Effect of Prone Position on Apnea Severity in Obstructive Sleep Apnea.

Abstract

We describe a patient with obstructive sleep apnea (OSA) whose apnea-hypopnea index (AHI) improved remarkably in the prone position accompanied by an improved sleep quality, despite a higher AHI in the supine position and even in the lateral position. Magnetic resonance imaging revealed the most dilated upper airway in the prone position, which suggests the role of anatomical narrowing of the upper airway as an important component in the pathophysiology of positional apnea patients. Further studies are needed to determine the therapeutic efficacy ofa prone sleeping position in patients with OSA.

Lower intracuff pressure of laryngeal mask airway in the lateral and prone positions compared with that in the supine position

“…When the LMA is ideally positioned in the pharynx, the LMA cuff faces the upper esophageal sphincter, the pyriform fossae, the base of the tongue, the posterior pharyngeal wall, and the aryepiglottic folds [17]. Forces from these tissues would vary among body positions due to the differing gravitational vectors [7,9]. Particularly in the lateral and prone positions, the tongue falling over the proximal cuff would be displaced in the direction of gravity [6,7] and would press the cuff to a lesser extent, thereby lowering the ICP.…”

“…Because the upper airway is dilated in the lateral and prone positions, probably due to gravitational changes in the geometry of pharyngeal tissues surrounding the LMA cuff [6][7][8][9], these positions may infl uence the intracuff pressure (ICP). To date, however, variations of the ICP in different body positions remain unknown.…”

The effects of body positioning on sucking behaviour in sick neonates

“…It has been noted that recruitment of the genioglossus, an upper airway dilating muscle, is reduced in preterm infants [7]. In adults, although snoring, sleep hypopnoea and sleep apnoea are more common when lying supine than lying in the lateral recumbent position [2] or in the prone position [15]. Yildirim et al [23] suspected that postural changes in upper airway dimensions would result from posterior movement of the soft palate and uvula in the supine posture because of gravity.…”

Sustained logging and discrimination of sleep postures with low-level, wrist-worn sensors

“…From several studies involving patients with sleeping disorders [11,2,13,14,17,8], a set of basic sleeping posture categories was extracted for a next experiment. These categories are commonly applied in the detection of obstructive sleep apnea, but are also mentioned in general sleep studies as an important parameter.…”

“…Central to this work are sleep postures, which are known to be an important parameter commonly applied in the detection of obstructive sleep apnea, but also utilized in general sleep studies [11,2,13,14,17,8]. The time segment when the user is in bed, sleeping postures, and amount of motion during sleep are proposed as such cues for detection of sleep and sleep characteristics.…”