Influence of head position on obstructive sleep apnea severity
- PMID: 28608295
- DOI: 10.1007/s11325-017-1525-2
Influence of head position on obstructive sleep apnea severity
Abstract
Objective: Supine body orientation plays an important role in precipitating upper airway collapse in a significant proportion of obstructive sleep apnea (OSA) patients known to have supine-predominant OSA (OSAsup). Traditionally, trunk position is used to assess OSAsup, but the role of the head position has not been established. We hypothesized that head position influences OSA independently of trunk position.
Methods: Head and trunk positions were determined from subjects undergoing overnight polysomnography. The apnea-hypopnea index (AHI), rapid eye movement (REM), and non-REM sleep time of all trunk and head positions (lateral and supine) were calculated and compared against the complete supine position, i.e., head and trunk supine.
Results: In 26 subjects, lateral rotation of the head to the right or left with the trunk supine resulted in a significant reduction in AHI from 36.0 ± 22.5 to 25.8 ± 16.6 (p = 0.008), and an AHI drop <10 in 27% of patients. The "trunk lateral-head lateral" position resulted in a more dramatic reduction in AHI from 31.6 ± 20.2 to 4.1 ± 4.1 (p < 0.0001). The distributions of REM and non-REM sleep were not different among positions. In the subgroup with a body mass index (BMI) <32 kg/m2 (15 subjects), the AHI reduction with lateral head rotation was significant (p = 0.005) but not in remaining 11 obese patient with a BMI ≥32 kg/m2 (p = 0.24).
Conclusion: OSA severity with the trunk in the supine position decreased significantly when the head rotated from supine to lateral, particularly in non-obese patients. These results demonstrate an important influence of head position on the AHI, independently of trunk position and sleep stage, in patients with OSA.
Keywords: Head position; Obstructive sleep apnea; Supine-predominant sleep apnea; Trunk posture.
Similar articles
-
Body position and obstructive sleep apnea in 8-12-month-old infants.Int J Pediatr Otorhinolaryngol. 2008 Jun;72(6):897-900. doi: 10.1016/j.ijporl.2008.03.002. Int J Pediatr Otorhinolaryngol. 2008. PMID: 18423893
-
Upper airway collapse during drug induced sleep endoscopy: head rotation in supine position compared with lateral head and trunk position.Eur Arch Otorhinolaryngol. 2015 Feb;272(2):485-8. doi: 10.1007/s00405-014-3215-z. Epub 2014 Aug 21. Eur Arch Otorhinolaryngol. 2015. PMID: 25142078
-
REM-related obstructive sleep apnea: the effect of body position.J Clin Sleep Med. 2010 Aug 15;6(4):343-8. J Clin Sleep Med. 2010. PMID: 20726282 Free PMC article.
-
Supine position related obstructive sleep apnea in adults: pathogenesis and treatment.Sleep Med Rev. 2014 Feb;18(1):7-17. doi: 10.1016/j.smrv.2013.01.005. Epub 2013 May 10. Sleep Med Rev. 2014. PMID: 23669094 Review.
-
A review of supine position related obstructive sleep apnea: Classification, epidemiology, pathogenesis and treatment.Sleep Med Rev. 2023 Dec;72:101847. doi: 10.1016/j.smrv.2023.101847. Epub 2023 Sep 6. Sleep Med Rev. 2023. PMID: 37722317 Review.
Cited by
-
Patient compliance and satisfaction with a new forehead device for positional obstructive sleep apnoea treatment: a post hoc analysis of a randomised controlled trial.BMJ Open Respir Res. 2023 Jun;10(1):e001503. doi: 10.1136/bmjresp-2022-001503. BMJ Open Respir Res. 2023. PMID: 37349132 Free PMC article. Clinical Trial.
-
The effect of head rotation on OSA is associated with disease severity: a cross-sectional study.Eur Arch Otorhinolaryngol. 2023 Jul;280(7):3279-3285. doi: 10.1007/s00405-023-07860-x. Epub 2023 Feb 4. Eur Arch Otorhinolaryngol. 2023. PMID: 36738327
-
Interaction of positive airway pressure mask magnets with cardiac implantable electronic devices.J Clin Sleep Med. 2023 May 1;19(5):941-946. doi: 10.5664/jcsm.10478. J Clin Sleep Med. 2023. PMID: 36722607 Free PMC article.
-
Body position during laboratory and home polysomnography compared to habitual sleeping position at home.J Clin Sleep Med. 2022 Sep 1;18(9):2103-2111. doi: 10.5664/jcsm.9990. J Clin Sleep Med. 2022. PMID: 35459447 Free PMC article.
-
A Vision-Based System for In-Sleep Upper-Body and Head Pose Classification.Sensors (Basel). 2022 Mar 4;22(5):2014. doi: 10.3390/s22052014. Sensors (Basel). 2022. PMID: 35271162 Free PMC article.
References
Publication types
MeSH terms
LinkOut - more resources
Full Text Sources
Other Literature Sources
Medical