Are We Missing Obstructive Sleep Apnea in Patients With Non-traumatic Subglottic Stenosis?

Objective: To investigate the association between subglottic stenosis (SGS) and obstructive sleep apnea (OSA).

Methods: This is a cross-sectional pilot cohort study conducted at a single tertiary academic center from 2022 to 2023. Subjects with non-traumatic SGS were recruited for enrollment. All subjects completed a peak expiratory flow (PEF) measurement, validated sleep questionnaires: Epworth Sleepiness Scale (ESS) and Pittsburgh Sleep Quality Index (PSQI), and a 1-night home sleep test (HST). Demographic data were summarized. Prevalence was calculated and descriptively compared to a matched population. Partial correlation analysis evaluated the relationship of PEF% and Meyer-Cotton grading, in addition to PEF% and apnea-hypopnea index (AHI). Sleep quality was compared in subjects with and without OSA via a Mann-Whitney U test.

Results: Twenty subjects participated; all were Caucasian females with a mean age of 48.4 (10.4) years and a body mass index (BMI) of 24.1 (3.8). The majority (80%) had idiopathic SGS, and a mean PEF 288 (71) L/min. OSA was present in 40% of subjects, of which 15% had moderate OSA. PEF% did not correlate to AHI (P > .05). Poor sleep quality (PSQI ≥ 5) was present in 70% of subjects and 20% had excessive daytime sleepiness (ESS > 9). PSQI and ESS did not differ between subjects with and without OSA (P > .05).

Conclusion: OSA prevalence is elevated in a cohort of subjects with SGS. Further study of airway dilation's impact on OSA is necessary. Screening and surveillance for OSA in patients with subglottic stenosis may need to be considered based on this study's findings.Level of Evidence: Level 3.