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The Impact of Body Weight Changes on Body Posture Dominance in Adult Obstructive Sleep Apnea Patients

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Positional Therapy in Obstructive Sleep Apnea

Abstract

The aim of this work was to assess the relationship between changes of body posture dominance and changes of body weight over time in obstructive sleep apnea (OSA) patients. The participants were 112 nontreated adults with OSA who underwent two polysomnographic evaluations within an average of 6.2 years, at our sleep disorders unit. Positional patients (PP)—having most of their breathing abnormalities in the supine posture and who became non-positional patients (NPP)—had a significant gain in weight and a significant increase in apnea-hypopnea index (AHI), mainly in lateral AHI.

On the contrary, NPP who became PP had a significant decrease in weight and showed a significant improvement in AHI, again mainly in lateral AHI. These NPP who became PP had initially a less severe disease as judged by AHI, lateral AHI, and minimum SaO2 during non-REM sleep and were less obese than NPP who remained NPP. The latter patients, who showed initially the worst disease, were more obese than the rest of the patients, and their condition did not change significantly over time.

NPP who converted to PP showed a decrease in body weight and improvement of OSA, while PP who converted to NPP showed an increase in body weight and worsening of OSA. It appears that body weight changes have a modulatory effect on positional dominance, and lateral AHI appears to be a sensitive parameter of these changes.

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References

  1. Oksenberg A, Silverberg DS, Arons E, Radwan H. Positional vs nonpositional obstructive sleep apnea patients. Anthropomorphic, nocturnal polysomnographic and multiple sleep latency test data. Chest. 1997;112:629–39.

    Article  CAS  PubMed  Google Scholar 

  2. Oksenberg A, Arons E, Greenberg-Dotan S, Nasser K, Radwan H. The significance of body posture on breathing abnormalities during sleep: data analysis of 2077 obstructive sleep apnea patients. Harefuah. 2009;148:157–62 (Article in Hebrew).

    Google Scholar 

  3. Mador MJ, Kufel TJ, Magalang UJ, Rajesh SK, Watwe V, Grant JB. Prevalence of Positional sleep apnea in patients undergoing polysomnography. Chest. 2005;128:2130–7.

    Article  PubMed  Google Scholar 

  4. Richard W, Kox D, den Herder C, Laman M, van Tinteren H, de Vries N. The role of sleep position in obstructive sleep apnea syndrome. Eur Arch Otorhinolaryngol. 2006;263:946–50.

    Article  PubMed  Google Scholar 

  5. Young T, Palta M, Dempsey J, Skatrud J, Weber S, Badr S. The occurrence of sleep disordered breathing among middle-aged adults. N Engl J Med. 1993;328:1230–5.

    Article  CAS  PubMed  Google Scholar 

  6. Oksenberg A, Silverberg DS. Avoiding the supine posture during sleep for patients with mild obstructive sleep apnea. Am J Respir Crit Care Med. 2009;180:101. (letter); author reply 101–2.

    Article  PubMed  Google Scholar 

  7. Mo JH, Lee CH, Rhee CS, Yoon IY, Kim JW. Positional dependency in Asian patients with obstructive sleep apnea and its implication for hypertension. Arch Otolaryngol Head Neck Surg. 2011;137:786–90.

    Article  PubMed  Google Scholar 

  8. Teerapraipruk B, Chirakalwasan N, Simon R, Hirunwiwatkul P, Jaimchariyatam N, Desudchit T, et al. Clinical and polysomnographic data of positional sleep apnea and its predictors. Sleep Breath. 2012;16:1167–72.

    Article  PubMed  Google Scholar 

  9. Lee CH, Jung HJ, Lee WH, Rhee CS, Yoon IY, Yun PY, et al. The effect of positional dependency on outcomes of treatment with a mandibular advancement device. Arch Otolaryngol Head Neck Surg. 2012;138:479–83.

    Article  PubMed  Google Scholar 

  10. Rosenthal L, Gerhardstein R, Lumley A, Guido P, Day R, Syron ML, et al. CPAP therapy in patients with mild OSA: implementation and treatment outcome. Sleep Med. 2000;1:215–20.

    Article  PubMed  Google Scholar 

  11. Berger G, Berger R, Oksenberg A. Progression of snoring and obstructive sleep apnea: the role of increasing weight and time. Eur Respir J. 2009;33:338–45.

    Article  CAS  PubMed  Google Scholar 

  12. Peppard PE, Young T, Palta M, Dempsey J, Skatrud J. Longitudinal study of moderate weight changes and sleep disordered breathing. JAMA. 2000;284:3015–21.

    Article  CAS  PubMed  Google Scholar 

  13. Redline S, Schluchter MD, Larkin EK, Tishler PV. Predictors of longitudinal change in sleep-disordered breathing in a non-clinic population. Sleep. 2003;26:703–9.

    PubMed  Google Scholar 

  14. Newman AB, Foster G, Givelber R, Nieto FJ, Redline S, Young T. Progression and regression of sleep-disordered breathing with changes in weight: the Sleep Heart Health Study. Arch Intern Med. 2005;165:2408–13.

    Article  PubMed  Google Scholar 

  15. Randerath WJ, Verbraecken J, Andreas S, Bettega G, Boudewyns A, Hamans E, et al. Non CPAP therapies in obstructive sleep apnea. Eur Respir J. 2011;37:1000–28.

    Article  CAS  PubMed  Google Scholar 

  16. Rechtschaffen A, Kales A, editors. A manual of standardized terminology techniques and scoring system for sleep stages of human subjects. Los Angeles, CA: Brain Information Service/Brain Research Institute, University of California at Los Angeles; 1968.

    Google Scholar 

  17. Guilleminault C, editor. Sleep and breathing in sleeping and waking disorders: indications and techniques. Menlo Park, CA: Addison-Wesley; 1982. p. 155–82.

    Google Scholar 

  18. Johns MW. A new method for measuring daytime sleepiness: the Epworth sleepiness scale. Sleep. 1991;14:540–5.

    CAS  PubMed  Google Scholar 

  19. Saigusa H, Suzuki M, Higurashi N, Kodera K. Three-dimensional morphological analyses of positional dependence in patients with obstructive sleep apnea syndrome. Anesthesiology. 2009;110:885–90.

    Article  PubMed  Google Scholar 

  20. Schwab RJ, Pasirstein M, Pierson R, Mackley A, Hachadoorian R, Arens R, et al. Identification of upper airway anatomic risk factors for obstructive sleep apnea with volumetric magnetic resonance imaging. Am J Respir Crit Care Med. 2003;168:522–30.

    Article  PubMed  Google Scholar 

  21. Spiegel K, Tasali E, Penev P, Van Cauter E. Sleep curtailment in healthy young men is associated with decreased leptin levels, elevated ghrelin levels, and increased hunger and appetite. Ann Intern Med. 2004;141:846–56.

    Article  PubMed  Google Scholar 

  22. Pillar G, Shehadeh N. Abdominal fat and sleep Apnea. The chicken or the egg? Diabetes Care. 2008;31 Suppl 2:S303–9.

    Article  PubMed  Google Scholar 

  23. Vgontzas AN, Bixler EO, Tan TL, Kantner D, Martin LF, Kales A. Obesity without sleep apnea is associated with daytime sleepiness. Arch Intern Med. 1998;158:1333–7.

    Article  CAS  PubMed  Google Scholar 

  24. Greenburg DL, Lettieri CJ, Eliasson AH. Effects of surgical weight loss on measures of obstructive sleep apnea: a meta-analysis. Am J Med. 2009;122:535–42.

    Article  PubMed  Google Scholar 

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Correspondence to Arie Oksenberg Ph.D. .

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Oksenberg, A., Dynia, A., Nasser, K., Goizman, V., Eitan, E., Gadoth, N. (2015). The Impact of Body Weight Changes on Body Posture Dominance in Adult Obstructive Sleep Apnea Patients. In: de Vries, N., Ravesloot, M., van Maanen, J. (eds) Positional Therapy in Obstructive Sleep Apnea. Springer, Cham. https://doi.org/10.1007/978-3-319-09626-1_18

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  • DOI: https://doi.org/10.1007/978-3-319-09626-1_18

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-09625-4

  • Online ISBN: 978-3-319-09626-1

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