Abstract
Introduction: Recent studies have shown that respiratory events that occur during sleep in supine position have a high prevalence in mild and moderate OSA patients.
Objectives: To determine the prevalence of positional OSA in patients with mild to moderate OSA; Compare biometric characteristics and response to APAP between positional and nonpositional OSA patients.
Methods: 404 polysomnographies (Embla S7000) were analyzed by an experienced technician.
Positional OSA was considered when AHI normalized in the nonsupine position (AHI ≤ 5 events per hour of sleep). Patients who adapted APAP were evaluated one month after starting treatment.
Results: We studied 126 patients, 65% male, with a mean age of 53 ± 11.7 years and a mean RDI of 14.3±6.1 respiratory events/hour.
Prevalence of positional OSA was 53.2% in the total group (56.8% in mild patients and 48% in moderate patients).
Thirty four out of 66 patients with positional OSA adapted APAP, 22 (64.7%) had no compliance to therapy and 12 (35.3%) had a mean compliance rate of more than 4.5 hours.
Concerning APAP parameters, the 95-percentile pressure (P95) was lower in patients with positional OSA (p=0.003). Leaks and residual AHI were not different between the two groups.
Conclusion: We found a high prevalence of positional OSA in patients with mild to moderate OSA.
Most patients with positional OSA were not compliant to therapy with APAP (64.7%). So, despite continuous positive airway pressure is considered the gold standard treatment of OSA, patients who did not have compliance should be encouraged for positional therapy.
Keywords: Positional OSA, Polysomnography, APAP.
- © 2012 ERS