Abstract
Introduction: Positional (supine) dependent obstructive sleep apnea (POSA) is a common condition in adults occurring in > 50% of adult OSA patients. Data regarding the effect of sleep position on the occurrence of respiratory events in children are limited and conflicting.
Aim: To study the prevalence of POSA in children with moderate to severe OSA and correlate the data with upper airway findings.
Methods: Sleep position was measured by means of a position sensor during full-night polysomnography. Obstructive apnea/hypopnea index (oAHI) was calculated for supine (oAHIsup) and non-supine (oAHInsup) positions. Time spent in each position was recorded. POSA is defined as oAHIsup > 2 X oAHInsup. Positional data were correlated to upper airway findings during drug induced sedation endoscopy (DISE). Data are presented as median and 25-75th percentile.
Results: Data are available for 37 patients (15 girls, 22 boys), age 3.1 years (1.8-4.7), BMIz-score 0,29 (-0.96-1.3) with moderate to severe OSA: oAHI 14.3/hr (7.0-23.4). There was no significant difference between oAHIsup 13.6/hr (6.1-20.1) and oAHInsup 10.8 hr (6.6-19.2). Three patients had POSA, 2 of them had less than 5 minutes sleep in the non-supine position. There were no correlations between oAHIsup or oAHInsup and degree of adenoidal, tonsilar or tongue base obstruction during DISE.
Conclusions: Positional (supine) dependent OSA is an uncommon condition in children with moderate to severe OSA. Further studies are needed to explore the prevalence of this condition in subgroups such as obese children or those with Down syndrome.
- Copyright ©the authors 2016