Clinical differences in positional obstructive sleep apnea patients

Jorquera, Jorge; Labarca, Gonzalo; Dreyse, Jorge; Salas, Constanza

doi:10.1183/13993003.congress-2016.pa333

Cited by 2 publications

(8 citation statements)

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“…Hence, we believe our study may be of value in understanding the demographic, clinical and PSG profile of POSA in this population. In this study, POSA was noted in 61%, in line with previous reports [11][12][13][14] and was predominantly noted among males (62%) and in non-Indigenous Australians (92%). This translates to three in every five patients with OSA have POSA and thus may merit greater focus and interventions.…”

Section: Discussionsupporting

confidence: 92%

“…There exists evidence in the literature for differences in POSA prevalence among differing ethnicities, most notably a potential increased prevalence among patients of Asian ethnicity compared to Caucasian, which may be related to differences in the craniofacial structure. [11][12][13][14][15][16]29 Further evidence from direct correlation studies however is lacking.…”

Section: Discussionmentioning

confidence: 99%

“…44 Our study, in line with the majority of previous literature reporting on prevalence of POSA and the severity of OSA, found the prevalence of POSA was higher in patients with milder OSA and reduced with increasing severity of the OSA. [12][13][14]16,28,29,37,45 It is likely that as the disease severity progresses the positional variability of the obstructive events is lost, and events start being observed in all body positions. 46,47 This may also be the reason that POSA is more commonly observed in patients with lower BMI, as BMI generally correlates with OSA severity.…”

Section: Discussionmentioning

confidence: 99%

“…9,11 There are currently multiple clinical definitions of POSA; however, regardless of which definition is used, prevalence of POSA typically exceeds 50% among patients undergoing a PSG and diagnosed to have OSA. [12][13][14][15] It is also observed that in supine sleep, apneas and arousals are longer, desaturations are deeper, snoring is louder, and occurrence of tachy-bradycardia following an apnoeic episode are more severe compared to lateral sleep position. 16 Continuous positive airway pressure (CPAP) therapy is a well-established treatment modality for OSA and has been shown to improve quality of life in these patients.…”

Section: Introductionmentioning

confidence: 99%

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<p>Positional Sleep Apnea Among Regional and Remote Australian Population and Simulated Positional Treatment Effects</p>

Garg¹,

Er²,

Howarth³

et al. 2020

NSS

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Purpose: To assess the prevalence of positional sleep apnea (POSA) and its predictors in patients diagnosed to have obstructive sleep apnea (OSA) in the regional and remote population of the Northern Territory of Australia over a two-year study period (2018 and 2019). Patients and Methods: Of the total 1463 adult patients who underwent a diagnostic polysomnography (PSG), 946 patients were eligible to be included in the study, of them, 810 consecutive patients with OSA (Apnea-Hypopnea Index (AHI) ≥ 5) who slept >4 h and had ≥30 min sleep in both supine and lateral positions were assessed. Patients were considered to have POSA if supine AHI to lateral AHI ratio ≥2. The likely comparative impact of use of continuous positive airway therapy (CPAP) or positional therapy (PT) on disease severity was evaluated using model simulation. Results: A total of 495/810 (61%) patients had POSA, the majority were males (68% vs 60%, p=0.013) and non-Indigenous Australians (93% vs 87%, p=0.004). POSA patients were younger (mean difference 2.23 years (95% CI 0.27, 4.19)), less obese (BMI mean difference 3.06 (95% CI 2.11, 4.01)), demonstrated less severe OSA (p < 0.001) and a greater proportion reported alcohol consumption (72% vs 62%, p=0.001) as compared to those with non-POSA. Using the simulation model, if patients with POSA use PT two-thirds (323/495, 65%) would obtain significant improvement of their OSA severity, with one in five (92/495, 19%) displaying complete resolution. Comparing this to simulated CPAP therapy, where the majority (444/495, 90%) will show significant improvement, and onethird (162/495, 33%) will display complete resolution. Conclusion: POSA needs to be routinely recognised and positional therapy integrated in practice especially in the remote regions and in the developing world when effective methods are in place to monitor positional therapy.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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<p>Positional Sleep Apnea Among Regional and Remote Australian Population and Simulated Positional Treatment Effects</p>

Garg¹,

Er²,

Howarth³

et al. 2020

NSS

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“…The copyright holder for this preprint this version posted July 30, 2020. ; https://doi.org/10.1101/2020.07.28.20164053 doi: medRxiv preprint sion or other diseases among patients with pOSA can be attributed to the lower AHI of these patients compared with those without pOSA [23,24]. Similarly, patients with pOSA had slower heart rates, lower values for snoring and respiratory-related limb movement indexes, greater sleep efficiency, and higher mean oxygen saturation levels.…”

Section: Discussionmentioning

confidence: 99%

Demographic and clinical differences in patients with positional obstructive sleep apnea and development of a discrimination model

Lin

Tsai²,

Liu

2020

Preprint

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Purpose: Obstructive sleep apnea (OSA) is a highly prevalent disease, and positional OSA (pOSA) is a subgroup whose OSA severity is highly affected by sleeping position. This study investigated differences in demographic and sleep characteristics between patients with and without pOSA and developed a simple discrimination model. Methods: We reviewed polysomnography records of patients admitted to the Sleep Center at Shuang-Ho Hospital between March 2015 and March 2019. They were categorized into pOSA and non-pOSA groups, and their demographic and sleep characteristics were compared. The receiver operating characteristic (ROC) curve was used to estimate the feasibility of discrimination model. Results: Of the patients, 33% received diagnoses of pOSA; they had smaller neck circumference and waistline and lower weight, body mass index (BMI), OSA severity, heart rate, and snoring and respiratory-related limb movement indexes but higher sleep efficiency and mean oxygen saturation compared with patients without pOSA. Sleep stage analysis revealed that as severity increased, the proportion of sleep time spent in N2, N3, and rapid eye movement stages decreased, but the pro-portion of time spent in the N1 stage increased in both populations. Sleep position analysis revealed a higher proportion of sleep time in a supine position among patients with pOSA after adjustment for severity. The corresponding area under the ROC curve of our discrimination model was 0.924. Conclusions: Demographic and sleep characteristics differed significantly between patients with and without pOSA. Our model uses readily available measurements such as BMI and waistline and can aid physicians in the timely identification of patients with pOSA.

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Clinical differences in positional obstructive sleep apnea patients

Cited by 2 publications

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<p>Positional Sleep Apnea Among Regional and Remote Australian Population and Simulated Positional Treatment Effects</p>

<p>Positional Sleep Apnea Among Regional and Remote Australian Population and Simulated Positional Treatment Effects</p>

Demographic and clinical differences in patients with positional obstructive sleep apnea and development of a discrimination model

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