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Published in: European Archives of Oto-Rhino-Laryngology 10/2006

01-10-2006 | Miscellaneous

The role of sleep position in obstructive sleep apnea syndrome

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

Published in: European Archives of Oto-Rhino-Laryngology | Issue 10/2006

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Abstract

We analyzed the role of sleep position in obstructive sleep apnea syndrome (OSAS). The polysomnograms of 120 patients with sleep apnea syndrome were analyzed. We associated the apnea hypopnea index (AHI) of the supine position with the AHI of the other positions. Patients were stratified in a group of positional patients (PP) (AHI supine ≥ 2 × AHI other positions) and a group of non-positional patients (NPP). In 55.8% of our patients, OSAS was position dependent. PP patients were significantly (6.7 years) younger. BMI and AHI were higher in the NPP group, but the difference was not significant. Level of obstruction in the upper airway (retropalatinal vs retrolingual vs both levels) as assessed by sleep endoscopy was not significantly different between the two groups. Total sleep time (TST) was equal in both groups, but the average time in supine position was 37 min longer in the PP group. This study confirms the finding that in more than 50% of patients, OSAS is position dependent. Apart from age, no patient characteristics were found indicating the position dependency. Overall AHI does not identify positional OSAS.
Literature
1.
2.
go back to reference Young T, Palta M, Dempsey J, Skatrud J, Badr S (1993) The occurrence of sleep-disordered breathing among middle-aged adults. N Engl J Med 328(17):1230–1235PubMedCrossRef Young T, Palta M, Dempsey J, Skatrud J, Badr S (1993) The occurrence of sleep-disordered breathing among middle-aged adults. N Engl J Med 328(17):1230–1235PubMedCrossRef
3.
go back to reference Young T, Evans L, Finn L, Palta M (1997) Estimation of the clinically diagnosed proportion of sleep apnea syndrome in middle-aged men and women. Sleep 20(9):705–706PubMed Young T, Evans L, Finn L, Palta M (1997) Estimation of the clinically diagnosed proportion of sleep apnea syndrome in middle-aged men and women. Sleep 20(9):705–706PubMed
4.
go back to reference Shamsuzzaman ASM, Gersh BJ, Somers VK (2003) Obstructive sleep apnea, implications for cardiac and vascular disease. JAMA 290(14):1906–1914PubMedCrossRef Shamsuzzaman ASM, Gersh BJ, Somers VK (2003) Obstructive sleep apnea, implications for cardiac and vascular disease. JAMA 290(14):1906–1914PubMedCrossRef
5.
6.
go back to reference Shahar E, Whitney CW, Redline S, Lee ET, Newman AB, Javier Nieto F, O’Connor GT, Boland LL, Schwartz JE, Samet JM (2001) Sleep-disordered breathing and cardiovascular disease: cross-sectional results of the sleep heart health study. Am J Respir Crit Care Med 163:19–25PubMed Shahar E, Whitney CW, Redline S, Lee ET, Newman AB, Javier Nieto F, O’Connor GT, Boland LL, Schwartz JE, Samet JM (2001) Sleep-disordered breathing and cardiovascular disease: cross-sectional results of the sleep heart health study. Am J Respir Crit Care Med 163:19–25PubMed
7.
go back to reference Marin JM, Carrizo SJ, Vicente E, Agusti AG (2005) Long-term cardiovascular outcomes in men with obstructive sleep apnoea–hypopnoea with or without treatment with continuous positive airway pressure: an observational study. Lancet 365(9464):1046–1053PubMed Marin JM, Carrizo SJ, Vicente E, Agusti AG (2005) Long-term cardiovascular outcomes in men with obstructive sleep apnoea–hypopnoea with or without treatment with continuous positive airway pressure: an observational study. Lancet 365(9464):1046–1053PubMed
8.
go back to reference Dyken ME, Somers VK, Yamada T, Ren ZY, Zimmerman MB (1996) Investigating the relationship between stroke and obstructive sleep apnea. Stroke 27:401–407PubMed Dyken ME, Somers VK, Yamada T, Ren ZY, Zimmerman MB (1996) Investigating the relationship between stroke and obstructive sleep apnea. Stroke 27:401–407PubMed
9.
go back to reference Peppard PE, Young T, Palta M, Skatrud J (2000) Prospective study of the association between sleep-disordered breathing and hypertension. N Engl J Med 342:1378–1384PubMedCrossRef Peppard PE, Young T, Palta M, Skatrud J (2000) Prospective study of the association between sleep-disordered breathing and hypertension. N Engl J Med 342:1378–1384PubMedCrossRef
10.
go back to reference George CF, Smiley A (1999) Sleep apnea and automobile crashes. Sleep 22:790–795PubMed George CF, Smiley A (1999) Sleep apnea and automobile crashes. Sleep 22:790–795PubMed
11.
go back to reference Schmidt-Nowara W, Lowe A, Wiegand L, Cartwright R, Perez-Guerra F, Menn S (1995) Oral appliances for the treatment of snoring and obstructive sleep apnea: a review. Sleep 18(6):501–510PubMed Schmidt-Nowara W, Lowe A, Wiegand L, Cartwright R, Perez-Guerra F, Menn S (1995) Oral appliances for the treatment of snoring and obstructive sleep apnea: a review. Sleep 18(6):501–510PubMed
12.
go back to reference Jenkinson C, Davies RJ, Mullins R, Stradling JR (1999) Comparison of therapeutic and subtherapeutic nasal continuous positive airway pressure for obstructive sleep apnoea: a randomised prospective parallel trial. Lancet 353(9170):2100–2105PubMedCrossRef Jenkinson C, Davies RJ, Mullins R, Stradling JR (1999) Comparison of therapeutic and subtherapeutic nasal continuous positive airway pressure for obstructive sleep apnoea: a randomised prospective parallel trial. Lancet 353(9170):2100–2105PubMedCrossRef
13.
go back to reference Grunstein RR (1995) Nasal continuous positive airway pressure treatment for obstructive sleep apnoea. Thorax 50:1106–1113PubMedCrossRef Grunstein RR (1995) Nasal continuous positive airway pressure treatment for obstructive sleep apnoea. Thorax 50:1106–1113PubMedCrossRef
14.
go back to reference Indications and standards for use of nasal continuous positive airway pressure (CPAP) in sleep apnea syndromes: statement of the american thoracic society. (1994) Am J Crit Care Med 150:1738–1745 Indications and standards for use of nasal continuous positive airway pressure (CPAP) in sleep apnea syndromes: statement of the american thoracic society. (1994) Am J Crit Care Med 150:1738–1745
15.
go back to reference Cartwright RD (1984) Effect of sleep position on sleep apnea severity. Sleep 7:110–114PubMed Cartwright RD (1984) Effect of sleep position on sleep apnea severity. Sleep 7:110–114PubMed
16.
go back to reference George CF, Millar TW, Kryger MH (1988) Sleep apnea and body position during sleep. Sleep 11(1):90–99PubMed George CF, Millar TW, Kryger MH (1988) Sleep apnea and body position during sleep. Sleep 11(1):90–99PubMed
17.
go back to reference Cartwright RD, Diaz F, Lloyd S (1991) The effect of sleep posture and sleep stage on apnea frequency. Sleep 14(4):351–353PubMed Cartwright RD, Diaz F, Lloyd S (1991) The effect of sleep posture and sleep stage on apnea frequency. Sleep 14(4):351–353PubMed
18.
go back to reference Oksenberg A, Silverberg DS, Arons E, Radwan H (1997) Positional versus non-positional obstructive sleep apnea patients. Chest 112:629–639PubMedCrossRef Oksenberg A, Silverberg DS, Arons E, Radwan H (1997) Positional versus non-positional obstructive sleep apnea patients. Chest 112:629–639PubMedCrossRef
19.
go back to reference Oksenberg A, Khamaysi I, Silverberg DS, Tarasiuk A (2000) Association of body position with severity of apneic events in patients with severe non-positional obstructive sleep apnea. Chest 118:1018–1024PubMedCrossRef Oksenberg A, Khamaysi I, Silverberg DS, Tarasiuk A (2000) Association of body position with severity of apneic events in patients with severe non-positional obstructive sleep apnea. Chest 118:1018–1024PubMedCrossRef
20.
go back to reference Itasaka Y, Miyazaki S, Ishikawa K, Togawa K (2000) The influence of sleep position and obesity on sleep apnea. Psychiatry Clin Neurosci 54(3):340–341PubMedCrossRef Itasaka Y, Miyazaki S, Ishikawa K, Togawa K (2000) The influence of sleep position and obesity on sleep apnea. Psychiatry Clin Neurosci 54(3):340–341PubMedCrossRef
21.
go back to reference Akita Y, Kawakatsu K, Hattori C, Hattori H, Suzuki K, Nishimura T (2003) Posture of patients with sleep apnea during sleep. Acta Otolaryngol 550:41–45CrossRef Akita Y, Kawakatsu K, Hattori C, Hattori H, Suzuki K, Nishimura T (2003) Posture of patients with sleep apnea during sleep. Acta Otolaryngol 550:41–45CrossRef
22.
go back to reference Maurer JT, Stuck BA, Hein G, Verse T, Hörmann K (2003) Schlafapnoetherapie mit einer neuartigen rückenlage-verhinderungs-weste. Dtsch Med Wochenschr 128:71–75PubMedCrossRef Maurer JT, Stuck BA, Hein G, Verse T, Hörmann K (2003) Schlafapnoetherapie mit einer neuartigen rückenlage-verhinderungs-weste. Dtsch Med Wochenschr 128:71–75PubMedCrossRef
23.
go back to reference Hessel NS, de Vries N (2002) Diagnostic work-up of socially unacceptable snoring II Sleependoscopy. Eur Arch Otorhinolaryngol 259:158–161PubMedCrossRef Hessel NS, de Vries N (2002) Diagnostic work-up of socially unacceptable snoring II Sleependoscopy. Eur Arch Otorhinolaryngol 259:158–161PubMedCrossRef
24.
go back to reference Den Herder C, van Tinteren H, de Vries N (2005) Sleep endoscopy versus modified Mallampati score in sleep apnea and snoring. Laryngoscope 115(4):735–739 Den Herder C, van Tinteren H, de Vries N (2005) Sleep endoscopy versus modified Mallampati score in sleep apnea and snoring. Laryngoscope 115(4):735–739
25.
go back to reference Sleep-related breathing disorders in adults: recommendations for syndrome definition and measurement techniques in clinical research (1999) The report of an American academy of sleep medicine task force. Sleep 22(5):667–689 Sleep-related breathing disorders in adults: recommendations for syndrome definition and measurement techniques in clinical research (1999) The report of an American academy of sleep medicine task force. Sleep 22(5):667–689
26.
go back to reference Johns MW (1991) A new method for measuring daytime sleepiness: the Epworth sleepiness scale. Sleep 14(6):540–545PubMed Johns MW (1991) A new method for measuring daytime sleepiness: the Epworth sleepiness scale. Sleep 14(6):540–545PubMed
Metadata
Title
The role of sleep position in obstructive sleep apnea syndrome
Authors
Wietske Richard
Dennis Kox
Cindy den Herder
Martin Laman
Harm van Tinteren
Nico de Vries
Publication date
01-10-2006
Publisher
Springer-Verlag
Published in
European Archives of Oto-Rhino-Laryngology / Issue 10/2006
Print ISSN: 0937-4477
Electronic ISSN: 1434-4726
DOI
https://doi.org/10.1007/s00405-006-0090-2

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