Drug Induced Sleep Endoscopy- Evaluation of snoring and sleep apnea.
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- čas přidán 8. 09. 2024
- Sleep endoscopy, also known as sleep nasoendoscopy (SNE) or drug-induced sleep endoscopy (DISE), is a powerful tool for studying the dynamic airway in a sleeping patient with obstructive sleep apnea (OSA). Using the knowledge gained from sleep endoscopy, the surgeon can tailor the operative procedure to the patient's specific condition.
Due to the difficulty in establishing the site of obstruction in the conscious patient who carries a diagnosis of OSA, the diagnosis and treatment of OSA is a complex and multidimensional issue. The first proposed sleep endoscopy was performed in 1991. Using midazolam as a sedating agent, the procedure demonstrated the utility of passing a fiberoptic endoscope through a sleeping patient’s nasal cavity to assess pharyngeal structures for evidence of obstruction. They were able to induce the preexisting snoring in 95% of their patients.
This procedure greatly increases the precision of care for patients with Obstructive Sleep Apnea (OSA).
In this video, the patient also kindly shares his experience with us, and elaborates on what drove him to seek out a Drug Induced Sleep Endoscopy.
The expert anesthesiologist, and collaborating dental sleep medicine specialist also offer their notes on the procedure. Today most DISE procedures including this one are performed with propofol as the sedating agent, whereas leading researchers are exploring other medications such as dexmedotimidine as the preferred drug for sleep induction.
www.zaghimd.com/
Proper diagnosis alone can be life-changing. I was moved by this man's emotions; that he finally felt validated and "believed" about the severity of his sleep issues, as it so negatively impacted his quality of life!
I can’t believe anyone believed that was normal !!! Those doctors must have been total wack jobs
@@miralabualjadail4206 Hi Miral. I am Austin, the patient in the video.
It's not that the doctors believed that this was normal: they never saw this. The take home test studies showed horribly false negatives. It also shows how grossly lacking some of our current technologies are at adequately diagnosing sleep apnea, and also how remarkably effective the DISE is at pinpointing the area of obstruction. Every doctor I went to said I was fine because the tests said so. I had a friend that went through the same thing as me. I think this video shows the potential of helping so many that are like me where traditional sleep studies are lacking.
@@austinkim7804 You could be leading a medical breakthrough and revolution to help people with this! Thank you for putting this out there and sharing this with everyone. Its quite significant.
@@austinkim7804 Hi Austin, could you pls tell me did you pay for testing by yourself or you had insurance? If you know could you tell me what is the price of testing? Thank you
@@ojc8203 I had insurance, but insurance refused to pay a lot of times, and would play ridiculous games with me to avoid paying. For the first DISE, Dr. Zaghi was very kind to me and worked something out with me. For the second, I can't remember, it was a couple of K at least. Insurance also refused to pay that, made some more wonderful excuses.
My total medical bills over 5 years related to my sleep apnea / PTSD was $519k. With insurance, I paid less than 10% of that.
You know this person had the best nap ever after waking up
Lol I really did xD
Thank you for such a video, thank you to the client Austin for allowing such a video!
Omg the groaning is scary. I hope this guy recovers
Hope he is ok poor guy he is in my prayers and thoughts
Cured. :D
@@austinkim7804 curious... what surg proceedures did they do?
@@bookemdano100 copy pasting from a response below
Turbinate reduction (twice), septoplasty, maxillomandibular rotational advancement, nasal polyp removal, lingual frenectomy, soft palate coblation, uvulopalatal flap surgery/uvulopalatopharyngoplasty, lateral pharyngeal wall removal, tonsillectomy, hyoid suspension.
My obstruction was quite severe at multiple locations. We needed to make a lot of room as my entire airway was like breathing through a straw.
In retrospect, a few of those surgeries didn't help me as much as we hoped, but we carefully assessed each situation before making any decisions. I have no regrets!
The doctor said “ I was really impressed with his sleep apnea” 🤣🤣🤣
Interestingly, many doctors that I showed that video to used the word "impressed" or "impressive" when talking about my sleep apnea. Must be a medical thing haha.
I need to translate this video to Spanish and show it to my doctors here and try to convince them to do all the things Dr Zaghi did to Austin. Oral appliances and CPAP haven't worked for me so I want my second DISE to help a lot in terms of what works and what doesn't and the sites and severity of my obstructions. Thank you for making and posting this video.
wow I've never seen apnea so severe
I started to use a CPAP 2 years ago and it is so nice to actually sleep again..
Wow...i have to go through this process soon and for me is a little scary seeing this man hardly breath..
I've had exactly one good night of sleep. Been through position change, taping my mouth shut, cpap, tongue extender, the jaw thing... I think this is my next step.
I am post op day 8 Transoral Robotic Surgery of Tounge Base Reduction + lingual tonsillectomy + epiglottoplasty + uvulopalatoplasty + septoplaty + turbinoplasty. I can really feel the difference in my breathing and sleep now. My doctor said the result will be maximum after 6months once all the wound heals, it will form scars at the back of my toungue, uvula and palate. The scars will prevent vibration hence eliminate snoring. Overalll she said she create the best channel possible for my airways.
Recovery is hard. Still cant eat anything solid as now. Hopefully in 2-3weeks i will be able to eat at least soft foods.
I recommend anyone for same surgery if u suffer from loud snoring like me. It improve ur confidence to sleep beside someone else.
How are you doing since you posted this, Sho Bulat, eleven months ago? How's your sleep? Do you have any symptoms from the procedures with the back of the tongue, uvula, and palate?
@@murchai1853 i feel great. About 99% currd my sleep apnea and most importantly i dont snore anymore. I lose weigt 16kg so far too, effortlessly
@@nyatio thanks a lot , could you please send me the location of the hospital you have visited , I am from the UK dr don’t seem to understand these conditions well , I was thinking to going to India
The mouth guards don't really work. I paid 200 bucks for one with a 30 day money back guarantee.. I used it for a week, and every morning I woke up with it lying beside me on the bed.. One time on the floor across the room so I must have thrown it lol.. I got my money back..
Sounds like SnoreRX or something. They help some, but if you get the professionally molded one by a dentist, they're much more effective.
But it also depends on the cause for your sleep apnea. If a mouth guard isn't addressing the area of obstruction, it won't work anyway even if it fits and stays overnight.
I have to be checked as had enough . My boyfriend tried to wake me up as i was choking with flem. He had said the 3 weeks before i was breathing very fast then stopped. Then i did a big gasp. It's becoming worse each month 🙃.
Goddamn he was waking up 40 times every hour
That's nothing lol when I did my test it was 69 times an hour
I went untreated for 10 years so, this dude was extremely lucky that he got treatment
I used to be on a lot of methadone and klonopin and it gave me sleep apnea. My gf used to wake me up and tell me to breath. Now that im off them it's gone. My family doesn't hear me snore anymore. Pretty weird. That sounds scary that dude breathing.
Hi Austin, did your insurance cover the DICE? . After the sleep study, what was your treatment?
Every time I watch this video I cry because im also severe, im bedridden, have done a lot of things (including MMA) and im worse. I need to fill out the online forms to see Dr Zaghi virtually and I can't think to do it. Im in South America without severe sleep apnea/UARS treatment. Doctors just want me to use CPAP which don't tolerate. I have to take sleep meds in order to sleep and I already think im losing my mind (alzimer or dementia).
Which condition do you have UARS or sleep apnea ? Your initial diagnosis
Poor guy
My child suffers from this according to sleep study as severe. I dont belive in Sleep study should I go for sleep edoscopy with him? he is 18m Please reply what kind of drugs are they using to do this? he is also on oxygen during day and night. Not known cause of it. Had regual endoscopy nose done and nothing showed there blocking and requireing oxygen. Please help
What is the cost of something like this?
None of my doctors believe that I can't breathe too good, either.
Try to get a polysomnography (in lab sleep study). They're far more accurate than take home sleep studies.
Or get a drug induced sleep endoscopy. Which is harder to find and more expensive, but in my opinion, it's the most accurate assessment.
8:44 What does he say?
I believe he said "pharyngeal tissue blocking his airway".
My lateral pharyngeal walls were also a major cause of obstruction. I later had to get that removed and it was an additional tremendous improvement to my sleep.
@@austinkim7804 Did you have that lateral pharyngeal wall surgery after the MMA or before the MMA?
@@smileyjay2753 After
This is illegal. You cannot record a patient.
7:07 listen... Listen close! Omg.. did he just say he allowed them to record it? Well damn, I do believe so.😂😂😂 #Notillegal
@@DreamWander50 lol...
Yah I gave them permission to record it so they could use it as a case study to help other people. Without this video, I don't think we could have ever convinced insurance to cover my surgeries since my sleep studies kept testing negative.
@@austinkim7804 hi Austin! I’m having a DISE with dr zaghi on the 2nd. I’m a little nervous - do you remember the procedure at all? Was it uncomfortable?
@@coyotestarastrology oh just saw this. The DISE is very painless. You're under the whole time so you don't remember much. Unless your legs are kicking up cause that woke me up for a sec.
Well your issues are similar to what I was experiencing sometime back. In addition to the medical procedures, I found a simple relaxation process of Heartfulness institute to be quite effective. You may find the relaxation video at this link czcams.com/video/MYmSycW_Ayo/video.html
What medical procedures did you have???