{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T08:19:53Z","timestamp":1781597993922,"version":"3.54.5"},"reference-count":27,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2024,2,14]],"date-time":"2024-02-14T00:00:00Z","timestamp":1707868800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"published-print":{"date-parts":[[2024,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>With the recent addition of airflow and respiratory effort channels, our group has observed central and mixed apnea events during drug\u2010induced sleep endoscopy (DISE). We measured the frequency and timing of sentinel central and\/or mixed events (SCents), as well as assessed for differences in velum, oropharynx, tongue, and epiglottis (VOTE) classification compared to obstructive events.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Prospective single\u2010cohort study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Tertiary Care Academic Medical Center.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients underwent DISE between June 2020 and November 2022. Nasal airflow, thoracoabdominal effort belt signals, and videoendoscopy were simultaneously captured. Demographics, sleep study, and DISE data were compared among patients with and without SCents using Student's <jats:italic>T<\/jats:italic> tests or <jats:italic>\u03c7<\/jats:italic><jats:sup>2<\/jats:sup> tests.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>On average, the cohort (n\u2009=\u2009103) was middle\u2010aged (53.5\u2009\u00b1\u200912.1 years), overweight (body mass index of 29.7\u2009\u00b1\u20095.3\u2009kg\/m<jats:sup>2<\/jats:sup>), and had severe obstructive sleep apnea (apnea\u2010hypopnea index of 30.7\u2009\u00b1\u200918.7\u2009events\/h). Forty\u2010seven patients (46%) were found to have at least 1 SCent. Among those with SCent, 45 (95.7%) transitioned to obstructive pathology after an average of 7.91\u2009\u00b1\u20092.74\u00a0minutes, with at least 95% of patients expected to do so within 12.57\u00a0minutes. Twenty\u2010nine out of 47 patients (61.2% [95% confidence interval: 46.4.9%, 75.5%]) with SCent had meaningful differences between central\/mixed and obstructive VOTE scores.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Central events were present in almost half of our cohort. At least 95% of patients were expected to transition to obstructive events within 12 to 13\u00a0minutes of propofol initiation. In addition, over half of patients demonstrate significantly different VOTE scores between central and obstructive events. These factors should raise awareness of central events and scoring passive apneas during DISE and consider delaying VOTE scoring.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ohn.679","type":"journal-article","created":{"date-parts":[[2024,2,14]],"date-time":"2024-02-14T07:39:28Z","timestamp":1707896368000},"page":"1467-1473","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["The Prevalence of Sentinel Central Events (SCent) During Drug\u2010Induced Sleep Endoscopy"],"prefix":"10.1002","volume":"170","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7391-5020","authenticated-orcid":false,"given":"Julianna G.","family":"Rodin","sequence":"first","affiliation":[{"name":"Department of Otorhinolaryngology University of Pennsylvania Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manan H.","family":"Parekh","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology University of Pennsylvania Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi","family":"Cai","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology University of Pennsylvania Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brendan T.","family":"Keenan","sequence":"additional","affiliation":[{"name":"Division of Sleep Medicine, Department of Medicine University of Pennsylvania Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric R.","family":"Thuler","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology University of Pennsylvania Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Everett","family":"Seay","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology University of Pennsylvania Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joshua H.","family":"Atkins","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Critical Care University of Pennsylvania Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alan R.","family":"Schwartz","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology University of Pennsylvania Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raj C.","family":"Dedhia","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology University of Pennsylvania Philadelphia Pennsylvania 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