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Development of positional obstructive sleep apnea (POSA) after upper airway surgery in OSA patients

  • Sleep Breathing Physiology and Disorders • Original Article
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Abstract

Purpose

Positional therapy (PT) has become more reliable for obstructive sleep apnea (OSA) patients with the use of new devices. The objectives of this study were to determine the preoperative prevalence of positional OSA (POSA) in our population of surgically treated patients and the proportion of patients who developed POSA after surgery and might improve with additional positional therapy.

Methods

This was a retrospective study of surgically treated OSA patients from 1999 to 2017. The Cartwright definition was used to define POSA. All patients completed a sleep study before and 6 months after surgery and a complete upper airway (UA) exploration (awake ± DISE). A total of 125 patients were included.

Results

The global prevalence of POSA before surgery was 31.2%. In those who were cured by surgery, the preoperative prevalence of POSA was 38.3%. Having POSA was not related with surgical success outcome. For patients not cured by surgery, the proportion of POSA significantly increased from 25.64 to 53.85% after surgery. Eighteen patients of them (23.1%) achieved AHI < 5/h in a lateral position. In those patients, PT with Night-Shift™ was suggested, 50% of them accepted it and 88.9% of them experienced excellent satisfaction. Lateral velum collapse and the absence of concentric collapse at the tongue base had statistical relationships with the development of POSA.

Conclusions

The prevalence of POSA is increased after surgery in patients with persistent OSA after surgery. In these patients, the development of POSA gives an extra therapeutic chance as 23.1% of these cases can be successfully treated by using PT.

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Authors and Affiliations

  1. Hospital Universitario Dr. Peset, Avenida Gaspar Aguilar 90, 46017, Valencia, Spain

    Paula Martínez Ruiz de Apodaca, Marina Carrasco Llatas, Silvia Matarredona Quiles & José Dalmau Galofre

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  1. Paula Martínez Ruiz de Apodaca
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  2. Marina Carrasco Llatas
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  3. Silvia Matarredona Quiles
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  4. José Dalmau Galofre
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Correspondence to Marina Carrasco Llatas.

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All procedures in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Martínez Ruiz de Apodaca, P., Carrasco Llatas, M., Matarredona Quiles, S. et al. Development of positional obstructive sleep apnea (POSA) after upper airway surgery in OSA patients. Sleep Breath 24, 849–856 (2020). https://doi.org/10.1007/s11325-019-01910-7

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