Evaluation of Upper Airway Dynamics Using Multichannel Drug-Induced Sleep Endoscopy in Patients With Obstructive Sleep Apnea-Multichannel Drug-Induced Sleep Endoscopy

Drug-induced sleep endoscopy (DISE) is an essential diagnostic tool for assessing upper airway obstruction in patients with obstructive sleep apnea (OSA). However, traditional single-channel DISE (SDS) often fails to capture important external maneuvers, vital signs, and dynamic changes in the airway. To address these limitations, we developed and implemented a multichannel DISE (MDS) protocol, which has been routinely used since 2018 at Chonnam National University Hospital for OSA patients undergoing polysomnography. This system integrates up to six synchronized video channels, including endoscopic views, vital sign monitoring, patient positioning, continuous positive airway pressure (CPAP) status, external maneuvers, and acoustic signals. The procedure consists of three phases: awake evaluation, sedation, and CPAP titration to determine the optimal therapeutic pressure. The MDS system allows for a comprehensive assessment of both anatomical and functional factors contributing to obstruction. Real-time visualization and maneuver testing enhance procedural safety, enabling trained residents to perform the examination under supervision, with no complications reported to date. Additionally, the ability to review recorded videos aids in clinical interpretation and facilitates patient education and treatment compliance. In conclusion, MDS offers a practical and scalable improvement over conventional DISE. It enables detailed evaluation of upper airway dynamics and supports individualized therapeutic decision-making, demonstrating strong potential for both clinical practice and research in OSA management.