Association of body position with severity of apneic events in patients with severe nonpositional obstructive sleep apnea
- PMID: 11035672
- DOI: 10.1378/chest.118.4.1018
Association of body position with severity of apneic events in patients with severe nonpositional obstructive sleep apnea
Abstract
Study objective: To compare the severity of sleep apneic events occurring in the supine posture vs the severity of sleep apneic events occurring in the lateral posture in patients with severe obstructive sleep apnea (OSA).
Design: A retrospective analysis of apneic event variables in a group of 30 OSA patients who underwent a complete polysomnographic evaluation in our sleep disorders unit.
Patients: Thirty patients with severe OSA (respiratory disturbance index [RDI] = 70.1+/-18.2) who were nonpositional patients (NPP), ie, in whom the ratio of the supine RDI to the lateral RDI is < 2 (supine RDI = 85.7+/-11.7, lateral RDI = 64.8+/-17.3), and who had > or =30 apneic events in the lateral position and 30 apneic events in the supine position during sleep stage 2 were included in the study.
Measurements: For the 30 apneic events in each body position, the following variables were evaluated: apnea duration (ApDur), minimum desaturation (MinDes), Delta desaturation (Delta-Des), duration of arousal (DurArous), maximum snoring loudness (MaxSL), and Delta heart rate (Delta-HR). In addition, three other variables assessed as a ratio of ApDur (Rate-D = Delta-Des/ApDur, R-HR =Delta-HR/ApDur, and R-Arous = DurArous/ApDur) were also calculated.
Results: For all variables evaluated, apneic events occurring in the supine posture were significantly more severe than those apneic events occurring in the lateral posture during sleep stage 2. ApDur of both body postures correlated significantly with DurArous, Delta-HR, and MaxSL, but not with Delta-Des and MinDes. ApDur correlated linearly with DurArous for both postures. The slopes of the two regression lines were similar (p = 0.578) but the regression line intercept for the supine apneas was significantly higher than that of lateral apneas (p<0.0001). In addition, the average number of supine apneic events that did not end with an arousal was smaller than the average number of lateral apneic events not ending with an arousal (4.4+/-6.0 vs. 10.5+/-6.7, respectively; p< 0.0001). Also, only 4 of 900 (0.44%) apneic events analyzed in the lateral posture ended with an awakening (> 15 s), whereas in the supine posture, there were 37 (4.1%) such events (p<0.001).
Conclusions: These results show that even in patients with severe OSA who have a high number of apneic events in the supine and lateral posture, the apneic events occurring in the supine position are more severe than those occurring while sleeping in the lateral position. Thus, it is not only the number of apneic events that worsen in the supine sleep position but, probably no less important, the nature of the apneic events themselves.
Similar articles
-
Positional vs nonpositional obstructive sleep apnea patients: anthropomorphic, nocturnal polysomnographic, and multiple sleep latency test data.Chest. 1997 Sep;112(3):629-39. doi: 10.1378/chest.112.3.629. Chest. 1997. PMID: 9315794
-
Lateral sleeping position reduces severity of central sleep apnea / Cheyne-Stokes respiration.Sleep. 2006 Aug;29(8):1045-51. doi: 10.1093/sleep/29.8.1045. Sleep. 2006. PMID: 16944673
-
Effects of body position on snoring in apneic and nonapneic snorers.Sleep. 2003 Mar 15;26(2):169-72. doi: 10.1093/sleep/26.2.169. Sleep. 2003. PMID: 12683476
-
Standardized framework to report on the role of sleeping position in sleep apnea patients.Sleep Breath. 2021 Dec;25(4):1717-1728. doi: 10.1007/s11325-020-02255-2. Epub 2021 Jan 11. Sleep Breath. 2021. PMID: 33426584 Review.
-
Duration of respiratory events in obstructive sleep apnea: Factors influencing the duration of respiratory events.Sleep Med Rev. 2023 Apr;68:101729. doi: 10.1016/j.smrv.2022.101729. Epub 2022 Dec 9. Sleep Med Rev. 2023. PMID: 36549231 Review.
Cited by
-
Prolonged lung-to-finger circulation time indicates an increased risk of intermittent hypoxaemia in sleep apnoea patients.ERJ Open Res. 2024 Jul 22;10(4):01051-2023. doi: 10.1183/23120541.01051-2023. eCollection 2024 Jul. ERJ Open Res. 2024. PMID: 39040584 Free PMC article.
-
Polysomnographic characteristics and predictors of positional obstructive sleep apnea in Japanese elderly.Sleep Biol Rhythms. 2022 Mar 20;20(3):403-411. doi: 10.1007/s41105-022-00385-6. eCollection 2022 Jul. Sleep Biol Rhythms. 2022. PMID: 38469417 Free PMC article.
-
Recent Advances and Applications of Textile Technology in Patient Monitoring.Healthcare (Basel). 2023 Nov 29;11(23):3066. doi: 10.3390/healthcare11233066. Healthcare (Basel). 2023. PMID: 38063634 Free PMC article. Review.
-
Factors determining the therapeutic level of positive airway pressure in patients with obstructive sleep apnea syndrome.Lung India. 2023 Mar-Apr;40(2):112-116. doi: 10.4103/lungindia.lungindia_417_22. Lung India. 2023. PMID: 37006093 Free PMC article.
-
In-Bed Posture Classification Using Deep Neural Network.Sensors (Basel). 2023 Feb 22;23(5):2430. doi: 10.3390/s23052430. Sensors (Basel). 2023. PMID: 36904634 Free PMC article.
Publication types
MeSH terms
LinkOut - more resources
Full Text Sources
Other Literature Sources
Medical