Introduction:Obstructive sleep apnea (OSA) patients undergoing procedures under sedation may have increased tendency for respiratory failure and hypoxemia.
The aim of our study was to investigate if screening for OSA can be used to detect high risk patients for desaturations and apneas during the bronchoscopy and whether non-invasive mechanical ventilation (NIMV) could be used to improve oxygenation and reduce peri- and post- bronchoscopy complications.

Methods: This is a prospective, single-center study performed in our Institution. Patients undergoing bronchoscopy were recruited. Those with Stop Bang Score ?4 and/or Epworth Sleepiness scale (ESS) ?11 were categorized as high-risk patients for OSA and randomized to receive either NIMV or nasal cannula oxygenation during bronchoscopy. Low risk patients (Stop Bang Score <4 and/or ESS<11) received with nasal cannula oxygenation.

Results: A total of 56 patients (33 males), with a median age of 65.5 years old and a median BMI of 27 kg/m2 were included. Witnessed apneas, excessive dynamic airway collapse (EDAC) episodes and airway maneuvers during the bronchoscopy were significantly more in high-risk patients compared to low-risk patients (81.8% vs 41.1%, 72.2% vs 35.2%, 72.7% vs 26.4% p<0.05, respectively). NIMV use reduced witnessed apneas, desaturations and EDAC (18.1% vs 81.8%, 36.3% vs 81.8%, 9% vs 92.2% p<0.05 respectively).

Conclusions: Screening for sleep apnea, with these well-established questionnaires could be a helpful addition to the standard pre-bronchoscopy evaluation. Moreover, bronchoscopy under NIMV may be considered when high risk patients for OSA are identified in pre-bronchoscopy evaluation.