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A pilot study in men to show the effects of postural fluid shifts on the severity of obstructive sleep apnea

  • Sleep Breathing Physiology and Disorders • Original Article
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Abstract

Purpose

Studies reveal that rostral fluid shifts due to body posture changes from standing to lying down may narrow the upper airway. However, without credible and direct experimental evidence, it remains unclear what the role of natural fluid redistribution in the neck is in affecting obstructive sleep apnea (OSA) severity. Our aim is using direct experimental evidence to determine whether or not postural fluid shifts affect OSA severity.

Methods

We performed overnight polysomnography on two consecutive nights for 22 men. The bed was set horizontally on the control night, while its tail part was lowered by 30° on the experimental night to reduce the amount of fluid shifted into the neck. We measured sleep and anthropometric parameters on each night.

Results

The mean (95% CI) apnea-hypopnea index (AHI) in the supine head and trunk position decreased from 66.6 events per hour (57.6–75.6) to 61.2 (52.0–70.4) (t = 4.507, p <0.001), and the oxygen desaturation index from 69.5 events per hour (56.4–82.6) to 61.6 (50.5–72.6) (t = 3.293, p = 0.004), from the control to the experimental night with a decrease in the change of leg fluid volume from 17.7% (15.7–19.8) to 4.7% (1.9–7.5) (t = 11.659, p < 0.001).

Conclusions

Our findings provide direct experimental evidence to show that natural fluid shift caused by the day-to-night posture change does contribute to OSA pathogenesis and severity. It is likely that the neck fluid increase from an actual day-to-night position change, with 90° change in posture, would produce a much larger AHI increase than the 11.2% found in this study, which contains only a 30° change in posture. These findings suggest that reducing the amount of fluid in the neck region may relieve airway obstructions for patients with moderate and severe OSA.

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Acknowledgements

This work was supported by the National Natural Science Foundation of China (31670959, 81171422); the National Science and Technology Pillar Program of China (2012BAI05B03); and the Key Projects in Science and Technology Program of Beijing Municipal Education Commission, China (KZ201210025022).

Funding

This study was supported by the National Natural Science Foundation of China (31670959, 81171422); the National Science and Technology Pillar Program of China [2012BAI05B03]; and the Key Projects in Science and Technology Program of Beijing Municipal Education Commission, China (KZ201210025022).

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Author notes

  1. Songjian Wang and Han Zhang contributed equally to this work.

Authors and Affiliations

  1. School of Biomedical Engineering, Capital Medical University, 10 Xitoutiao, Youanmenwai, Beijing, 100069, China

    Songjian Wang, Han Zhang, Xiaoqing Huang, Cunting Wang, Hongyi Lin, Huixiang Xu, Changjin Ji & Yaqi Huang

  2. Beijing Key Laboratory of Fundamental Research on Biomechanics in Clinical Application, Capital Medical University, Beijing, China

    Songjian Wang, Han Zhang, Xiaoqing Huang, Cunting Wang, Hongyi Lin, Huixiang Xu, Changjin Ji & Yaqi Huang

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  1. Songjian Wang
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  2. Han Zhang
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Correspondence to Yaqi Huang.

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Wang, S., Zhang, H., Huang, X. et al. A pilot study in men to show the effects of postural fluid shifts on the severity of obstructive sleep apnea. Sleep Breath 24, 1623–1631 (2020). https://doi.org/10.1007/s11325-020-02044-x

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  • DOI: https://doi.org/10.1007/s11325-020-02044-x

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