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http://dx.doi.org/10.14401/KASMED.2017.24.1.32

Correlational Analysis of Supine Position Time and Sleep-related Variables in Obstructive Sleep Apnea Syndrome  

Kim, Si Young (Department of Psychiatry, Konkuk University Hospital)
Park, Doo-Heum (Department of Psychiatry, Konkuk University Hospital)
Yu, Jaehak (Department of Psychiatry, Konkuk University Hospital)
Ryu, Seung-Ho (Department of Psychiatry, Konkuk University Hospital)
Ha, Ji-Hyeon (Department of Psychiatry, Konkuk University Hospital)
Publication Information
Sleep Medicine and Psychophysiology / v.24, no.1, 2017 , pp. 32-37 More about this Journal
Abstract
Objectives: A supine sleep position increases sleep apneas compared to non-supine positions in obstructive sleep apnea syndrome (OSAS). However, supine position time (SPT) is not highly associated with apnea-hypopnea index (AHI) in OSAS. We evaluated the correlation among sleep-related variables and SPT in OSAS. Methods: A total of 365 men with OSAS were enrolled in this study. We analyzed how SPT was correlated with demographic data, sleep structure-related variables, OSAS-related variables and heart rate variability (HRV). Multiple linear regression analysis was conducted to investigate the factors that affected SPT. Results: SPT had the most significant correlation with total sleep time (TST ; r = 0.443, p < 0.001), followed by sleep efficiency (SE ; r = 0.300, p < 0.001). Snoring time (r = 0.238, p < 0.001), time at < 90% SpO2 (r = 0.188, p < 0.001), apnea-hypopnea index (AHI ; r = 0.180, p = 0.001) and oxygen desaturation index (ODI ; r = 0.149, p = 0.004) were significantly correlated with SPT. Multiple regression analysis revealed that TST (t = 7.781, p < 0.001), snoring time (t = 3.794, p < 0.001), AHI (t = 3.768, p < 0.001) and NN50 count (t = 1.993, p = 0.047) were associated with SPT. Conclusion: SPT was more highly associated with sleep structure-related parameters than OSAS-related variables. SPT was correlated with TST, SE, AHI, snoring time and NN50 count. This suggests that SPT is likely to be determined by sleep structure, HRV and the severity of OSAS.
Keywords
Heart rate variability; Obstructive sleep apnea syndrome; Sleep structure; Supine position time;
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1 Bidarian-monir, Nilsson M, Rasmusson L, Attia J, Ejnell H. The effect of the prone sleeping position on obstructive sleep apnoea. Acta Oto-Laryngologica. 2015;135:79-84.   DOI
2 Cartwright RD. Effect of sleep position on sleep apnea severity. Sleep 1984;7:110-114.   DOI
3 Yalciner G, Babademez MA, Gul F. Association of sleep time in supine position with apnea-hypopnea index as evidenced by successive polysomnography. Sleep Breath 2017;21:289-294.   DOI
4 Hori T, Sugita Y, Koga E, Shirakawa S, Inoue K, Uchida S, et al. Proposed supplements and amendments to 'A Manual of Standardized Terminology, Techniques and Scoring System for Sleep Stages of Human Subjects', the Rechtschaffen & Kales (1968) standard. Psychiatry Clin Neurosci 2001;55:305-310.   DOI
5 Iber C, Ancoli-Israel S, Chesson AL Jr, Quan SF. The AASM manual for the scoring of sleep and associated events: rules, terminology and technical specifications. Westchester, IL: American Academy of Sleep Medicine;2007.
6 Kleiger RE, Stein PK, Bosner MS, Rottman JN. Time domain measurements of heart rate variability. Cardiol Clin 1992;10:487-98.   DOI
7 Leppanen T, Toyras J, Muraja-Murro A, Kupari S, Tiihonen P, Mervaala E, et al. Length of individual apnea events is increased by supine position and modulated by severity of obstructive sleep apnea. Sleep Disorders 2016;2016:9645347.
8 Mador MJ, Kufel TJ, Magalang UJ, Rajesh SK, Watwe V, Grant BJ. Prevalence of positional sleep apnea in patients undergoing polysomnography. Chest 2005;128:2130-2137.   DOI
9 Menon A, Kumar M. Influence of body position on severity of obstructive sleep apnea: a systematic review. ISRN Otolaryngol 2013;2013:670381.
10 Nakano H, Ikeda T, Hayashi M, Ohshima E, Onizuka A. Effects of body position on snoring in apneic and nonapneic snorers. Sleep 2003;2:169-172.
11 Oksenberg A, Silverberg D, Offenbach D, Arons E. Positional therapy for obstructive sleep apnea patients: a 6-month follow-up study. Laryngoscope 2006;116:1995-2000.   DOI
12 Oksenberg A, Gadoth N. Are we missing a simple treatment for most adult sleep apnea patients? The avoidance of the supine sleep position. J Sleep Res 2014;23:204-210.   DOI
13 Pevernagie DA, Shepard JW Jr. Relations between sleep stage, posture and effective nasal CPAP levels in OSA. Sleep 1992;15: 162-167.   DOI
14 Richard W, Kox D, Herder CD, Laman M, van Tinteren H, de Vries N. The role of sleep position in obstructive sleep apnea syndrome. Eur Arch Otorhinolaryngol 2006;263:946-950.   DOI
15 Silber MH, Ancoli-Israel S, Bonnet MH, Chokroverty S, Grigg-Damberger MM, Hirshkowitz M, et al. The visual scoring of sleep in adults. J Clin Sleep Med 2007;3:121-131.
16 Song MK, Ha JH, Ryu SH, Yu JH, Park DH. The effect of aging and severity of sleep apnea on heart rate variability indices in obstructive sleep apnea syndrome. Psychiatry Investig 2012;9: 65-72.   DOI
17 Sunnergren O, Brostrom A, Svanborg E. Positional sensitivity as a confounder in diagnosis of severity of obstructive sleep apnea. Sleep Breath 2013;17:173-179.   DOI
18 Yamakoshi S, Kasai T, Tomita Y, Takaya H, Kasagi S, Kawabata M, et al. Comparison of clinical features and polysomnographic findings between men and women with sleep apnea. J Thorac Dis 2016;8:145-151.
19 Tabata R, Yin M, Nakayama M, Ikeda M, Hata T, Shibata Y, et al. A preliminary study on the influence of obstructive sleep apnea upon cumulative parasympathetic system activity. Auris Nasus Larynx 2008;35:242-246.   DOI