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Morbidity and mortality risk ratios are elevated in severe supine dominant OSA: a long-term follow-up study

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Abstract

Purpose

Obstructive sleep apnoea (OSA) is a common public health problem. Sleeping position dependency has been related to OSA, and around half of OSA patients suffer from positional OSA where majority of the respiratory events occur in supine position. The consequences of supine dominant OSA have not been thoroughly investigated in long-term follow-up studies. The aim of the study was to retrospectively investigate the effects of supine dominant OSA on morbidity and mortality risk ratios during long-term follow-up and compare the findings with a non-supine OSA group at different OSA severities.

Methods

Ambulatory polygraphic recordings of 793 patients with median follow-up time of 194.5 months were retrospectively analysed. The risk ratios of morbidity and mortality of supine dominant OSA and non-supine OSA patients were compared.

Results

Supine dominant OSA patients, having majority of the obstruction events occurring in supine position, showed higher mortality and morbidity risk ratios in severe OSA category than the non-supine OSA patients. In severe category, the observed risk ratios were statistically significant.

Conclusions

The increased risk ratios of mortality and morbidity found further emphasises that supine OSA might have more severe health consequences than non-positional OSA especially in severe OSA. Severe OSA occurring in supine position was shown to be more deleterious than non-supine OSA based on long-term mortality and morbidity evidence.

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Acknowledgments

The study was financially supported by the Seinäjoki Central Hospital, the Competitive State Research Financing of the Expert Responsibility area of Tampere University Hospital Grant Numbers VTR3040 and VTR3114 and by Kuopio University Hospital (Competitive State Research Financing, project 5041732 and project 5041740). The authors have no financial or personal relationships with other people or organisation that could have inappropriately influenced the study presented in this paper.

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Authors and Affiliations

  1. Department of Clinical Neurophysiology, Seinäjoki Central Hospital, 60220, Seinäjoki, Finland

    Antti Kulkas

  2. Department of Clinical Neurophysiology, Kuopio University Hospital, Kuopio, Finland

    Anu Muraja-Murro, Pekka Tiihonen, Esa Mervaala & Juha Töyräs

  3. Institute of Clinical Medicine, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland

    Anu Muraja-Murro & Esa Mervaala

  4. Department of Applied Physics, University of Eastern Finland, Kuopio, Finland

    Antti Kulkas & Juha Töyräs

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  1. Antti Kulkas
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  2. Anu Muraja-Murro
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  3. Pekka Tiihonen
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Correspondence to Antti Kulkas.

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Kulkas, A., Muraja-Murro, A., Tiihonen, P. et al. Morbidity and mortality risk ratios are elevated in severe supine dominant OSA: a long-term follow-up study. Sleep Breath 19, 653–660 (2015). https://doi.org/10.1007/s11325-014-1071-0

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  • DOI: https://doi.org/10.1007/s11325-014-1071-0

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