Positional device therapy for the treatment of positional obstructive sleep apnea in children: a pilot study

Xiao, Lena; Baker, Adele; Voutsas, Giorge; Massicotte, Colin; Wolter, Nikolaus E.; Propst, Evan J.; Narang, Indra

doi:10.1016/j.sleep.2021.07.036

Cited by 11 publications

(5 citation statements)

References 19 publications

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“…The median body mass index z-score was 1.6. Compared to the baseline data, PSG results obtained while using a positional device showed reductions in the median oAHI (15.2 vs. 6.7 events/h, respectively; p = 0.004) and in the percentage of total sleep time in supine position (54.4 vs. 4.2 h, respectively; p = 0.04) [86]. More studies are needed but, considering the cost effectiveness and non-invasive nature of this treatment, positional therapy may be a viable option for children with POSA.…”

Section: Positional Therapymentioning

confidence: 75%

Medical Treatment of Obstructive Sleep Apnea in Children

Ergenekon,

Gokdemir,

Ersu

2023

JCM

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Obstructive sleep apnea (OSA) is characterized by recurrent complete or partial obstruction of the upper airway. The prevalence is 1–4% in children aged between 2 and 8 years and rising due to the increase in obesity rates in children. Although persistent OSA following adenotonsillectomy is usually associated with obesity and underlying complex disorders, it can also affect otherwise healthy children. Medical treatment strategies are frequently required when adenotonsillectomy is not indicated in children with OSA or if OSA is persistent following adenotonsillectomy. Positive airway pressure treatment is a very effective modality for persistent OSA in childhood; however, adherence rates are low. The aim of this review article is to summarize medical treatment options for OSA in children.

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Section: Positional Therapymentioning

confidence: 75%

Medical Treatment of Obstructive Sleep Apnea in Children

Ergenekon,

Gokdemir,

Ersu

2023

JCM

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“…PT has evolved over time with the development of efficient and comfortable devices which can monitor sleep position changes as well as compliance. 6 In this case, our patient showed excellent response to PT, along with an intranasal steroid and a leukotriene inhibitor with reduction in AHI and resolution of hypoventilation. Spontaneous resolution of OSA would have unlikely to have played a role considering her age and underlying diagnosis, though it has been described in older children (CHAT study).…”

Section: Discussionmentioning

confidence: 55%

“…Positional therapy (PT) is a reasonable approach to certain patients who demonstrate differences in AHI, oxygenation and ventilation depending on position. In fact, Xiao et al in their novel pilot study showed reduction in Obstructive AHI and oxygen desaturation in non-supine position compared to supine position using positional device therapy 6 . It is reasonable to trial patients not fully controlled on CPAP and/or with adenotonsillectomy on PT and monitor for improvements in symptoms or PSG.…”

Section: Discussionmentioning

confidence: 99%

Positional Therapy in a Child with Down Syndrome and Obstructive Sleep Apnea: A Case Report

Rao

Hadley

2023

Preprint

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Obstructive sleep apnea (OSA) is very common in children with Down Syndrome. We report an 11-month-old female infant with Down syndrome who presented with OSA and Hypoventilation. As surgery was not indicated she was referred for institution of CPAP. As her family had concerns about CPAP, she was started on medications (nasal steroids and leukotriene antagonists) and advised Positional Therapy. Repeat sleep study in lateral position performed 7 months later showed resolution of hypoventilation and significant reduction in AHI.

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“…Positional therapy for children with OSA involves the use of a chest-worn belt with cushions located on the back to prevent the child from adopting the supine position during sleep. In a pilot study [27], positional therapy using the chest-worn belt significantly reduced a median AHI (15.…”

Section: Positional Trainingmentioning

confidence: 99%

Positional Therapy for Obstructive Sleep Apnea: Therapeutic Modalities and Clinical Effects

Lee,

Choi

2023

Sleep Med Res

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Obstructive sleep apnea (OSA) is characterized by recurrent occurrences of partial or complete collapse of the upper airway during sleep, leading to shallow breathing or breathing pauses. These repeated breathing disruptions can result in intermittent hypoxia, hypercapnia, hyperactivity of the sympathetic nervous system, and fragmented sleep patterns. Left untreated, OSA can have significant health implications, including various symptoms and serious consequences. Positional OSA is a subtype of OSA where during sleep, the severity of apnea events is significantly higher in the supine position. This condition can worsen respiratory parameters, such as apnea/hypopnea events, oxygen desaturation and arousals, and cardiovascular burdens. Positional therapy is a treatment approach used for patients with positional OSA. Typically, positional therapy involves encouraging the patient to avoid sleeping on their back, and instead sleep in a lateral position. Various modalities for positional therapy exist, including positional training using a tennis ball, alarm, or vest, and sleep positioning pillows. Novel electric-operated postural devices have also been developed. Positional therapy has shown promise in improving apneic events and lowest oxygen saturation in patients with position-dependent sleep apnea. In comparison to positive airway pressure treatment, positional therapy has been reported to demonstrate non-inferior effects, while achieving better compliance. Consequently, positional therapy can be a cost-effective and non-invasive therapeutic alternative for managing positional OSA.

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Positional device therapy for the treatment of positional obstructive sleep apnea in children: a pilot study

Cited by 11 publications

References 19 publications

Medical Treatment of Obstructive Sleep Apnea in Children

Medical Treatment of Obstructive Sleep Apnea in Children

Positional Therapy in a Child with Down Syndrome and Obstructive Sleep Apnea: A Case Report

Positional Therapy for Obstructive Sleep Apnea: Therapeutic Modalities and Clinical Effects

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