The role of sleep position in obstructive sleep apnea syndrome

Richard, Wietske; Kox, Dennis; Herder, Cindy den; Laman, Martin; Tinteren, Harm van; Vries, Nico de

doi:10.1007/s00405-006-0090-2

Cited by 185 publications

(139 citation statements)

References 27 publications

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“…Yan yatış pozisyonu iki hasta grubunda da bir miktar rahatlama sağlayabilir ancak, gece uykuda sırt üstü yatışın engellendiği "pozisyonel tedavi'' AHİ yan yatış pozisyonunda da yüksek kalanlarda etkili olamaz; bizim çalışmamızda PH grubunun sadece %31'inde, tüm grubun ise %15'inde AHİ yan yatış pozisyonunda normal bulundu. Dolayısıyla pozisyonel tedavinin pozisyonel OUAS'li hastalarımızın tümünde etkin bir tedavi yöntemi olamayacağı düşünüldü; bir seride 5 PH grubunda %89 oranında yan yatış pozisyonunda AHİ'nin 20'nin altına indiği, bir başka çalışmada ise 29 hastaların %75'inde AHİ'nin 10'un altına indiği, bu nedenle pozisyonel hastalarda kullanılabilir bir tedavi olduğu bildirilmiştir.…”

Section: Discussionunclassified

“…Pozisyonel hastalarda üst hava yolundaki anatomik deği-şikliklerin incelendiği iki çalışmadan 5,11 birinde PH grubunda anlamlı olarak posterior hava yolu bölgesinin daha geniş olduğu ve yumuşak damakta uzamanın daha az olduğu tespit edilmiştir. 11 Diğer bir çalışmada Müller manevrası ile kapanmanın görüldüğü farenks bölgelerinin iki grup arasında farklılık göstermediği belirlenmiştir.…”

Section: Discussionunclassified

“…2,3 Pek çok çalışmada, yan yatış pozisyonunda solunumsal olayların belirgin bir biçimde düzeldiği bildirilmektedir. [3][4][5] Ancak bu durumun anatomik ve fizyolojik olarak altta yatan sebepleri tam olarak bilinmemektedir.…”

Section: Introductionunclassified

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Clinical and Polysomnographic Properties of Patients with Positional Obstructive Sleep Apnea Syndrome

Yosunkaya¹,

Öztürk²

2012

Solunum

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ÖZETAmaç: Obstrüktif uyku apne sendromlu (OUAS) hastalardan, sırt üstü yatış pozisyonunda, yan yatış pozisyonuna göre, apne hipopne indeksi (AHİ) en az iki kat artan veya yan yatış pozisyonunda normalleşen (AHİ<5) hastalar yani "pozisyonel hasta"lar ile sırt üstü yatış pozisyonlarında AHİ'de iki kattan daha az bir artış olan "pozisyonel olmayan" OUAS'li hastaların klinik bulgularının, fizik muayene bulgularının ve polisomnografik özelliklerinin karşılaştırılması. Sonuç: Bu çalışmayla, iki yıllık bir süreyi kapsayan hasta kayıtları-mızdan pozisyonel OUAS tanısı alanların temel özelliklerini, hastalığın pozisyonel olup olmamasına göre gruplandırarak belgelemiş olduk. Pozisyonel hastaların bazı klinik, fizik muayene ve polisomnografik bulgularında POH'ye göre farklılıklar tespit edildi. Anah tar kelimeler:Uyku apnesi, apne, tıkayıcı uyku apne sendromu ABST RACTAim: "Positional patients" (PP) were patients with obstructive sleep apnea (OSA) whose apnea hypopnea index (AHI) becomes at least twice as high in the supine position as in the lateral position and an AHI that normalizes (AHI<5) in the non-supine position. Non-positional patients (NPP) were characterised by an AHI in the supine position less than twice as high as in the lateral position. In this study we aimed to compare clinical, polysomnographic and physical characteristics of patients with non-positional and positional sleep apnea. Materials and Methods:Medical records of 500 patients diagnosed with OSA syndrome (OSAS) by polysomnography (PSG) in our clinic, between 2006-2008, were retrospectively reviewed, and 230 of these were included in the study. Patients were separated into two groups according to polisomnographic results as PP and NPP. The clinical, polysomnographic and physical characteristics of the two groups were compared.Results: 112 of the 230 patients (48.6%) were classified as PP. These were younger, with lower body mass index and neck circumflex and a milder OSAS as compared to the NPP. AHI in 31% of the PP fell below 5 in the lateral recumbent position. Excessive daytime sleepiness (EDS), as assessed by the Epworth Sleepiness Scale, was lighter in the PP group. Also, frequency of complaint from year-long nasal blockage and frequency of finding turbinate hypertrophy were more common in the PP as compared to the NPP. Conclusion:In this study, basic features of patients diagnosed as positional OSAS over a two-year period were documented by grouping as PP and NPP. Some differences were identified at the physical examination, clinical and polysomnographic features of the positional and non-positional cases.Keywords: Sleep apnea, apnea, obstructive sleep apnea syndrome Solunum Dergisi'ne www.solunum.org.tr adresinden ulaşabilirsiniz.

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Section: Discussionunclassified

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Clinical and Polysomnographic Properties of Patients with Positional Obstructive Sleep Apnea Syndrome

Yosunkaya¹,

Öztürk²

2012

Solunum

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“…[39,40] Many other surgical and non-surgical approaches are being explored as stand-alone therapy, or in combination. [41,42] Therefore, a gradual shift can be expected to take place to alternatives to nCPAP, being a combination of surgery, lifestyle alterations and if possible positional therapy, [43,44] in well- selected, well-informed patients, while nCPAP therapy in those patients will still be in reserve in case of failure.…”

Section: Discussionmentioning

confidence: 99%

Acceptance and long-term compliance of nCPAP in obstructive sleep apnea

Richard

Venker

Herder

et al. 2007

Eur Arch Otorhinolaryngol

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“…10 Positional OSA, traditionally defi ned as supine AHI ≥ twice that of non-supine postures, has a prevalence of 50% to 60%. 7,11,12 According to a more recent and stringent defi nition requiring a supine AHI ≥ twice that of non-supine AHI and normalization of AHI in non-supine postures, 13 positional OSA patients who meet these criteria should remain within normal limits by using effective positional therapy alone to simply avoid supine sleep. Approxi-…”

Section: S C I E N T I F I C I N V E S T I G a T I O N Smentioning

confidence: 99%

Accurate Position Monitoring and Improved Supine-Dependent Obstructive Sleep Apnea with a New Position Recording and Supine Avoidance Device

Bignold

Mercer

Antic³

et al. 2011

Journal of Clinical Sleep Medicine

124

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Study Objectives: Approximately 30% of obstructive sleep apnea (OSA) patients have supine-predominant OSA, and simply avoiding supine sleep should normalise respiratory disturbance event rates. However, traditional supineavoidance therapies are inherently uncomfortable, and treatment adherence is poor and diffi cult to monitor objectively. This study evaluated the effi cacy of a novel, potentially more acceptable position monitor and supine-avoidance device for managing supine-predominant OSA and snoring. Design and Setting: In-laboratory evaluation of position recording accuracy versus video recordings (validation study), and randomized controlled crossover trial of active versus inactive supine-avoidance therapy in the home setting (effi cacy study). Patients: 17 patients undergoing in-laboratory sleep studies (validation) and 15 patients with supine-predominant OSA (effi cacy). Interventions: Effi cacy study: 1 week of inactive and 1 week of active treatment in randomized order, separated by 1 week. Measurements and Results: Agreement between 30-sec epoch-based posture classifi cations from device versus video records was high (median κ 0.95, interquartile range: 0.88-1.00), and there was good supine time agreement (bias 0.3%, 95%CI: −4.0% to 4.6%). In the effi cacy study, apnea-hypopnea index (AHI) and snoring frequency were measured in-home using a nasal pressure and microphone based system during inactive and active treatment weeks. The position monitoring and supine alarm device markedly inhibited supine time (mean ± SEM 19.3% ± 4.3% to 0.4% ± 0.3%, p < 0.001) and reduced AHI (25.0 ± 1.7 to 13.7 ± 1.1 events/h, p = 0.030) but not snoring frequency.

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The role of sleep position in obstructive sleep apnea syndrome

Cited by 185 publications

References 27 publications

Clinical and Polysomnographic Properties of Patients with Positional Obstructive Sleep Apnea Syndrome

Clinical and Polysomnographic Properties of Patients with Positional Obstructive Sleep Apnea Syndrome

Acceptance and long-term compliance of nCPAP in obstructive sleep apnea

Accurate Position Monitoring and Improved Supine-Dependent Obstructive Sleep Apnea with a New Position Recording and Supine Avoidance Device

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