Evaluation of position dependency in non-apneic snorers


The aims of this study are to determine the prevalence of position dependency in non-apneic snorers, as defined by the American Academy of Sleep Medicine (AASM) guidelines, and to investigate the influence of various factors such as BMI, neck circumference, age, gender, and sleep efficiency on sleeping position. A cohort of consecutive patients was screened for complaints of excessive snoring or symptoms suspicious for sleep disordered breathing. Overnight polysomnographic data were collected and non-apneic snorers who met all the inclusion criteria were selected for statistical analysis. To assess position-dependent snoring, the snore index (total snores/h) was used. Supine-dependent patients were defined as having a supine snore index higher than their total non-supine snore index. 76 patients were eligible for statistical analysis. Prevalence of position dependency in non-apneic snorers was 65.8 % (p < 0.008). A stepwise regression showed that only BMI had a significant effect (p < 0.003) on the supine snore index. This is the first study that uses the AASM guidelines to accurately define non-apneic snorers (AHI < 5) and provides scientific evidence that the majority of non-apneic snorers are supine dependent. Furthermore, these results show that non-apneic snorers with a higher BMI snore more frequently in supine position. The use of sleep position therapy therefore, has the potential to play a significant role in improving snoring and its associated physical and psychosocial health outcomes in this population.

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The authors wish to thank Ellen Beekman and Eduard van Giesen from the Clinical Neurophysiology and Noera Kieviet, resident in Epidemiology St Lucas Andreas Hospital, for providing access to data and guidance of writing the manuscript and statistical analysis.

Conflict of interest

N de Vries is member of the Medical advisory board of MSD, ReVent Medical and NightBalance, is investigator for Inspire, has had honoraria payments from MSD, is consultant for Philips and has stock options in ReVent Medical. None of the other authors has any financial support or conflict of interest to disclose.

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Correspondence to L. B. L. Benoist.

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Benoist, L.B.L., Morong, S., van Maanen, J.P. et al. Evaluation of position dependency in non-apneic snorers. Eur Arch Otorhinolaryngol 271, 189–194 (2014). https://doi.org/10.1007/s00405-013-2570-5

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  • Habitual snoring
  • Position dependency
  • Non-apneic snorers
  • Polysomnography
  • Positional therapy