REM-related Obstructive Sleep Apnea: the Effect of Body Position

Overview

Journal J Clin Sleep Med

Specialties Neurology
Psychiatry

Date 2010 Aug 24

PMID 20726282

Citations 32

Authors

Arie Oksenberg

Elena Arons

Khitam Nasser

Tatiana Vander

Henryk Radwan

Affiliations

Soon will be listed here.

Abstract

Study Objectives: To evaluate the effect of body position on REM-related obstructive sleep apnea (OSA) patients.

Design: Retrospective analysis.

Patients: 100 consecutive adult OSA patients (apnea-hypopnea index [AHI] > or = 5) who had > or = 10 min of REM sleep in both supine and lateral postures. REM-related OSA was defined by previously used criteria (REM AHI/Non-REM (NREM) AHI > or = 2) and was compared with data from Not-REM-related OSA (REM AHI/NREM AHI < 2).

Measurements And Results: Most (93%) of the REM-related OSA patients (n = 45) had a mild-moderate syndrome, compared to 50.9% in the Not-REM-related OSA patients (n = 55). REM-related OSA patients had a lower apnea index (AL), AHI, supine and lateral AHI, and NREM AHI, but similar REM AHI compared to the Not-REM-related OSA group. For the entire group, the following sequence was observed: AHI REM supine > AHI NREM supine > AHI REM lateral > AHI NREM lateral. Also, for the REM-related and Not-REM-related OSA patients, the interaction between supine posture and REM sleep led to the highest AHI. However, the average length of apnea and hypopneas during REM sleep was similar in the supine and lateral postures.

Conclusions: During REM sleep, the supine position is associated with increased frequency but not increased duration of apneas and hypopneas. These body position effects prevail over the differences between REM-related and Not-REM-related OSA patients.

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References

Richard W, Kox D, den Herder C, Laman M, van Tinteren H, de Vries N . The role of sleep position in obstructive sleep apnea syndrome. Eur Arch Otorhinolaryngol. 2006; 263(10):946-50. DOI: 10.1007/s00405-006-0090-2. View

Oksenberg A, Silverberg D . Avoiding the supine posture during sleep for patients with mild obstructive sleep apnea. Am J Respir Crit Care Med. 2009; 180(1):101. DOI: 10.1164/ajrccm.180.1.101. View

Oksenberg A, Khamaysi I, Silverberg D, Tarasiuk A . Association of body position with severity of apneic events in patients with severe nonpositional obstructive sleep apnea. Chest. 2000; 118(4):1018-24. DOI: 10.1378/chest.118.4.1018. View

Campos-Rodriguez F, Fernandez-Palacin A, Reyes-Nunez N, Reina-Gonzalez A . [Clinical and polysomnographic features of rapid-eye-movement-specific sleep-disordered breathing]. Arch Bronconeumol. 2009; 45(7):330-4. DOI: 10.1016/j.arbres.2008.12.003. View

OConnor C, Thornley K, Hanly P . Gender differences in the polysomnographic features of obstructive sleep apnea. Am J Respir Crit Care Med. 2000; 161(5):1465-72. DOI: 10.1164/ajrccm.161.5.9904121. View

Walsh J, Leigh M, Paduch A, Maddison K, Armstrong J, Sampson D . Effect of body posture on pharyngeal shape and size in adults with and without obstructive sleep apnea. Sleep. 2008; 31(11):1543-9. PMC: 2579983. DOI: 10.1093/sleep/31.11.1543. View

. EEG arousals: scoring rules and examples: a preliminary report from the Sleep Disorders Atlas Task Force of the American Sleep Disorders Association. Sleep. 1992; 15(2):173-84. View

Johns M . A new method for measuring daytime sleepiness: the Epworth sleepiness scale. Sleep. 1991; 14(6):540-5. DOI: 10.1093/sleep/14.6.540. View

Haba-Rubio J, Janssens J, Rochat T, Sforza E . Rapid eye movement-related disordered breathing: clinical and polysomnographic features. Chest. 2005; 128(5):3350-7. DOI: 10.1378/chest.128.5.3350. View

10.

Oksenberg A, Silverberg D . The effect of body posture on sleep-related breathing disorders: facts and therapeutic implications. Sleep Med Rev. 2004; 2(3):139-62. DOI: 10.1016/s1087-0792(98)90018-1. View

11.

Koo B, Dostal J, Ioachimescu O, Budur K . The effects of gender and age on REM-related sleep-disordered breathing. Sleep Breath. 2007; 12(3):259-64. DOI: 10.1007/s11325-007-0161-7. View

12.

Oksenberg A, Silverberg D, Arons E, Radwan H . Positional vs nonpositional obstructive sleep apnea patients: anthropomorphic, nocturnal polysomnographic, and multiple sleep latency test data. Chest. 1997; 112(3):629-39. DOI: 10.1378/chest.112.3.629. View

13.

Koo B, Patel S, Strohl K, Hoffstein V . Rapid eye movement-related sleep-disordered breathing: influence of age and gender. Chest. 2008; 134(6):1156-1161. PMC: 7448537. DOI: 10.1378/chest.08-1311. View

14.

. Sleep-related breathing disorders in adults: recommendations for syndrome definition and measurement techniques in clinical research. The Report of an American Academy of Sleep Medicine Task Force. Sleep. 1999; 22(5):667-89. View

15.

Findley L, Wilhoit S, Suratt P . Apnea duration and hypoxemia during REM sleep in patients with obstructive sleep apnea. Chest. 1985; 87(4):432-6. DOI: 10.1378/chest.87.4.432. View

16.

Saigusa H, Suzuki M, Higurashi N, Kodera K . Three-dimensional morphological analyses of positional dependence in patients with obstructive sleep apnea syndrome. Anesthesiology. 2009; 110(4):885-90. DOI: 10.1097/ALN.0b013e31819b5d57. View

17.

Lee J, Park Y, Hong J, Lee S, Jung K, Kim J . Determining optimal sleep position in patients with positional sleep-disordered breathing using response surface analysis. J Sleep Res. 2009; 18(1):26-35. DOI: 10.1111/j.1365-2869.2008.00703.x. View

18.

Oksenberg A, Silverberg D, Offenbach D, Arons E . Positional therapy for obstructive sleep apnea patients: A 6-month follow-up study. Laryngoscope. 2006; 116(11):1995-2000. DOI: 10.1097/01.mlg.0000237674.66716.a7. View

19.

Soga T, Nakata S, Yasuma F, Noda A, Sugiura T, Yatsuya H . Upper airway morphology in patients with obstructive sleep apnea syndrome: effects of lateral positioning. Auris Nasus Larynx. 2008; 36(3):305-9. DOI: 10.1016/j.anl.2008.04.007. View