Abstract
In this chapter, we discuss the various definitions of position-dependent obstructive apnea. The first was introduced in 1984 by Cartwright, who suggested that physicians should differentiate between patients with either positional (POSA) or non-positional obstructive sleep apnea.
Treatment of POSA has advanced dramatically recently with the introduction of a new generation of positional therapy (PT), a small device attached to either the neck or chest which corrects the patient from adopting the supine position through a vibrating stimulus. Encouraging data have been published suggesting that this simple therapy successfully prevents patients with POSA from adopting the supine position without negatively influencing sleep efficiency, as well as allowing for good adherence. Unfortunately, evaluating the efficacy of PT and comparing results are hindered by the fact that there are no universally used POSA criteria.
In this chapter a new classification system is discussed called the Amsterdam Positional OSA Classification (APOC) aimed at identifying suitable candidates for PT: patients who will benefit from a clinically, significant improvement of their OSA with PT.
The shared use of this classification can facilitate collection of data across multiple centres and comparison of results across studies.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
van Maanen JP, Meester KA, Dun LN et al. The sleep position trainer: a new treatment for positional obstructive sleep apnoea. Sleep Breath. 2013;17:771ā9.
van Maanen JP, Richard W, Van Kesteren ER et al. Evaluation of a new simple treatment for positional sleep apnoea patients. J Sleep Res. 2012;21:322ā9.
Bignold JJ, Mercer JD, Antic NA, McEvoy RD, Catcheside PG. Accurate position monitoring and improved supine-dependent obstructive sleep apnea with a new position recording and supine avoidance device. J Clin Sleep Med. 2011;7(4):376ā83.
Cartwright RD. Effect of sleep position on sleep apnea severity. Sleep. 1984;7(2):110ā4.
Oksenberg A, Khamaysi I, Silverberg DS, Tarasiuk A. Association of body position with severity of apneic events in patients with severe nonpositional obstructive sleep apnea. Chest. 2000;118(4):1018ā24.
Cartwright RD, Diaz F, Lloyd S. The effects of sleep posture and sleep stage on apnea frequency. Sleep. 1991;14(4):351ā3.
Marklund M, Persson M, Franklin KA. Treatment success with a mandibular advancement device is related to supine-dependent sleep apnea. Chest. 1998;114(6):1630ā5.
Permut I, Diaz-Abad M, Chatila W, Crocetti J, Gaughan JP, DāAlonzo GE, Krachman SL. Comparison of positional therapy to CPAP in patients with positional obstructive sleep apnea. J Clin Sleep Med. 2010;6(3):238ā43.
Mador MJ, Kufel TJ, Magalang UJ, Rajesh SK, Watwe V, Grant BJB. Prevalence of positional sleep apnea in patients undergoing polysomnography. Chest. 2005;128(4):2130ā7.
Bignold JJ, Mercer JD, Antic NA, McEvoy RD, Catcheside PG. Accurate position monitoring and improved supine-dependent obstructive sleep apnea with a new position recording and supine avoidance device. J Clin Sleep Med. 2011;7(4):376ā83.
Frank MH, Ravesloot MJL, van Maanen JP, Verhagen E, de Lange J, de Vries N. Positional OSA part 1: towards a clinical classification system for position-dependent obstructive sleep apnoea. Sleep Breath. 2014 [Epub ahead of print].
Iber C, Ancoli-Israel S, Chesson Jr AL, Quan SF, for the American Academy of Sleep Medicine. The AASM manual for the scoring of sleep and associated events: rules, terminology and technical specifications. 1st ed. Westchester, IL: American Academy of Sleep Medicine; 2007.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
Ā© 2015 Springer International Publishing Switzerland
About this chapter
Cite this chapter
Ravesloot, M., Frank, M.H., van Maanen, J.P., Verhagen, E.A., de Lange, J., de Vries, N. (2015). Towards a Clinical Classification System for Position-Dependent Obstructive Sleep Apnea. In: de Vries, N., Ravesloot, M., van Maanen, J. (eds) Positional Therapy in Obstructive Sleep Apnea. Springer, Cham. https://doi.org/10.1007/978-3-319-09626-1_11
Download citation
DOI: https://doi.org/10.1007/978-3-319-09626-1_11
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-09625-4
Online ISBN: 978-3-319-09626-1
eBook Packages: MedicineMedicine (R0)