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Published on: December 6, 2016

Positional obstructive sleep apnea treatments in children: A qualitative study

Kris Ysabel Miranda Sanchez1, Shania Sheth1, Adele Baker2

  • 1Faculty of Medicine, University of Toronto, Toronto, Canada; Department of Pediatrics, The Hospital for Sick Children, Toronto, Canada.

Sleep Medicine
|June 27, 2026
PubMed

Insights

Families have varied preferences for treating positional obstructive sleep apnea (POSA) in children. Understanding these priorities can improve satisfaction with treatments like positional therapy and positive airway pressure (PAP) therapy.

Area of Science:

  • Pediatric Sleep Medicine
  • Respiratory Medicine
  • Otolaryngology

Background:

  • Positional obstructive sleep apnea (POSA) is worsened by supine sleep.
  • Current treatments include adenotonsillectomy, positive airway pressure (PAP) therapy, and emerging positional therapy devices.
  • Positional therapy aims to prevent supine sleep using wearable technology.

Purpose of the Study:

  • To explore the experiences and preferences of children and caregivers regarding POSA treatments.
  • To compare adenotonsillectomy, PAP therapy, and positional therapy from a patient and caregiver perspective.

Main Methods:

  • Semi-structured interviews were conducted with caregivers of children (aged 4-18) involved in a positional therapy trial.
  • Children were invited to participate when feasible.
  • Thematic analysis was employed, with interviews coded by two reviewers and themes generated by the research team.

Main Results:

  • Four children and 16 caregivers participated, identifying four key themes: comfort/convenience, symptom improvement, psychosocial aspects, and shared decision-making.
  • Positional therapy was perceived as least burdensome and minimally invasive, though symptom improvement was modest.
  • PAP therapy offered symptom relief but faced adherence challenges due to discomfort.
  • Adenotonsillectomy, while potentially curative, raised concerns about surgical risks.

Conclusions:

  • Family preferences for POSA treatments vary significantly.
  • Aligning treatments with family priorities may enhance satisfaction.
  • Addressing barriers like sensory issues and device management is crucial for improving adherence to positional and PAP therapy in pediatric patients.
Abstract

Keywords:
ChildrenObstructive sleep apneaPositional therapy

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