The importance of sleep position in obstructive sleep apnea syndrome

Key Findings & Data:Significant increase in the Apnea- Hypopnea Index (AHI) in cases with Positional Obstructive Sleep Apnea Syndrome (OSAS) seen in the side-lying position and in those sleeping in the supine position with moderate total AHI index scores, induce striking decreases in oxygen saturation.

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Conclusion & Impact:Thus, development of OSAS related complications could be prevented in the earlier stages.

🔬Design:Research Article

📍Scope:Comprehensive Sample

⚙️Variables:Domain Parameters

Abstract

OBJECTIVE: Sleeping in the supine position has an important role in the severity and development of sleep apnea. Significant increase in the Apnea- Hypopnea Index (AHI) in cases with Positional Obstructive Sleep Apnea Syndrome (OSAS) seen in the side-lying position and in those sleeping in the supine position with moderate total AHI index scores, induce striking decreases in oxygen saturation. This condition is crucial in the emergence of OSAS-related complications secondary to hypoxemia. The objective of this study is to compare the incidence of comorbidities, and polysomnographic findings in cases diagnosed as positional OSAS, and those with different degrees of OSAS. MATERIAL AND METHODS: We performed a retrospective study. Patients whose supine AHI scores increased relative to their non- supine AHI scores leading to further deterioration of their OSAS (from mild to moderate-severe, and from moderate to severe degrees of OSAS) were included in the study. RESULTS: A total of 170 patients with positional OSAS, with a mean age of 49.4 years, were included. Patients were divided according to their AHI values as mild (AHI=5-15, n=37) and moderate-severe OSAS patients (AHI >15, n=133). There were no differences between the two groups as to concomitant conditions (hypertension, congestive heart failure, coronary artery disease, cerebrovascular disease), Epworth Sleepiness Score (ESS) and average oxygen saturation. CONCLUSION: Lack of differences in the rates of additional disorders between the two groups may indicate OSAS related complications that developed in patients with mild degree positional OSAS. Therefore, AHI should be evaluated in cases with OSAS sleeping in every lying position. Cases with positional OSAS should be evaluated as a different clinical entity and the treatment plan should be made ac- cordingly. Thus, development of OSAS related complications could be prevented in the earlier stages.

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Cite This Article

KÖSEOĞLU, H. İ., KÖKTÜRK, O., ULUKAVAK, T. Ç., ETİKAN, İ. (2014). The importance of sleep position in obstructive sleep apnea syndrome. Türk Toraks Dergisi, Cilt: 15 - Sayı: 1, 23–26. https://ajindex.com/articles/329465

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References (4)

Bixler EO, Vgontzas AN, Lin HM, et al. Prevalence of sleep dis- orders breathing in women: effects of gender. Am J Respir Crit Care Med 2001;163:608-13. [CrossRef] Schwab RJ, Kuna ST, Remmers JE. Anatomy and Physiology of Upper Airway Obstruction. In: Kryger MH, Roth T, Dement WC (eds). Principles and Practise of Sleep Medicine, 4rd edn. Phila- delphia, WB Saunders; 2005.p.983-1000. [CrossRef] Chuang LP, Chen NH, Li HY, et al. Dynamic upper airway changes during sleep in patients with obstructive sleep apnea syndrome. Acta Otolaryngol 2009;129:1474-9. [CrossRef] Köktürk O, Köktürk N. [Pathophysiology of obstructive sleep ap- nea syndrome]. Tüberküloz ve Toraks Dergisi 1998;46:288-300.
Oksenberg A, Silverberg SD, Arons E, Radwan H. Positional vs nonpositional obstructive sleep apnea patients: anthropomor- phic, nocturnal polysomnographic, and multiple sleep latency test data. Chest 1997;112:629-39. [CrossRef] Oksenberg A, Khamaysi I, Silverberg SD, Tarasiuk A. Associa- tion of body position with severity of apneic events in patients with severe nonpositional obstructive sleep apnea. Chest 2000;118:1018-24. [CrossRef] Sleep-related breathing disorders in adults: recommendations for syndrome definition and measurement techniques in clinical research. The Report of an American Academy of Sleep Medi- cine Task Force. Sleep 1999;22:667-89.
Rechtschaffen A, Kales A, eds. A Manual of Standardized Ter- minology Techniques and Scoring System for Sleep Stages of Human Subjects. Los Angeles: Brain Information Service/Brain Research Institute, University of California at Los Angeles, 1968. EEG arousals: scoring rules and examples: a preliminary report from the Sleep Disorders Atlas Task Force of the American Sleep Disorders Association. Sleep 1992;15:173-84. Iber C. The AASM Manual for the Scoring of Sleep and Associ- ated Events. Rules, Terminology and Technical Specifications. U.S.A. 2007.p.45-50.
Oksenberg A, Silverberg SD. The effect of body posture on sleep-related breathing disorders: facts and therapeutic implica- tions. review article. Sleep Medicine 1998;2:139-62. [CrossRef] Richard W, Kox D, Herder C, et al. The role of sleep position in obstructive sleep apnea syndrome. Eur Arch Otorhinolaryngol 2006;263:946-50. [CrossRef] Mador MJ, Kufel TJ, Magalang UJ, et al. Prevalence of positional sleep apnea in patients undergoing polysomnography. Chest 2005;128:2130-7. [CrossRef] Oksenberg A. Positional and non-positional obstructive sleep apnea patients. Sleep Med 2