Are we missing a simple treatment for most adult sleep apnea patients? The avoidance of the supine sleep position

Abstract Purpose Polysomnography (PSG) is considered the best objective study to diagnose and quantify sleep disorders. However, PSG involves multiple electrodes and is usually performed in a sleep laboratory that in itself may change the physiology of sleep. One of the parameters that can change during PSG is the sleep position, leading to more supine sleep. The aim of this study was to quantify the amount of supine sleep during PSG and compare it to consecutive nights of a home sleep apnea test (HSAT) in the same patients. Methods This prospective study evaluated 22 consecutive patients undergoing PSG followed by HSAT. Sleep position was analyzed during PSG and subsequently on 2 to 6 nights (mean 3.7 nights) at home, and the amount of supine sleep was recorded during each night. Results Of 22 patients, there were 12 men (55%). The median age was 60.0 years for women and 45.5 years for men. Median proportion of supine sleep during PSG and HSAT was 61% and 26% (p < 0.001), respectively. Four “phenotypes” were identified according to their sleep position during PSG and HSAT, with 5 patients sleeping mainly supine during all nights, 7 patients sleeping mainly non-supine during all nights, 3 patients sleeping in different positions during each night, and 7 patients sleeping supine during PSG but non-supine at home, during HSAT. Conclusions There is a higher proportion of supine sleep during PSG compared to home sleep. We identified a subgroup of patients who slept mainly supine during PSG and mainly non-supine during HSAT. PSG may overestimate OSA severity in a specific phenotype of patients.

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Infant Sleep Position: Pediatricians' Advice to Parents

PEDIATRICS ◽

10.1542/peds.95.1.55 ◽

1995 ◽

Vol 95 (1) ◽

pp. 55-58

Author(s):

Bonnie B. Hudak ◽

Jane O'Donnell ◽

Nadine Mazyrka

Keyword(s):

Primary Care ◽

New York ◽

Primary Care Physicians ◽

Sleep Position ◽

Infant Sleep ◽

Sources Of Information ◽

Professional Literature ◽

Infant Sleep Position ◽

Supine Sleep ◽

Question Survey

Objective. The American Academy of Pediatrics' (AAP) recommendation for side or supine sleep position in healthy babies has generated much controversy. We surveyed primary care physicians to determine the effect of the AAP statement on physician attitude toward infant sleep position and advice to parents. Methods. We sent a 23-question survey to 194 physicians in Western New York. The survey addressed their attitude toward the AAP recommendations and its impact on their advice to parents. Results. Of the 149 physicians treating newborns, 121 (82%) completed the questionnaire; 98% were aware of the AAP statement. The most common sources of information were the AAP (86%) and professional literature (77%). Of the respondents, 79% agreed with the AAP statement. Reasons for reservation were lack of data (64%), potential adverse consequences of supine position (52%), and their own experience (47%). Gender, years in practice, and type of reimbursement did not influence attitude toward the AAP recommendation. The AAP statement increased the frequency with which physicians routinely discussed sleep position from 34 to 70% (P < .02). Physicians recommending the prone position decreased from 57 to 7% (P < .001), while those recommending supine sleep position increased from 10 to 42% (P < .001). Conclusions. Most physicians agreed with the AAP statement and more frequently discussed sleep position following the AAP recommendations. However, they did not routinely recommend supine sleep position. The majority (69%) recommended the side position even though it is unstable. Although the AAP statement has increased discussion of infant sleep position by primary care physicians in WNY, only a minority recommend that infants sleep supine.

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Parents’ choice of non-supine sleep position for newborns: A cross-sectional study

Journal of Health Visiting ◽

10.12968/johv.2014.2.9.500 ◽

2014 ◽

Vol 2 (9) ◽

pp. 500-504

Author(s):

Charlotte Wright ◽

Hannah Beard ◽

Jennifer Cox ◽

Paula Scott ◽

Joyce Miller

Keyword(s):

Cross Sectional Study ◽

Sleep Position ◽

Sectional Study ◽

Cross Sectional ◽

Supine Sleep

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Effect of sleep position on obstructive sleep apnea.

The Tohoku Journal of Experimental Medicine ◽

10.1620/tjem.156.suppl_143 ◽

1988 ◽

Vol 156 (Suppl) ◽

pp. 143-149 ◽

Cited By ~ 11

Author(s):

HIROSHI MIKI ◽

WATARU HIDA ◽

YOSHIHIRO KIKUCHI ◽

TAMOTSU TAKISHIMA

Keyword(s):

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Sleep Position ◽

Obstructive Sleep

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Skull Morphology Affected by Different Sleep Positions in Infancy

The Cleft Palate-Craniofacial Journal ◽

10.1597/1545-1569_1995_032_0413_smabds_2.3.co_2 ◽

1995 ◽

Vol 32 (5) ◽

pp. 413-419 ◽

Cited By ~ 6

Author(s):

Chiung-Shing Huang ◽

Hsin-Chung Cheng ◽

Wen-Yuan Lin ◽

Jein-Wein Liou ◽

Yu-Ray Chen

Keyword(s):

Cleft Lip ◽

The Body ◽

Head Length ◽

Sleep Position ◽

Head Width ◽

Cephalic Index ◽

Craniofacial Skeleton ◽

Skull Morphology ◽

Supine Sleep ◽

The Relationship

In Infancy, prior to cranial suture and fontanel calcification, the craniofacial skeleton can be easily deformed by an externally exerted force. In this study, the relationship between the sleep position and skull morphology was investigated. A group of 81 cleft lip and/or palate infants without other systemic anomalies was first seen in the craniofacial center at approximately 1 month of age. The sleep position of each infant was recorded as supine, prone, or mixed type. The body and skull growth were longitudinally measured at 1, 3, and 6 months of age. Infants sleeping in the supine sleep position tended to have a wider head width, shorter head length, and a larger cephalic Index by 6 months of age. The opposite phenomena were observed in the prone sleep group. The mixed sleep group tended to have head width, head length, and cephalic index between those of the supine sleep group and the prone sleep group. During the first 3 months of life, the sleep position could mold the skull primarily in the dimension of head width. In conclusion, the supine sleep position may promote brachycephaly and the prone sleep position dolichocephaly.

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