OBJECTIVE: To investigate the effect of sleep position on surgical outcomes in obstructive sleep apnea (OSA). STUDY DESIGN: Retrospective review of 69 consecutive patients. SUBJECTS AND METHODS: Preoperative and postoperative polysomnographic data and Epworth sleepiness scale were obtained. Patients were categorized into success, response, no response, and failure groups according to apnea-hypopnea index (AHI) after uvulopalatopharyngoplasty. Proportions of supine or lateral position and AHI of each position were evaluated. Position-corrected AHI was developed in order to eliminate the effect of sleep position. RESULTS: Preoperative proportion of supine position in the failure group (n = 26) was 41.3 percent, which was the lowest among four groups (P = 0.010), and increased to 60.8 percent postoperatively (P = 0.028). Twenty-two (84.6%) among the failure group had supine position dependency. Regrouped by position-corrected AHI, 15 patients moved into different groups. Postoperative AHI showed positive correlation with increased supine position when BMI was controlled (r = 0.515, P = 0.006). CONCLUSION: Without appropriate correction based on the change of sleep position, the fluctuation of sleep position in each polysomnography might confound surgical outcomes in OSA patients. Thus, it is a substantial issue how to control or reflect the positional effect on AHI when treatment results are evaluated.
OBJECTIVE: To investigate the effect of sleep position on surgical outcomes in obstructive sleep apnea (OSA). STUDY DESIGN: Retrospective review of 69 consecutive patients. SUBJECTS AND METHODS: Preoperative and postoperative polysomnographic data and Epworth sleepiness scale were obtained. Patients were categorized into success, response, no response, and failure groups according to apnea-hypopnea index (AHI) after uvulopalatopharyngoplasty. Proportions of supine or lateral position and AHI of each position were evaluated. Position-corrected AHI was developed in order to eliminate the effect of sleep position. RESULTS: Preoperative proportion of supine position in the failure group (n = 26) was 41.3 percent, which was the lowest among four groups (P = 0.010), and increased to 60.8 percent postoperatively (P = 0.028). Twenty-two (84.6%) among the failure group had supine position dependency. Regrouped by position-corrected AHI, 15 patients moved into different groups. Postoperative AHI showed positive correlation with increased supine position when BMI was controlled (r = 0.515, P = 0.006). CONCLUSION: Without appropriate correction based on the change of sleep position, the fluctuation of sleep position in each polysomnography might confound surgical outcomes in OSA patients. Thus, it is a substantial issue how to control or reflect the positional effect on AHI when treatment results are evaluated.
Authors: C Kastoer; L B L Benoist; M Dieltjens; B Torensma; L H de Vries; P E Vonk; M J L Ravesloot; N de Vries Journal: Sleep Breath Date: 2018-08-01 Impact factor: 2.816
Authors: Patty E Vonk; Perry J Rotteveel; Madeline J L Ravesloot; Jean-Pierre T F Ho; Jan de Lange; Nico de Vries Journal: J Clin Sleep Med Date: 2019-11-27 Impact factor: 4.062