Incidence and risk factors of nocturnal penetrations and aspirations in patients with obstructive sleep apnea during drug‐induced sedation endoscopy

Author:

Vainer Igor12ORCID,Allon Raviv34,Shapira‐Galitz Yael34ORCID,Strinkovsky Lior12,Toh Song Tar56,Loh Shaun56,Alkan Uri12

Affiliation:

1. Department of Otolaryngology Head and Neck Surgery Rabin Medical Center Petach‐Tikva Israel

2. Sackler Faculty of Medicine Tel Aviv University Tel Aviv Israel

3. Department of Otolaryngology, Head and Neck Surgery Kaplan Medical Center Rehovot Israel

4. Faculty of Medicine Hebrew University of Jerusalem Jerusalem Israel

5. Department of Otorhinolaryngology‐Head and Neck Surgery Singapore General Hospital Singapore Singapore

6. Singapore SingHealth Duke‐NUS Sleep Centre Singapore Singapore

Abstract

SummaryObstructive sleep apnea has been linked to an increased risk of pneumonia, possibly due to higher rates of nighttime aspirations. Few studies have directly investigated such aspirations in individuals with sleep apnea. This retrospective study included 142 adult patients with obstructive sleep apnea who underwent drug‐induced sedation endoscopy between 2017 and 2020. The incidence of penetrations and aspirations during the procedure was assessed, along with potential associated factors. The results showed that 28.1% of the patients experienced penetrations, 48.5% had aspirations, and 23.2% had neither. Male gender and epiglottic collapse were significantly associated with both penetrations and aspirations, while oropharyngeal collapse was more common in those without these events. This study highlights a high rate of aspirations during the procedure in individuals with sleep apnea, with epiglottic collapse and male gender identified as potential risk factors. These findings underscore the need for further research to understand the mechanisms of nighttime aspirations in sleep apnea and to develop targeted strategies to reduce pneumonia risk in this population.

Publisher

Wiley

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