the solution. Sleep endoscopy is the key to address all the levels of obstruction. There could be multiple obstructions at the mouth, nose and tongue levels. Sleep endoscopy is also suited for patients who are having severe snoring and desire surgical options.

What are the indications that show that a person would require sleep endoscopy?
It is difficult to determine the anatomic area in some patients that is responsible for obstruction when the person is awake. The symptoms are absent when a person is absent and an examination during this stage would not reveal much information. The procedure would become very useful in such cases. Different surgical techniques exist and sleep endoscopy would reveal which surgical procedure to follow.

What are some of the important components in the procedure?
Sleep endoscopy consists of two distinct components:

  1. The process of endoscopy involves the introduction of a flexible and thin camera through the nose to examine the upper airway. The entire structure from the tip of the nose to the voice box can be diagnosed.
  2. The sedated or sleep endoscopy involves putting the patient to sleep. This is unlike the traditional method of performing the procedure when the person is awake.

Most patients would wake up immediately if the doctor tries to insert something through the nose and it makes no sense for a doctor to wait for the patient to fall asleep. The patient is sedated by an anaesthesiologist with the help of certain medications.

What are some of the areas that are examined during the process?

There are areas that are specifically examined during sleep endoscopy. These include - uvula, epiglottis, walls of the throat, voicebox, back of the tongue and behind the palate. One or more of the areas might be experiencing collapse that causes the obstructions and snoring.

How does the sleep endoscopy proceed?
Before proper evaluation, the person goes through a basic evaluation. A baseline endoscopic evaluation of the airway is also performed when the person is awake. Sedated or sleep endoscopy is not required for all patients. The procedure might even need to be performed in the operating room depending on the obesity of the person. The procedure is scheduled on a different day if it becomes apparent that sleep endoscopy is necessary.
The person is advised to eat or drink nothing after midnight the day of the procedure. The restrictions thus minimise any chances of vomiting during the procedure.
Before the procedure, the anaesthesiologist puts an injection that induces general anaesthesia, putting you to sleep. The endoscopy is performed when you are asleep. The procedure is generally not more than 15 minutes long. The person is observed for about 30 minutes before getting discharged.

Thus, sleep endoscopy can help uncover a lot of information about the airways during your sleep. This helps to decide on the processes to be performed by the surgeon.

Authored by Dr Shailesh Pandey, ENT Specialist

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