Automatic scoring of drug-induced sleep endoscopy for obstructive sleep apnea using deep learning

Umaer Hanif, Eva Kirkegaard Kiaer, Robson Capasso, Stanley Y. Liu, Emmanuel J.M. Mignot, Helge B.D. Sorensen, Poul Jennum

Research output: Contribution to journalJournal articleResearchpeer-review

144 Downloads (Pure)


Background: Treatment of obstructive sleep apnea is crucial for long term health and reduced economic burden. For those considered for surgery, drug-induced sleep endoscopy (DISE) is a method to characterize location and pattern of sleep-related upper airway collapse. According to the VOTE classification system, four upper airway sites of collapse are characterized: velum (V),oropharynx (O), tongue (T), and epiglottis (E). The degree of obstruction per site is classified as 0(no obstruction), 1 (partial obstruction), or 2 (complete obstruction). Here we propose a deep learning approach for automatic scoring of VOTE obstruction degrees from DISE videos.
Methods: We included 281 DISE videos with varying durations (6 seconds – 16 minutes) from two sleep clinics: Copenhagen University Hospital and Stanford University Hospital. Examinations were split into 5-second clips, each receiving annotations of 0, 1, 2, or X (site not visible) for each site (V, O, T, and E), which was used to train a deep learning model. Predicted VOTE obstruction degrees per examination was obtained by taking the highest predicted degree per site across 5-second clips, which was evaluated against VOTE degrees annotated by surgeons.
Results: Mean F1 score of 70% was obtained across all DISE examinations (V: 85%, O: 72%, T:57%, E: 65%). For each site, sensitivity was highest for degree 2 and lowest for degree 0. No bias in performance was observed between videos from different clinicians/hospitals.
Conclusions: This study demonstrates that automating scoring of DISE examinations show high validity and feasibility in degree of upper airway collapse.
Original languageEnglish
JournalSleep Medicine
Pages (from-to)19-29
Publication statusPublished - 2023


  • Deep learning
  • Drug-induced sleep endoscopy
  • Obstructive sleep apnea
  • Vote classification


Dive into the research topics of 'Automatic scoring of drug-induced sleep endoscopy for obstructive sleep apnea using deep learning'. Together they form a unique fingerprint.

Cite this