Examining the impact of multilevel upper airway surgery on the obstructive sleep apnoea endotypes and their utility in predicting surgical outcomes

Upper airway surgery for obstructive sleep apnoea (OSA) is an alternative treatment for patients intolerant of continuous positive airway pressure (CPAP). While we now know that several endotypes are contributing to OSA (i.e., upper airway collapsibility, airway muscle response/compensation, respiratory arousal threshold and loop gain), no study to date has examined: (i) how upper airway surgery affects all four OSA endotypes, (ii) whether knowledge of baseline OSA endotypes predicts response to surgery and (iii) whether there are any differences when OSA endotypes are measured using the CPAP dial‐down or clinical polysomnographic (PSG) methods. Surgery unpredictably alters upper airway collapsibility but does not alter the non‐anatomical endotypes. In addition, there are no baseline predictors of response to surgery.