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Elevated posture for the management of obstructive sleep apnea.
Margot A Skinner1, Ruth N Kingshott, David R Jones
1Respiratory Research Unit, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand. margot.skinner@otago.ac.nz
Sleep & Breathing = Schlaf & Atmung
|December 22, 2004
Summary
Elevated head posture using a shoulder-head elevation pillow (SHEP) shows some benefit for obstructive sleep apnea (OSA) management. While less effective than nCPAP, SHEP may serve as a second-line therapy for certain OSA patients.
Area of Science:
- Sleep Medicine
- Respiratory Physiology
Background:
- Obstructive sleep apnea (OSA) is a common sleep disorder characterized by repeated airway collapse.
- Current treatments include positive airway pressure and oral appliances, but adherence can be an issue.
Purpose of the Study:
- To evaluate the effectiveness of elevated head posture as a management strategy for mild-to-moderate obstructive sleep apnea (OSA).
- To compare the efficacy of a shoulder-head elevation pillow (SHEP) against nasal continuous positive airway pressure (nCPAP).
Main Methods:
- A randomized crossover study involving 14 subjects with mild-to-moderate OSA (apnea-hypopnea index [AHI] 10-60/h).
- Subjects were treated with either SHEP or nCPAP, with outcomes assessed by AHI.
- Treatment success was defined as AHI ≤ 10/h, partial success as 10 < AHI < 16/h.
Main Results:
- nCPAP achieved success in 12 subjects, while SHEP resulted in success for 4 and partial success for 3.
- Mean AHI reduction with SHEP was from 27±12/h to 21±17/h, compared to 5±3/h with nCPAP (p=0.008).
- No baseline predictors were identified to determine which patients would benefit from elevated posture therapy.
Conclusions:
- Elevated head posture with SHEP can be helpful for some individuals with OSA.
- Results suggest elevated posture may be a viable second-line therapy option for OSA management.
- Further research is needed to identify predictors for successful elevated posture therapy in OSA.