Position Sensitive Apnea

[roster]

Carried over from another thread:

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DSM,

I am six feet tall and weigh 170 - slim by almost everyone's standards. The ENT says my tongue is only slightly thick at the base so I assume my airway is narrow.

This forum is wonderful and I have few complaints about it. One that I do have is that the effect of sleep position on apnea and pressure requirements doesn't get much coverage here. Maybe the solution to get more coverage is as simple as having a good term to describe the condition.

I would support a campaign to get "position sensitive apnea" entrenched on this forum (and elsewhere). If anyone has a better term, please come forward.

BTW, brain damage caused me to forget many rules of English, but should it be "position-sensitive apnea"? I seem to remember some rule about needing a hyphen when you use a noun to modify another noun.

[Guest]

It took me 7 months on my own and with a few tidbits on this forum to figure it out. I no longer fight the high pressure and all the aggravation that comes with it....leaking mask, gas in the stomach,etc.
I was getting no where finding effective and consistent treatment until I started controlling my sleep position. The results I get on my side are far better than those I was getting on my back...and at a much lower pressure.

[ozij]

Juliet:
"What's in a name? That which we call a rose
By any other name would smell as sweet."

And that which chokes us, by any other name still chokes us.


"Postional Sleep Apnea"
http://www.chestjournal.org/cgi/content ... /112/3/629

Positional vs Nonpositional Obstructive Sleep Apnea Patients
(Chest. 1997;112:629-639.)

Conclusions: In a large population of OSA patients, most were found to have at least twice as many apneas/hypopneas in the supine than in the lateral position. These so-called "positional patients" are on the average thinner and younger than "nonpositional patients." They had fewer and less severe breathing abnormalities than the NPP group. Consequently their nocturnal sleep quality was better preserved and, according to MSLT data, they were less sleepy during daytime hours. RDI was the most dominant factor that could predict the positional dependency followed by BMI and age. RDI showed a threshold effect, the prevalence of PP in those with severe RDI (RDI40) was significantly lower than in those OSA patients with mild-moderate RDI. BMI showed a major significant inverse relationship with positional dependency, while age had only a minor although significant inverse relationship with it. Body position during sleep has a profound effect on the frequency and severity of breathing abnormalities in OSA patients.

http://www.chestjournal.org/cgi/content ... 128/4/2130

Prevalence of Positional Sleep Apnea in Patients Undergoing Polysomnography*
(Chest. 2005;128:2130-2137.)

Results: Positional sleep apnea was seen in 49 of 99 patients (49.5%) with mild sleep apnea (AHI, 5 to 15/h), 14 of 72 patients (19.4%) with moderate sleep apnea (AHI, 15 to 30/h), and 5 of 77 patients (6.5%) with severe sleep apnea (AHI > 30/h). Sufficient sleep (> 15 min) in both postures was not seen in 104 of 269 patients (38.7%) and 80 of 242 overnight studies (33.1%) at the VAWNY and ASC, respectively, and was not seen in 47 of 57 split-night studies (82.5%). The percentage of studies with insufficient sleep in both postures was significantly greater for split-night studies (p < 0.0001).

Conclusions: Positional sleep apnea is common particularly in patients with mild disease. Positional sleep apnea cannot usually be assessed during a split-night study.

O.

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CPAPopedia Keywords Contained In This Post (Click For Definition): RDI

[dsm]

Trust Ozij to come up with the answer - good find.

So it seems that the athletic ones among us are more prone to positional sleep apnea.

Interestingly the topic of why people still get AHI scores above 0 cropped up in another thread I am engaged in & it does seem to me that apart from 'leak apnea' (apneas that occur because leaks have allowed the splinting of the airway to fail) combined with 'positional apnea', we may have a big percentage of the causes for AHI scores covered.

Interesting theme

DSM

[Guest]

Hmmmmmmmmmmmmmmmm......................

I was titrated at 10cm ON MY BACK.

I never sleep on my back. Side sleeper 100%.

Of course, when I self-titrated, I basically was 10-11 on my side...

How do docs manage to figure out your CORRECT prescription, if they demand you sleep in a position that you don't normally sleep in?

Just wondering,
Babs

[Slinky]

The GOOD sleep techs and sleep doctors DON'T require you to sleep in any particular position. Since the majority of apneas DO occur during REM and in the supine position they do like to see you spend a least a little time sleeping on your back but to REQUIRE you to spend most or all of the night on your back as I've occasionally read in the forums is a crock!!!

That being said, while I didn't try sleep position training to train myself NOT to sleep on my back, after a whiplash and resulting neck problems I DID train myself NOT to sleep on my stomach which is how I slept most all of my life. I didnt' even like the thought of the tennis ball bit so I just knotted up some old hunting socks of my husband's and basted them to the front of my PJs. Worked like a charm. That was 10-12 years ago and I still don't sleep on my tummy any more (and I had for 52 years prior).

I'm 5'4", female and weighed 105-115 most of my life. I've been as high as 120 lbs (other than when pregnant) and as low as 89 lbs (prior to a resection for Crohn's disease). 110-115 seems to be my best weight. 13" neck circumference. The 120 lbs was muscle mass accumulated when I was handling 50 lbs bags of dog and horse feed and working the "pouch rack" for the USPS dispatchng up to 70 lbs mail sacks to the steels and dock.

[roster]

Thanks Ozij. So Positional Sleep Apnea it is. Now the males have two PSAs to concern them. .

[kteague]

Just checked my study from last year. My supine AHI was 55.7, none of those during REM. (Wonder how bad supine and in REM would have been!)Non-supine was 37.2. To have such a high index even on my side fits with the quoted reports - severe OSA and overweight.