• Jorge Iriarte, Jose-Alberto Palma, Secundino Fernandez, Elena Urrestarazu, Manuel Alegre, Julio Artieda, and Peter Baptista.
• Sleep Unit and Clinical Neurophysiology Section, Clinica Universidad de Navarra, Pamplona, Spain. jiriarte@unav.es
• Sleep Med. 2013 Feb 1; 14 (2): 217-9.

ObjectivesThis is a video case report of a 58-year-old male patient with severe obstructive sleep apnea (OSA) who underwent a pharyngo-laryngoscopy during non-drug-induced sleep.MethodsThe pharyngo-laryngoscopy was performed transnasally during a 30-minute nap, in the afternoon, with a flexible endoscope in supine position. During the procedure, the patient was monitored with polysomnography.ResultsThe patient slept for 20 minutes in supine position, reaching N2 sleep stage. During the sleep, 15 respiratory events (apneas or hypopneas) were recorded. The video-recording showed that, during apneas, the obstruction at the pharyngeal level was never complete, although the nasal sensor showed a total stop in the nasal airflow.ConclusionsThis case highlights that OSA could not be as obstructive as generally thought, at least during N2 sleep; moreover, it suggests that apneic episodes are not a totally passive and monomorphic phenomenon, but a rather complex event.Copyright © 2012 Elsevier B.V. All rights reserved.

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