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The effect of head rotation on OSA is associated with disease severity: a cross-sectional study

  • Laryngology
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

Purpose

Head rotation is an effective positional therapy for obstructive sleep apnea (OSA). However, not all OSA patients benefit from head rotation. This study aimed to explore the clinical phenotype of OSA patients who can benefit from head rotation.

Methods

We performed a retrospective review of 184 consecutive OSA patients who underwent polysomnography. Head rotation in supine position was determined by high-quality video recording. According to the changes in apnea–hypopnea index (AHI) after head rotation, OSA patients were divided into two groups: patients with response to head rotation(HR) and patients without response to head rotation(NHR). Demographic factors and overnight polysomnography were analyzed.

Results

Compared with NHR group, HR group showed significantly lower AHI (51.8 vs 31.5, p < 0.01), time spent with oxygen saturation below 90%(5.3% vs 0.51%, p < 0.01), and higher lowest oxygen saturation(80% vs 86%, p < 0.05). Logistic regression showed that AHI was an independent factor to predict the decrease of AHI in head rotation (OR 0.985, 95% CI 0.970–0.979, p < 0.05). Among mild to moderate group (AHI < 30/h), severe group (30/h ≤ AHI < 60/h), and extremely severe group (AHI ≥ 60/h), the percentage decrease of AHI in head rotation was 18.5%, 9.5%, and 2.6%, respectively. Surprisingly, the percentage decrease of AHI of 6 responders in mild to moderate group was more than 50%.

Conclusion

OSA patients who respond well to head rotation have less severe disease, and patients with mild to moderate OSA are more likely to improve and benefit from this position. Our research provides potential strategies and insights into the individual treatment of OSA patients.

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Data availability

Data is not available due to ethical restrictions.

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Acknowledgements

We thank all the patients and the staff from the Department of Otolaryngology and sleep medical center, Beijing Anzhen Hospital, China, who have participated in this study.

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Authors and Affiliations

  1. Department of Otolaryngology Head and Neck Surgery, Air Force Medical Center, PLA, Beijing, 100142, China

    Jiajia Dong, Honglei Zhang & Rui Guo

  2. Key Laboratory of Upper Airway Dysfunction-Related Cardiovascular Diseases, Beijing Anzhen Hospital, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Capital Medical University, Beijing, 100029, China

    Haili Sun

  3. Department of Otolaryngology Head and Neck Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, 100029, China

    Jiajia Dong

Authors
  1. Jiajia Dong
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  2. Haili Sun
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  3. Honglei Zhang
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  4. Rui Guo
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Contributions

JD designed the experimental apparatus, discussed the results and implications, and commented on the manuscript at all stages. JD performed the experiments. The research direction was provided by HZ and RG. HS helped to check the English.

Corresponding author

Correspondence to Rui Guo.

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Conflict of interest

The authors have no relevant financial or non-financial interests to disclose.

Ethics approval

The Medical Ethics Committee of Beijing Anzhen Hospital (No. 2017063X) approved this study.

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Dong, J., Sun, H., Zhang, H. et al. The effect of head rotation on OSA is associated with disease severity: a cross-sectional study. Eur Arch Otorhinolaryngol 280, 3279–3285 (2023). https://doi.org/10.1007/s00405-023-07860-x

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  • DOI: https://doi.org/10.1007/s00405-023-07860-x

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