Prognostic Factors for Improved Daytime Sleepiness after Uvulopalatal Flap for Obstructive Sleep Apnea

Kim, Young Hyo; Lim, Dong Wook; Bang, Kang Hyun; Hwang, Yoonseok; Jang, Tae Young

Abstract

BACKGROUND AND OBJECTIVES
We aimed to evaluate pre-operative factors for patients with obstructive sleep apnea (OSA) and determine the correlation these factors have with the improvement of daytime sleepiness based on the change of Epworth Sleepiness Scale (ESS) score before and after uvulopalatal flap (UPF).
SUBJECTS AND METHOD
Twenty-two patients with OSA who had received UPF surgery were enrolled in the study. We checked age, body mass index (BMI), size of tonsils, and position of palate. Using the Muller maneuver, we quantified the degree of obstruction at the velopharynx and the tongue base level. The cephalometric variables were checked by X-ray. Apnea-hypopnea index, respiratory distress index, and lowest oxygen saturation were obtained by portable monitoring. Finally, we obtained ESS score before and after UPF. The correlation between the aforementioned pre-operative factors and changes in ESS score was evaluated.
RESULTS
A significant correlation was observed between the change in ESS score and patients' age (R=0.168, p=0.031), BMI (R=0.642, p=0.004), and posterior airway space (PAS)(R=0.378, p=0.029). Patients who were older than 40 years old (p=0.030), obese patients with BMI> or =25.0 (p=0.001), and those who had reported severe daytime sleepiness before surgery (pre-operative ESS score >10, p<0.01) reported greater improvement of daytime sleepiness after UPF.
CONCLUSION
We propose age, BMI, and wider PAS as predictors for greater improvement of daytime sleepiness after UPF in patients with OSA.