Sleep position and obstructive sleep apnea (OSA): Do we know how we sleep? A new explorative sleeping questionnaire.
OSAS
POSA
Positional obstructive sleep apnea
Positional therapy
Sleep
Sleep position
Journal
Sleep & breathing = Schlaf & Atmung
ISSN: 1522-1709
Titre abrégé: Sleep Breath
Pays: Germany
ID NLM: 9804161
Informations de publication
Date de publication:
12 2022
12 2022
Historique:
received:
05
08
2021
accepted:
28
01
2022
revised:
27
12
2021
pubmed:
8
2
2022
medline:
18
11
2022
entrez:
7
2
2022
Statut:
ppublish
Résumé
Positional obstructive sleep apnea (POSA) has been defined as a difference of 50% or more in Apnea-Hypopnea Index (AHI) between supine and non-supine position. Sleep position is fundamental in the evaluation of obstructive sleep apnea syndrome (OSAS) severity but most tools used in the diagnosis of OSAS are not free from potential bias in the evaluation of usual sleep positions. The aim of this investigation was to evaluate a novel sleep questionnaire with the purpose of exploring sleep habits and evaluating if sleep assessment can identify the usual body position assumed for sleep. The questionnaire was administered to patients recruited from October to November 2018. Questions concerned sleeping positions and conditions that could influence sleeping positions. Patients who had previously undergone polysomnography (PSG) were asked how they slept during the study night. Whenever present during the examination, the patient's bed partner was also asked about the patient's usual body positions during sleep. Of 315 patients (211 men) enrolled, 35% were affected by OSAS and 69% of patients with OSAS had POSA. POSA was more prevalent among men (75%) compared to women (43%). The new questionnaire provided a discordant result from PSG recordings about sleeping positions and revealed a difference between usual sleeping position and the position during PSG recording. Reported sleep quality was much worse on PSG than at home suggesting that the "first night effect" is real and may lead to over-estimation of POSA cases. Information about sleeping positions is fundamental to the assessment of OSAS severity. Knowledge gained from the new questionnaire as described may represent a valuable addendum to develop a more detailed polygraphic report. Such a tool may be used in practice with the aim of better identifying patients with true positional OSAS. Such patients may benefit from targeted positional therapy.
Identifiants
pubmed: 35129756
doi: 10.1007/s11325-022-02576-4
pii: 10.1007/s11325-022-02576-4
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1973-1981Informations de copyright
© 2022. The Author(s), under exclusive licence to Springer Nature Switzerland AG.
Références
van Maanen JP, de Vries N (2014) Long-term effectiveness and compliance of positional therapy with the sleep position trainer in the treatment of positional obstructive sleep apnea syndrome. Sleep 37(7):1209–1215. https://doi.org/10.5665/sleep.3840
doi: 10.5665/sleep.3840
pubmed: 25061249
pmcid: 4098806
Cartwright RD, Diaz F, Lloyd S (1991) The effects of sleep posture and sleep stage on apnea frequency. Sleep 14(4):351–353. https://doi.org/10.1093/sleep/14.4.351
doi: 10.1093/sleep/14.4.351
pubmed: 1947599
Marklund M, Persson M, Franklin KA (1998) Treatment success with a mandibular advancement device is related to supine-dependent sleep apnea. Chest 114(6):1630–1635. https://doi.org/10.1378/chest.114.6.1630
doi: 10.1378/chest.114.6.1630
pubmed: 9872199
Permut I, Diaz-Abad M, Chatila W, Crocetti J, Gaughan JP, D’Alonzo GE, Krachman SL (2010) Comparison of positional therapy to CPAP in patients with positional obstructive sleep apnea. J Clin Sleep Med 6(3):238–243
doi: 10.5664/jcsm.27820
pubmed: 20572416
pmcid: 2883034
Mador MJ, Kufel TJ, Magalang UJ, Rajesh SK, Watwe V, Grant BJ (2005) Prevalence of positional sleep apnea in patients undergoing polysomnography. Chest 128(4):2130–2137. https://doi.org/10.1378/chest.128.4.2130
doi: 10.1378/chest.128.4.2130
pubmed: 16236865
Bignold JJ, Mercer JD, Antic NA, McEvoy RD, Catcheside PG (2011) Accurate position monitoring and improved supine-dependent obstructive sleep apnea with a new position recording and supine avoidance device. J Clin Sleep Med 7(4):376–383. https://doi.org/10.5664/JCSM.1194
doi: 10.5664/JCSM.1194
pubmed: 21897774
pmcid: 3161770
Frank MH, Ravesloot MJ, van Maanen JP, Verhagen E, de Lange J, de Vries N (2015) Positional OSA part 1: towards a clinical classification system for position-dependent obstructive sleep apnoea. Sleep Breath 19(2):473–480. https://doi.org/10.1007/s11325-014-1022-9
doi: 10.1007/s11325-014-1022-9
pubmed: 24943728
Kim B, Lee EM, Chung YS, Kim WS, Lee SA (2015) The utility of three screening questionnaires for obstructive sleep apnea in a sleep clinic setting. Yonsei Med J 56(3):684–690. https://doi.org/10.3349/ymj.2015.56.3.684
doi: 10.3349/ymj.2015.56.3.684
pubmed: 25837173
pmcid: 4397437
Lee SA, Paek JH, Chung YS, Kim WS (2017) Clinical features in patients with positional obstructive sleep apnea according to its subtypes. Sleep Breath 21(1):109–117. https://doi.org/10.1007/s11325-016-1379-z
doi: 10.1007/s11325-016-1379-z
pubmed: 27406180
Heinzer R, Petitpierre NJ, Marti-Soler H, Haba-Rubio J (2018) Prevalence and characteristics of positional sleep apnea in the HypnoLaus population-based cohort. Sleep Med 48:157–162. https://doi.org/10.1016/j.sleep.2018.02.011
doi: 10.1016/j.sleep.2018.02.011
pubmed: 29957486
Levendowski DJ, Seagraves S, Popovic D, Westbrook PR (2014) Assessment of a neck-based treatment and monitoring device for positional obstructive sleep apnea. J Clin Sleep Med JCSM Off Publ Am Acad Sleep Med 10(8):863–871. https://doi.org/10.5664/jcsm.3956
doi: 10.5664/jcsm.3956
Berry RB, Uhles ML, Abaluck BK et al (2019) NightBalance sleep position treatment device versus auto-adjusting positive airway pressure for treatment of positional obstructive sleep apnea. J Clin Sleep Med JCSM Off Publ Am Acad Sleep Med 15(7):947–956. https://doi.org/10.5664/jcsm.7868
doi: 10.5664/jcsm.7868
Armas LH, Turino C, Cordero-Guevara J et al (2019) A new postural device for the treatment of positional obstructive sleep apnea. A pilot study Respir Med 151:111–117. https://doi.org/10.1016/j.rmed.2019.02.005
doi: 10.1016/j.rmed.2019.02.005
Razjouyan J, Lee H, Parthasarathy S, Mohler J, Sharafkhaneh A, Najafi B (2017) Improving sleep quality assessment using wearable sensors by including information from postural/sleep position changes and body acceleration: a comparison of chest-worn sensors, wrist actigraphy, and polysomnography. J Clin Sleep Med JCSM Off Publ Am Acad Sleep Med 13(11):1301–1310. https://doi.org/10.5664/jcsm.6802
doi: 10.5664/jcsm.6802
van Kesteren ER, van Maanen JP, Hilgevoord AAJ, Laman DM, de Vries N (2011) Quantitative effects of trunk and head position on the apnea hypopnea index in obstructive sleep apnea. Sleep 34(8):1075–1081. https://doi.org/10.5665/SLEEP.1164
doi: 10.5665/SLEEP.1164
pubmed: 21804669
pmcid: 3138162
Safiruddin F, Koutsourelakis I, de Vries N (2014) Analysis of the influence of head rotation during drug-induced sleep endoscopy in obstructive sleep apnea. Laryngoscope 124(9):2195–2199. https://doi.org/10.1002/lary.24598
doi: 10.1002/lary.24598
pubmed: 24431007
Zhu K, Bradley TD, Patel M, Alshaer H (2017) Influence of head position on obstructive sleep apnea severity. Sleep Breath 21(4):821–828. https://doi.org/10.1007/s11325-017-1525-2
doi: 10.1007/s11325-017-1525-2
pubmed: 28608295
Safiruddin F, Koutsourelakis I, de Vries N (2015) Upper airway collapse during drug induced sleep endoscopy: head rotation in supine position compared with lateral head and trunk position. Eur Arch Oto-Rhino-Laryngol Off J Eur Fed Oto-Rhino-Laryngol Soc EUFOS Affil Ger Soc Oto-Rhino-Laryngol - Head Neck Surg 272(2):485–488. https://doi.org/10.1007/s00405-014-3215-z
doi: 10.1007/s00405-014-3215-z
Newell J, Mairesse O, Verbanck P, Neu D (2012) Is a one-night stay in the lab really enough to conclude? First-night effect and night-to-night variability in polysomnographic recordings among different clinical population samples. Psychiatry Res 200(2–3):795–801. https://doi.org/10.1016/j.psychres.2012.07.045
doi: 10.1016/j.psychres.2012.07.045
pubmed: 22901399
Frank MH, Ravesloot MJL, van Maanen JP, Verhagen E, de Lange J, de Vries N (2015) Positional OSA part 1: towards a clinical classification system for position-dependent obstructive sleep apnoea. Sleep Breath Schlaf Atm 19(2):473–480. https://doi.org/10.1007/s11325-014-1022-9
doi: 10.1007/s11325-014-1022-9
Joosten SA, O’Driscoll DM, Berger PJ, Hamilton GS (2014) Supine position related obstructive sleep apnea in adults: pathogenesis and treatment. Sleep Med Rev 18(1):7–17. https://doi.org/10.1016/j.smrv.2013.01.005
doi: 10.1016/j.smrv.2013.01.005
pubmed: 23669094
Logan MB, Branham GH, Eisenbeis JF, Hartse K (1996) 11:48 AM: unattended home monitoring in the evaluation of sleep apnea: is it equal to formal polysomnograph? Otolaryngol Neck Surg 115(2):P156–P156. https://doi.org/10.1016/S0194-5998(96)80859-X
doi: 10.1016/S0194-5998(96)80859-X
Vonk PE, de Vries N, Ravesloot MJL (2019) Polysomnography and sleep position, a Heisenberg phenomenon? : A large-scale series. HNO 67(9):679–684. https://doi.org/10.1007/s00106-019-0678-7
doi: 10.1007/s00106-019-0678-7
pubmed: 31165199
Metersky ML, Castriotta RJ (1996) The effect of polysomnography on sleep position: possible implications on the diagnosis of positional obstructive sleep apnea. Respir Int Rev Thorac Dis 63(5):283–287. https://doi.org/10.1159/000196561
doi: 10.1159/000196561
Skarpsno ES, Mork PJ, Nilsen TIL, Holtermann A (2017) Sleep positions and nocturnal body movements based on free-living accelerometer recordings: association with demographics, lifestyle, and insomnia symptoms. Nat Sci Sleep 9:267–275. https://doi.org/10.2147/NSS.S145777
doi: 10.2147/NSS.S145777
pubmed: 29138608
pmcid: 5677378
De Koninck J, Lorrain D, Gagnon P (1992) Sleep positions and position shifts in five age groups: an ontogenetic picture. Sleep 15(2):143–149. https://doi.org/10.1093/sleep/15.2.143
doi: 10.1093/sleep/15.2.143
pubmed: 1579788
Gordon S, Buettner P. Age and lateral sleep position: a pilot study. Internet J Allied Health Sci Pract. 2009;7(1). https://nsuworks.nova.edu/ijahsp/vol7/iss1/13
AASM publishes new guideline for diagnostic testing for adult sleep apnea. American Academy of Sleep Medicine – Association for Sleep Clinicians and Researchers. Published March 14, 2017. Accessed October 15, 2020. https://aasm.org/aasm-publishes-new-guideline-for-diagnostic-testing-for-adult-sleep-apnea/
Khoury RM, Camacho-Lobato L, Katz PO, Mohiuddin MA, Castell DO (1999) Influence of spontaneous sleep positions on nighttime recumbent reflux in patients with gastroesophageal reflux disease. Am J Gastroenterol 94(8):2069–2073. https://doi.org/10.1111/j.1572-0241.1999.01279.x
doi: 10.1111/j.1572-0241.1999.01279.x
pubmed: 10445529
Zenian J (2010) Sleep position and shoulder pain. Med Hypotheses 74(4):639–643. https://doi.org/10.1016/j.mehy.2009.11.013
doi: 10.1016/j.mehy.2009.11.013
pubmed: 20036076