European position paper on drug-induced sedation endoscopy (DISE)

Andrea De Vito, Marina Carrasco Llatas, Agnoletti Vanni, Marcello Bosi, Alberto Braghiroli, Aldo Campanini, Nico de Vries, Evert Hamans, Winfried Hohenhorst, Bhik T. Kotecha, Joachim Maurer, Filippo Montevecchi, Ottavio Piccin, Giovanni Sorrenti, Olivier M. Vanderveken, Claudio Vicini

Research output: Contribution to journalArticlepeer-review


Methods: The authors have evaluated all the available evidence reported in the literature and have compared experience among various departments in leading European centers in order to provide a standardization of the DISE procedure and an in-depth insight in the main aspects of this technique.

Background: Although drug-induced sedation endoscopy (DISE) represents the most widespread diagnostic tool for upper airway endoscopic evaluation of snoring and obstructive sleep apnea hypopnea syndrome (OSAHS), many controversies exist about how to perform the sedation, the indications for DISE, and how to report DISE findings. The present position paper reports on a consensus as proposed by a group of European experts in the field of DISE after discussion during a recent dedicated meeting.

Results: A proposal of the DISE procedure standardization has been achieved with a general agreement concerning the terminology, indications, contraindications, required preliminary examinations, setting, technical equipment required, staffing, local anesthesia and nasal decongestion, patient positioning, basis and special diagnostic maneuvers, and the applied sedation drugs and observation windows. Otherwise, no consensus has been reached on a scoring and classification system.

Conclusions: Although consensus has been reached on several aspects of the DISE procedure, some topics remain open to future research, such as a better analysis of the importance of positional aspects during DISE and a further comparison of the differences in degree, level and pattern of upper airway collapse observed during DISE versus during natural sleep and awake endoscopy. Finally, a universally accepted scoring and classification system is lacking.

Original languageEnglish
Pages (from-to)453-465
Number of pages13
JournalSleep and Breathing
Issue number3
Publication statusPublished - 2014


  • Obstructive sleep apnea hypopnea syndrome
  • Prediction
  • Sleep endoscopy
  • Sleep-disordered breathing
  • Therapy
  • Upper airway collapse

ASJC Scopus subject areas

  • Otorhinolaryngology
  • Clinical Neurology
  • Medicine(all)


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