• Fábio A W Rabelo, Adriano Braga, Daniel S Küpper, José A A De Oliveira, Fernando M Lopes, Pedro Luiz Vaz de Lima Mattos, Shirley G Barreto, Heidi H Sander, Regina M F Fernandes, and Fabiana C P Valera.
• Discipline of Otorhinolaryngology, University of São Paulo, São Paulo, Brazil. fawrabelo@hotmail.com
• Otolaryngol Head Neck Surg. 2010 Feb 1;142(2):218-24.

ObjectiveThe localization of upper airway obstruction in patients with obstructive sleep apnea (OSA) may optimize treatment. Nasoendoscopy during propofol sedation allows such an evaluation, but the effect of this drug on respiratory patterns and muscle relaxation is unknown. The objective of the present study was to determine through polysomnography whether propofol would change sleep parameters.Study DesignProspective study of subjects submitted to polysomnography under sedation with propofol.SettingTertiary referral center.Subjects And MethodsFifteen non-obese subjects (4 controls/11 OSA patients) were submitted to two diurnal polysomnograms (90-120 minutes of sleep), with and without the use of propofol. The parameters presence of snoring, apnea-hypopnea index (AHI), oxygen desaturation, and sleep architecture were compared.ResultsThe use of propofol did not induce snoring in the control subjects, whereas 100 percent of the OSA patients snored. AHI and mean oxygen saturation (SaO(2)) did not differ significantly between examinations with and without sedation. However, minimum SaO(2) differed significantly (P < 0.05) with sedation, being lower during propofol sedation. Propofol also significantly changed the sleep architecture, with a significant increase in N3 sleep (P < 0.005) and total abolishment of rapid eye movement sleep (P < 0.0005) during propofol sedation.ConclusionsThese preliminary results allow us to infer that sedation with propofol changes sleep architecture but permits respiratory evaluation, because the main respiratory parameters evaluated in OSA are maintained. These preliminary results support the view that nasoendoscopy under propofol sedation is a promising examination for management of this disease.Copyright 2010 American Academy of Otolaryngology-Head and Neck Surgery Foundation. Published by Mosby, Inc. All rights reserved.

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