The BiPAP A40 (Philips Respironics, Murrysville, PA, USA) in PAP mode was used for titration. PAP titration was performed immediately after DISE with the patient in supine position. An overpressure ventilation mask (Respironics PerforMax Full-face mask, Philips Respironics, Murrysville, PA, USA) of appropriate size was applied to the patient’s face. A special connecting valve (Philips Respironics, Murrysville, PA, USA) was inserted between the mask and the device hose, through which a flexible endoscope was inserted into the nose and nasopharynx. The mask was subsequently fixed with straps.
Sleep endoscopy was then performed under overpressure ventilation. The start of the examination was at a pressure of 6 hPa. Gradually, the PAP was elevated (always after at least 30 s) in the range of 6, 8, 10, 12, 14, and 18 hPa. At each pressure tested, an evaluation was performed by two physicians independently. The efficiency of overpressure ventilation was assessed visually, and at the same time the values of blood oxygen saturation measured on a finger of the upper limb were monitored.
The Kezirian VOTE classification was used for evaluation at each PAP tested to observe the effect of increasing pressure on the obstruction of the monitored localities.
Sleep endoscopy was then performed under overpressure ventilation. The start of the examination was at a pressure of 6 hPa. Gradually, the PAP was elevated (always after at least 30 s) in the range of 6, 8, 10, 12, 14, and 18 hPa. At each pressure tested, an evaluation was performed by two physicians independently. The efficiency of overpressure ventilation was assessed visually, and at the same time the values of blood oxygen saturation measured on a finger of the upper limb were monitored.
The Kezirian VOTE classification was used for evaluation at each PAP tested to observe the effect of increasing pressure on the obstruction of the monitored localities.