The objective of this study was to assess whether cervical positioning could improve mild to moderate cases of the obstructive sleep apnea syndrome (OSAS). Eighteen subjects recruited from a tertiary sleep disorders clinic population with mild to moderate cases of OSAS were evaluated using a custom-fitted cervical pillow designed to increase upper airway caliber by promoting head extension. The subjects used their usual pillows during two consecutive recorded baseline nights in our laboratory. They then used the cervical pillow for 5 days at home and returned for 2 consecutive recorded nights at our laboratory to use the cervical pillow. During the nights in our laboratory, the subjects completed questionnaires, were videotaped to record head and body position, and had full polysomnography. The subjects had a significant trend toward improvement in their respiratory disturbance indices with use of the cervical pillow, despite spending more time in the supine position and having similar amounts of REM sleep in the baseline and experimental conditions. They also had nonsignificant trends toward improvements in their sleep efficiency and subjective depth of their sleep as well as significantly fewer arousals and awakenings in the experimental compared with the baseline condition. We propose that cervical positioning (i.e., head extension) with a custom-fitted cervical pillow provides a simple, noninvasive, and comfortable means of reducing sleep-disordered breathing in patients with mild to moderate OSAS.
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Weiss JW, Launois SH, Anand A. Cardiorespiratory changes in sleep-disordered breathing. In: Kryger MH, Roth T, Dement WC, eds. Principles and Practice of Sleep Medicine. Philadelphia: WB Saunders; 2000:859–868
Findley LJ, Unverzagt ME, Suratt PM. Automobile accidents involving patients with obstructive sleep apnea. Am Rev Respir Dis 1988;138:337
American Sleep Disorders Association. International classification of sleep disorders, revised: diagnostic and coding manual Rochester, MN: American Sleep Disorders Association 1997; 52–58
Westhorpe RN. The position of the larynx in children and its relationship to the ease of intubation. Anaesth Intensive Care 1987;15:384–388
Shorten GD, Ali HH, Roberts JT. Assessment of patient position for fiberoptic intubation using videolaryngoscopy. J Clin Anesth 1995;7:31–34
Shorten GD, Armstrong DC, Roy WI, Brown L. Assessment of the effect of head and neck position on upper airway anatomy in sedated paediatric patients using magnetic resonance imaging. Paediatr Anaesth 1995;5:243–248
Liistro G, Stanescu D, Dooms G, Rodenstein D, Veriter C. J Appl Physiol 1988;641285–1288
Jan MA, Marshall I, Douglas NJ. Effect of posture on upper airway dimensions in normal human. Am J Respir Crit Care Med 1994;149:145–148
Hellsing E. Changes in the pharyngeal airway in relation to extension of the head. Eur J Orthod 1989;11:359–365
Kushida CA, Rao S, Guilleminault C, et al. Cervical positional effects on snoring and apneas. Sleep Research Online 1999;2:7–10
American Academy of Sleep Medicine. Sleep-related breathing disorders in adults: recommendations for syndrome definition and measurement techniques in clinical research. Sleep 1999;22:667–689
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Kushida, C.A., Sherrill, C.M.A., Hong, S.C. et al. Cervical Positioning for Reduction of Sleep-Disordered Breathing in Mild-to-Moderate OSAS. Sleep Breath 5, 71–78 (2001). https://doi.org/10.1007/s11325-001-0071-z
- Cervical positioning
- sleep-disordered breathing