Skip to main content

Prevalence of Positional Obstructive Sleep Apnea in Patients Undergoing Polysomnography and the Effect of Sleep Stage

  • Chapter
  • First Online:
Book cover Positional Therapy in Obstructive Sleep Apnea

Abstract

Determining whether sleep apnea is positional or not has important therapeutic consequences as discussed elsewhere in this book. In this chapter, we will discuss the prevalence of positional sleep apnea in patients with sleep apnea, factors that make positional sleep apnea more likely in a patient with sleep apnea, and the effect of sleep stage on positional sleep apnea. Using the standard definition for positional sleep apnea, the prevalence varies from 56 % to 71 %. Using a stricter definition where sleep apnea is only observed in the supine posture, the prevalence varies from 23 % to 27 %. Positional sleep apnea is substantially more common in patients with milder disease. Positional sleep apnea is present during both REM and NREM sleep.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 159.00
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Young T, et al. The occurrence of sleep-disordered breathing among middle-aged adults. N Engl J Med. 1993;328(17):1230–5.

    Article  CAS  PubMed  Google Scholar 

  2. Peppard PE, et al. Increased prevalence of sleep-disordered breathing in adults. Am J Epidemiol. 2013;177(9):1006–14.

    Article  PubMed Central  PubMed  Google Scholar 

  3. Cartwright RD. Effect of sleep position on sleep apnea severity. Sleep. 1984;7(2):110–4.

    CAS  PubMed  Google Scholar 

  4. Gillman A, et al. Comparison of supine-only and REM-only obstructive sleep apnoea. Sleep Med. 2012;13(7):875–8.

    Article  PubMed  Google Scholar 

  5. Mador MJ, et al. Prevalence of positional sleep apnea in patients undergoing polysomnography. Chest. 2005;128(4):2130–7.

    Article  PubMed  Google Scholar 

  6. Lee CH, et al. The effect of positional dependency on outcomes of treatment with a mandibular advancement device. Arch Otolaryngol Head Neck Surg. 2012;138(5):479–83.

    Article  PubMed  Google Scholar 

  7. Chung JW, et al. Treatment outcomes of mandibular advancement devices in positional and nonpositional OSA patients. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2010;109(5):724–31.

    Article  PubMed Central  PubMed  Google Scholar 

  8. Richard W, et al. The role of sleep position in obstructive sleep apnea syndrome. Eur Arch Otorhinolaryngol. 2006;263(10):946–50.

    Article  PubMed  Google Scholar 

  9. Sunwoo WS, et al. Association between positional dependency and obstruction site in obstructive sleep apnea syndrome. Clin Exp Otorhinolaryngol. 2012;5(4):218–21.

    Article  PubMed Central  PubMed  Google Scholar 

  10. Teerapraipruk B, et al. Clinical and polysomnographic data of positional sleep apnea and its predictors. Sleep Breath. 2012;16(4):1167–72.

    Article  PubMed  Google Scholar 

  11. Oksenberg A, et al. Positional vs nonpositional obstructive sleep apnea patients: anthropomorphic, nocturnal polysomnographic, and multiple sleep latency test data. Chest. 1997;112(3):629–39.

    Article  CAS  PubMed  Google Scholar 

  12. Metersky ML, Castriotta RJ. The effect of polysomnography on sleep position: possible implications on the diagnosis of positional obstructive sleep apnea. Respiration. 1996;63(5):283–7.

    Article  CAS  PubMed  Google Scholar 

  13. Ozeke O, et al. Influence of the right- versus left-sided sleeping position on the apnea-hypopnea index in patients with sleep apnea. Sleep Breath. 2012;16(3):617–20.

    Article  PubMed  Google Scholar 

  14. Tiotiu A, et al. Body position and breathing abnormalities during sleep: a systematic study. Pneumologia. 2011;60(4):216–21.

    PubMed  Google Scholar 

  15. 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.

    Google Scholar 

  16. Mador MJ, et al. Are the adverse effects of body position in patients with obstructive sleep apnea dependent on sleep stage? Sleep Breath. 2010;14(1):13–7.

    Article  PubMed  Google Scholar 

  17. Chung JW, et al. Patients with positional versus nonpositional obstructive sleep apnea: a retrospective study of risk factors associated with apnea-hypopnea severity. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2010;110(5):605–10.

    Article  PubMed  Google Scholar 

  18. Oksenberg A, et al. Association of body position with severity of apneic events in patients with severe nonpositional obstructive sleep apnea. Chest. 2000;118(4):1018–24.

    Article  CAS  PubMed  Google Scholar 

  19. Oksenberg A, et al. Obstructive sleep apnoea in adults: body postures and weight changes interactions. J Sleep Res. 2012;21(4):402–9.

    Article  PubMed  Google Scholar 

  20. Pevernagie DA, et al. Effects of body position on the upper airway of patients with obstructive sleep apnea. Am J Respir Crit Care Med. 1995;152(1):179–85.

    Article  CAS  PubMed  Google Scholar 

  21. Isono S, Tanaka A, Nishino T. Lateral position decreases collapsibility of the passive pharynx in patients with obstructive sleep apnea. Anesthesiology. 2002;97(4):780–5.

    Article  PubMed  Google Scholar 

  22. Saigusa H, et al. Three-dimensional morphological analyses of positional dependence in patients with obstructive sleep apnea syndrome. Anesthesiology. 2009;110(4):885–90.

    Article  PubMed  Google Scholar 

  23. Weihu C, et al. Relationship of body position, upper airway morphology, and severity of obstructive sleep apnea/hypopnea syndrome among Chinese patients. Acta Otolaryngol. 2011;131(2):173–80.

    Article  PubMed  Google Scholar 

  24. Soga T, et al. Upper airway morphology in patients with obstructive sleep apnea syndrome: effects of lateral positioning. Auris Nasus Larynx. 2009;36(3):305–9.

    Article  PubMed  Google Scholar 

  25. Ong JS, et al. Variability of human upper airway collapsibility during sleep and the influence of body posture and sleep stage. J Sleep Res. 2011;20(4):533–7.

    Article  PubMed  Google Scholar 

  26. Walsh JH, et al. Effect of body posture on pharyngeal shape and size in adults with and without obstructive sleep apnea. Sleep. 2008;31(11):1543–9.

    PubMed Central  PubMed  Google Scholar 

  27. Chang ET, Shiao GM. Craniofacial abnormalities in Chinese patients with obstructive and positional sleep apnea. Sleep Med. 2008;9(4):403–10.

    Article  PubMed  Google Scholar 

  28. Peppard PE, et al. Longitudinal study of moderate weight change and sleep-disordered breathing. JAMA. 2000;284(23):3015–21.

    Article  CAS  PubMed  Google Scholar 

  29. Itasaka Y, et al. The influence of sleep position and obesity on sleep apnea. Psychiatry Clin Neurosci. 2000;54(3):340–1.

    Article  CAS  PubMed  Google Scholar 

  30. Akita Y, et al. Posture of patients with sleep apnea during sleep. Acta Otolaryngol Suppl. 2003;550:41–5.

    Article  PubMed  Google Scholar 

  31. Oksenberg A, et al. The significance of body posture on breathing abnormalities during sleep: data analysis of 2077 obstructive sleep apnea patients. Harefuah. 2009;148(5):304–9. 350, 351.

    PubMed  Google Scholar 

  32. Penzel T, et al. Effect of sleep position and sleep stage on the collapsibility of the upper airways in patients with sleep apnea. Sleep. 2001;24(1):90–5.

    CAS  PubMed  Google Scholar 

  33. Ratnavadivel R, et al. Marked reduction in obstructive sleep apnea severity in slow wave sleep. J Clin Sleep Med. 2009;5(6):519–24.

    PubMed Central  PubMed  Google Scholar 

  34. Eiseman NA, et al. The impact of body posture and sleep stages on sleep apnea severity in adults. J Clin Sleep Med. 2012;8(6):655–6A.

    PubMed Central  PubMed  Google Scholar 

  35. Kryger MH, Roth T, Dement WC. Principles and practice of sleep medicine. 5th ed. Philadelphia, PA: Saunders/Elsevier; 2011.

    Google Scholar 

  36. Pevernagie DA, Shepard Jr JW. Relations between sleep stage, posture and effective nasal CPAP levels in OSA. Sleep. 1992;15(2):162–7.

    CAS  PubMed  Google Scholar 

  37. George CF, Millar TW, Kryger MH. Sleep apnea and body position during sleep. Sleep. 1988;11(1):90–9.

    CAS  PubMed  Google Scholar 

  38. Oksenberg A, et al. REM-related obstructive sleep apnea: the effect of body position. J Clin Sleep Med. 2010;6(4):343–8.

    PubMed Central  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to M. Jeffery Mador M.D. .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2015 Springer International Publishing Switzerland

About this chapter

Cite this chapter

Shetty, M., Mador, M.J. (2015). Prevalence of Positional Obstructive Sleep Apnea in Patients Undergoing Polysomnography and the Effect of Sleep Stage. In: de Vries, N., Ravesloot, M., van Maanen, J. (eds) Positional Therapy in Obstructive Sleep Apnea. Springer, Cham. https://doi.org/10.1007/978-3-319-09626-1_4

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-09626-1_4

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-09625-4

  • Online ISBN: 978-3-319-09626-1

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics