Year: 2026
Type: article
Study design: Observational Study
Abstract: BACKGROUND: Drug-induced sleep endoscopy (DISE) with a jaw-thrust maneuver is used to simulate mandibular advancement in obstructive sleep apnea (OSA), yet determinants of functional airway improvement remain incompletely defined. OBJECTIVE: To identify clinical, polysomnographic, and baseline DISE anatomic factors associated with jaw-thrust responsiveness. METHODS: We conducted a single-center retrospective observational study of adults with polysomnography-confirmed OSA who underwent DISE with paired baseline and jaw-thrust VOTE assessments between 1 January 2015 and 31 December 2025 (n = 355). Jaw-thrust responsiveness was defined a priori as a within-subject reduction in the number of obstructed VOTE sites (grade ≥ 1). Multivariable logistic regression was used to identify independent correlates within a prespecified explanatory modeling framework. The study was approved by the Institutional Review Board of Taipei Tzu Chi Hospital (protocol 14-IRB079), with the need for informed consent being waived. RESULTS: < 0.001). Overall, 62.8% met responder criteria and 18.9% achieved complete normalization. In multivariable analysis (n = 272), baseline tongue-base collapse (adjusted odds ratio [aOR] 2.46, 95% CI 1.20-5.04) and greater baseline multilevel obstruction burden (aOR 1.85 per SD, 95% CI 1.19-2.85) were independently associated with responsiveness, whereas conventional PSG severity metrics were not. CONCLUSIONS: In adults with OSA, jaw-thrust responsiveness during DISE is more strongly associated with baseline anatomic phenotype than with global PSG severity. Standardized DISE functional assessment may provide complementary information to support phenotype-informed selection of non-CPAP therapies, pending prospective validation.
Source: Life
DOI: 10.3390/life16030456
Authors: Wei-Hung Chang, Kuan-Pen Yu, Li-Kuo Kuo, Chung Lee
Language: English
Subfield: Physiology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,137
OpenAlex ID: W7134902479