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Obstructive Sleep Apnea: Do Positional Patients Become Nonpositional Patients With Time?

Arie Oksenberg1, Vlada Goizman1, Edith Eitan1

  • 1Sleep Disorders Unit, Loewenstein Hospital-Rehabilitation Center, Raanana, Israel.

The Laryngoscope
|November 14, 2019
PubMed
Summary
This summary is machine-generated.

Most positional obstructive sleep apnea (OSA) patients remain positional after 6.6 years. Positional therapy is effective for these patients, but positional patients who convert to non-positional status require monitoring.

Keywords:
Positional OSAnonpositional OSApositional therapysleeping posturesupine sleep

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Area of Science:

  • Sleep Medicine
  • Respiratory Medicine
  • Otolaryngology

Background:

  • Obstructive sleep apnea (OSA) is a common sleep disorder.
  • Positional patients (PPs) experience breathing abnormalities primarily in the supine position.
  • Positional therapy (PT) involves avoiding the supine posture and is a treatment for PPs.

Purpose of the Study:

  • To assess the long-term stability of positional obstructive sleep apnea (OSA).
  • To identify factors influencing the conversion of positional patients (PPs) to non-positional patients (NPPs).
  • To evaluate the implications for positional therapy (PT) effectiveness over time.

Main Methods:

  • Analysis of polysomnographic (PSG) recordings from 81 adult OSA patients initially identified as PPs.
  • Follow-up PSG evaluations were conducted after an average of 6.6 years.
  • Comparison of clinical and sleep parameters between patients who remained PPs and those who converted to NPPs.

Main Results:

  • 70.4% of PPs remained PPs at follow-up, while 29.6% converted to NPPs.
  • Significant increases in BMI, AHI, and lateral AHI, and a decrease in SpO2 during REM sleep were observed in both groups.
  • These parameter changes were more pronounced in patients who converted to NPPs.

Conclusions:

  • A majority of positional OSA patients remain positional long-term, suggesting continued benefit from positional therapy if adherence is good.
  • Positional therapy may become suboptimal for patients who convert to non-positional status, necessitating regular monitoring.
  • Early intervention with positional therapy may prevent the worsening of OSA in positional patients.