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Somnologie

Erschienen in:

12.02.2018 | Reviews

Positional obstructive sleep apnea

An underestimated phenomenon

verfasst von: P. E. Vonk, MD, M. J. L. Ravesloot, MD MSc PhD

Erschienen in: Somnologie | Ausgabe 2/2018

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Abstract

Background

The severity of obstructive sleep apnea (OSA) is, in 56–75 % influenced by body position. The prevalence of positional OSA (POSA) decreases as the severity of OSA increases, and 70–80% of POSA patients have mild to moderate OSA.

Materials and methods

The literature on POSA is reviewed. Many definitions have been applied using modified versions of Cartwright’s criteria (a difference in apnea index of 50% or more between supine and non-supine positions). Others have proposed a distinction among POSA patients (PP) between supine-isolated OSA (non-supine apnea–hypopnea index, AHI, < 5) and supine-predominant OSA (non-supine AHI ≥ 5).

Results

In PP, positional therapy (PT) as a standalone treatment or in combination with other treatment modalities has proven to be effective. To achieve high compliance, proper selection of PP suitable for treatment with PT remains of high importance. In 2014, the Amsterdam Positional OSA Classification (APOC) was proposed, which can be used to identify suitable candidates for PT.

Conclusion

There is strong evidence that PT is effective in reducing AHI during short- and long-term follow-up in PP, and can be used as a standalone treatment or in combination with other treatment modalities. Recently, several studies have pointed out the complexity of POSA pathophysiology, which leaves room for more understanding and knowledge of this underestimated phenomenon in the future.

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Titel: Positional obstructive sleep apnea
An underestimated phenomenon
verfasst von: P. E. Vonk, MD
M. J. L. Ravesloot, MD MSc PhD
Publikationsdatum: 12.02.2018
Verlag: Springer Medizin
Erschienen in: Somnologie / Ausgabe 2/2018
Print ISSN: 1432-9123
Elektronische ISSN: 1439-054X
DOI: https://doi.org/10.1007/s11818-018-0152-x

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