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Insufficient Sleep and Sleep Deprivation01:13

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Positional therapy for obstructive sleep apnoea.

P R Srijithesh1, Rajeswari Aghoram, Amit Goel

  • 1Department of Neurology, National Institute of Mental Health and Neuro Sciences (NIMHANS), Hosur Road, Bangalore, India.

The Cochrane Database of Systematic Reviews
|May 2, 2019
PubMed
Summary
This summary is machine-generated.

Positional therapy improves sleepiness and reduces apnoea-hypopnoea index compared to no therapy for obstructive sleep apnoea (OSA). Continuous positive airway pressure (CPAP) is more effective for reducing AHI than positional therapy, but adherence may be better with positional therapy.

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Area of Science:

  • Respiratory Medicine
  • Sleep Science
  • Clinical Trials

Background:

  • Obstructive sleep apnoea (OSA) is treated with various methods, including Continuous Positive Airway Pressure (CPAP) therapy.
  • While CPAP is effective, patient adherence is often suboptimal.
  • Positional therapy, a less invasive approach, is explored as an alternative with potentially better adherence.

Purpose of the Study:

  • To compare the efficacy of positional therapy against CPAP for treating OSA.
  • To evaluate the effectiveness of positional therapy compared to inactive control (no intervention) in OSA patients.

Main Methods:

  • Systematic review and meta-analysis of randomized controlled trials.
  • Searched multiple databases up to September 2018, with no language or publication type restrictions.
  • Included eight studies with 323 participants comparing positional therapy with CPAP or inactive control.

Main Results:

  • CPAP showed a greater reduction in Apnoea-Hypopnoea Index (AHI) than positional therapy (low-certainty evidence).
  • Positional therapy significantly improved Epworth Sleepiness Scale (ESS) scores and reduced AHI compared to inactive control (moderate to low-certainty evidence).
  • Subjective adherence was significantly greater with positional therapy compared to CPAP (moderate-certainty evidence); no significant difference in adherence was found compared to inactive control.

Conclusions:

  • Positional therapy is effective in improving sleepiness and reducing AHI compared to no intervention for positional OSA.
  • CPAP demonstrates greater efficacy in reducing AHI, but positional therapy may offer better patient adherence.
  • No significant differences were observed in quality of life or cognitive function; long-term effects remain unknown due to short study durations.