Positional obstructive sleep apnea and cardiovascular outcomes.

Area of Science:

• Sleep Medicine
• Cardiology
• Respiratory Medicine

Background:

• Obstructive sleep apnea (OSA) severity increases during supine sleep.
• Positional OSA (POSA) predominantly occurs in the supine position.
• The impact of POSA on future cardiovascular (CV) risk remains unclear.

Purpose of the Study:

• To investigate the association between POSA and future CV risk.
• To compare CV risk in patients with POSA versus those without POSA (non-POSA).

Main Methods:

• A single-center study analyzed polysomnography data from 3,779 patients.
• POSA was defined by specific apnea-hypopnea index (AHI) criteria for supine vs. non-supine positions.
• Cox proportional hazard models assessed future CV event risk.

Main Results:

• Patients with POSA exhibited a significantly lower risk of CV events compared to non-POSA patients (HR 0.85, p=0.010).
• A trend towards lower CV risk was observed in the exclusive POSA (ePOSA) subgroup.
• The study included 35.9% POSA, 38.4% non-POSA, and 25.7% no OSA patients.

Conclusions:

• POSA is associated with a lower future cardiovascular risk than non-POSA.
• POSA should be considered a distinct subtype in OSA research concerning CV outcomes.