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The effect of body position on airway patency in obstructive sleep apnea: CT imaging analysis

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Abstract

Purpose

Positional change during sleep influences upper airway patency. However, few studies have used imaging techniques to demonstrate the change. This study aims to determine the effect of positional change on the upper airway space.

Methods

A total of 118 subjects with sleep breathing disorders were analyzed. Participants underwent upper airway CT scans in the supine and lateral decubitus positions (right and left). They were divided into non-obstructive sleep apnea (n = 28) and obstructive sleep apnea (n = 90) groups. We measured the minimal cross-sectional area of the retropalatal/retroglossal spaces and compared the differences of those two spaces in the supine and lateral positions. CT was performed while patients were awake.

Results

The minimal cross-sectional area in the OSA group was significantly smaller than non-OSA group in both supine (median[interquartile range], 8.3[0.0–25.1] vs 22.2[1.0–39.6]; P = 0.018) and lateral decubitus positions (5.2[0.0–16.9] vs 21.3[6.1–38.4]; P = 0.002). As the body position of OSA patients shifted from supine to lateral, the retroglossal space increased significantly (67.3[25.1–116.3] vs 93.3[43.4–160.1]; P < 0.001). However, there was no significant difference in the retropalatal space between the supine and lateral decubitus positions.

Conclusions

Positional change from the supine to lateral decubitus position expands the upper airway lumen, especially the retroglossal space. Positional OSA may be related to anatomical change of the upper airway lumen based on body position.

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Funding

This research was supported by the Basic Science Research Program through the National Research Foundation of Korea (NRF), funded by the Ministry of Education of the Korean government (NRF-2017R1D1A1B03028964).

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Author notes

  1. Woo Young Kim and Seung-No Hong contributed equally to this work.

Authors and Affiliations

  1. Department of Internal Medicine, Westchester Medical Center and New York Medical College, Valhalla, NY, USA

    Woo Young Kim

  2. Department of Otorhinolaryngology, Boramae Medical Center, Seoul National University College of Medicine, Seoul, Republic of Korea

    Seung-No Hong & Seung Koo Yang

  3. Department of Otorhinolaryngology-Head and Neck Surgery, Korea University College of Medicine, Korea University of Ansan Hospital, 123, Jeokgeum-ro, Danwon-gu, Ansan-si, Gyeonggi-do, 15355, South Korea

    Kuk Jin Nam, Kang Hyeon Lim, Sun Jin Hwang, Min Young Seo & Seung Hoon Lee

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  1. Woo Young Kim
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Correspondence to Seung Hoon Lee.

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The authors declare that they have no conflicts of interest.

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Informed consent was obtained from all individual participants included in the study.

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The institutional review board reviewed and approved the research protocol.

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Kim, W.Y., Hong, SN., Yang, S.K. et al. The effect of body position on airway patency in obstructive sleep apnea: CT imaging analysis. Sleep Breath 23, 911–916 (2019). https://doi.org/10.1007/s11325-019-01863-x

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  • DOI: https://doi.org/10.1007/s11325-019-01863-x

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