Positional therapy for obstructive sleep apnea and snoring
A Swedish study reviewed the use of mattress and pillow for prone positioning for treatment of obstructive sleep apnea. Such “positional therapy” may offer either management possibilities or improvements in traditional management approaches to this common yet serious sleep disorder.
Obstructive sleep apnea remains a common but serious disorder of sleep . The number and duration of respiratory disturbances during sleep are influenced by the body position inmost patients with obstructive sleep apnea (OSA).
POSITIONAL OBSTRUCTIVE SLEEP APNEA
More than 50% of patients with OSA are considered to have positional OSA (POSA), a condition in which the apnea-hypopnea index (AHI) is at least twice as high in the supine position compared with non-supine positions.
In approximately 80% of all patients with OSA the AHI is higher in the supine position compared with the non-supine positions. This may be due to the body’s fluid dynamics during daytime-nighttime positional changes.
The body position has been studied although the neck in relation to body, less so. Clearly as the mouth/nose, neck and chest are involved in breathing, such a relationship is likely relevant.
THE PROBLEMS OF CPAP AND OAT
Equally so, some patients with OSA have contraindications for using oral devices .
Previous studies on positional therapies for patients with OSA have focused primarily on avoiding the supine position and/or sleeping in the lateral position alone.
POSITIONAL THERAPY HAS A PLACE IN OSA MANAGEMENT
In this study, prone positioning with the MPP (mattress and pillow for prone positioning) improved OSA severity, with satisfactory compliance during the 4-week follow-up.
Further studies are needed to assess the long-term compliance and efficiency of the use of mattress/pillow combinations. Sleeping prone may lead to neck strain although lateral (side sleeping) on an improved mattress/pillow combination may represent an improved baseline for those of us requiring OSA management.
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Dr Stephen Bray 2020