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Management of Sleep Disorders-Sleep Technology on Positional Therapy

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Introduction to Modern Sleep Technology

Part of the book series: Intelligent Systems, Control and Automation: Science and Engineering ((ISCA,volume 64))

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Abstract

Positional patients are defined as obstructive sleep apnea (OSA) patients in whom respiratory disturbance index (RDI) or apnea-hypopnea index (AHI) is at least twice as high in the supine position than in the non-supine position. Positional therapy (the avoidance of the supine posture during sleep) is a simple behavioral therapy for mild and moderate sleep disordered breathing. In this chapter, we 1) provide an overview of position dependent sleep and positional therapy for sleep disordered breathing, 2) update the clinical evidence for positional therapy and position dependent sleep advances in sleep technology, and 3) discuss issues regarding implementing positional therapy.

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References

  1. Hiestand DM, Britz P, Goldman M, Phillips B (2005) Prevalence of symptoms and risk of sleep apnea in the US population-results from the national sleep foundation sleep in America 2005 poll. Chest 130(3):780–6

    Article  Google Scholar 

  2. Kim JK, In KH, Kim JH, You SH, Kang KH, Shim JJ, Lee SY, Lee JB, Lee SG, Park C, Shin C (2004) Prevalence of sleep-disordered breathing in middle-aged Korean men and women. Am J Respir Crit Care Med 170(10):1108–13

    Article  Google Scholar 

  3. O’Connor GT, Caffo B, Newman AB, Quan SF, Rapoport DM, Redline S, Resnick HE, Samet J, Shahar E (2009) Prospective study of sleep-disordered breathing and hypertension: the sleep heart health study. Am J Respir Crit Care Med 179(12):1159–64

    Article  Google Scholar 

  4. Peppard PE, Young T, Palta M, Skatrud J (2000) Prospective study of the association between sleep-disordered breathing and hypertension. N Eng J Med 342(19):11378–84

    Article  Google Scholar 

  5. Redline S, Yenokyan G, Gottlieb DJ, Shahar E, O’Connor GT, Resnick HE, Diener-West M, Sanders MH, Wolf PA, Geraghty EM, Ali T, Lebowitz M, Punjabi NM (2010) Obstructive sleep apnea-hypopnea and incident stroke: the sleep heart health study. Am J Respir Crit Care Med 182(2):269–77

    Article  Google Scholar 

  6. Resnick HE, Redline S, Shahar E, Gilpin A, Newman A, Walter R, Ewy GA, Howard BV, Punjabi NM (2003) Diabetes and sleep disturbances: findings from the sleep heart health study. Diabetes Care 26(3):702–9

    Article  Google Scholar 

  7. Veasey SC, Guilleminault C, Strohl KP, Sanders MH, Ballard RD, Magalang UJ (2006) Medical therapy for obstructive sleep apnea: a review by the medical therapy for obstructive sleep apnea task force of the standards of practice committee of the American Academy of sleep medicine. Sleep 29(8):1036–44

    Google Scholar 

  8. Kushida CA, Littner MR, Morgenthaler T, Alessi CA, Bailey D, Coleman J Jr, Friedman L, Hirshkowitz M, Kapen S, Kramer M, Lee-Chiong T, Loube DL, Owens J, Pancer JP, Wise M (2005) Practice parameters for the indications for polysomnography and related procedures: an update for 2005. Sleep 28(4):499–521

    Google Scholar 

  9. Morgenthaler TI, Kapur VK, Brown T, Swick TJ, Alessi C, Aurora RN, Boehlecke B, Chesson AL Jr, Friedman L, Maganti R, Owens J, Pancer J, Zak R (2007) Standards of practice committee of the American academy of sleep medicine: 2007, practice parameters for the treatment of narcolepsy and other hypersomnias of central origin. Sleep 30(12):1705–11

    Google Scholar 

  10. Weaver TE, Grunstein RR (2008) Adherence to continuous positive airway pressure therapy: the challenge to effective treatment. Proc Am Thorac Soc 5(2):173–8

    Article  Google Scholar 

  11. Littner MR (2007) Mild obstructive sleep apnea syndrome should npot be treated. J Clin Sleep Med 3(3):263–4

    Google Scholar 

  12. Rosenthal L, Gerhardstein R, Lumley A, Guido P, Day R, Syron ML, Roth T (2000) CPAP therapy in patients with mild OSA: implementation and treatment outcome. Sleep Med 1(3):215–20

    Article  Google Scholar 

  13. Oksenberg A, Siverberg D, Offenbach D, Arons E (2006) Positional therapy for obstructive sleep apnea patients: a 6-month follow-up study. Laryngoscope 116:1995–2000

    Article  Google Scholar 

  14. Cartwright RD (1984) Effective sleep position on sleep apnea severity. Sleep 7(2):100–14

    Google Scholar 

  15. Oksenberg A, Siverberg D (1998) The effect of body posture on sleep-related breathing disorders: facts and therapeutic implications. Sleep Med Rev 2(3):139–62

    Article  Google Scholar 

  16. Jokic R, Klimaszewski A, Crossly M, Sridhar G, Fitzpatrick MF (1999) Positional treatment vs continuous positive airway pressure in patients with positional obstructive sleep apnea syndrome. Chest 115(3):771–81

    Article  Google Scholar 

  17. Permut I, Diaz-Abad M, Chatila W, Crocetti J, Gaughan JP, D’Alonzo GE, Krachman SL (2010) Comparison of positional therapy to CPAP in patients with positional obstructive sleep apnea. J Clin Sleep Med 6(3):238–43

    Google Scholar 

  18. Mador MJ, Kufel TJ, Magalang UJ, Rajesh SK, Watwe V, Grant BJ (2005) Prevalence of positional sleep apnea in patients undergoing polysomnography. Chest 128(4):2130–7

    Article  Google Scholar 

  19. Oksenberg A (2005) Images in sleep medicine: positional and non-positional obstructive sleep apnea patients. Sleep Med 6:377–8

    Article  Google Scholar 

  20. George CF, Millar TW, Kryger MH (1988) Sleep apnea and body position during sleep. Sleep 11:90–9

    Google Scholar 

  21. Kavey NB, Blitzer A, Gidro-Frank S, Korstanje K (1985) Sleeping position and sleep apnea syndrome. Am J Otolaryngol 6(5):373–7

    Article  Google Scholar 

  22. Lloyd SR, Cartwright RD (1987) Physiologic basis of therapy for sleep apnea(letter). Am Rev Respir Dis 136:525–6

    Article  Google Scholar 

  23. Miles L, Bailey A (1990) Evaluation of sleep apnea treatment must be related to sleep position. Sleep Res 19:256

    Google Scholar 

  24. Oksenberg A, Silverberg DS, Arons E, Radwan H (1997) Positional vs nonpositional obstructive sleep apnea patients: thropomorphic, nocturnal polysomnographic, and multiple sleep latency test data. Chest 112(3):629–39

    Article  Google Scholar 

  25. Pevernagies DA, Shepard JW (1992) Relations between sleep tage, posture and effective nasal CPAP levels in OSA. Sleep 15(2):162–7

    Google Scholar 

  26. Kim EJ, Choi H, Kang SM, Choi JH, Kwan SY, Lee SH (2009) The prevalence and characteristics positional sleep apnea in Korea. Korean J Otorhinolaryngol Head Neck Surg 52:407–12

    Article  Google Scholar 

  27. Richard W, Kox D, den Herder C, Laman M, Tinteren H, de Vries N (2006) The role of sleep position in obstructive sleep apnea syndrome. Eur Arch Otorhinolaryngol 263(10):946–50

    Article  Google Scholar 

  28. Braver HM, Block AJ (1994) Effect of nasal spray, positional therapy, and the combination thereof in the asymptomatic snorer. Sleep 17(6):516–21

    Google Scholar 

  29. Nakano H, Ikeda T, Hayashi M, Ohshima E, Onizuka A (2003) Effects of body position on snoring in apneic and nonapneic snorers. Sleep 26(2):169–72

    Google Scholar 

  30. Choi JH, Park YH, Hong JH, Park DS, Miyazaki S, Lee SH, Shin C, Lee JB (2009) Efficacy study of a vest-type device for positional therapy in position dependent snorers. Sleep Biol Rhythm 7(3):181–7

    Article  Google Scholar 

  31. Cartwright RD, Lloyd SR (1991) The sleep stage and sleep position effects in the apnea severity in positional patients. Sleep Res 20:218

    Google Scholar 

  32. Penzel T, Möller M, Becker HF, Knaack L, Peter JH (2001) Effect of sleep position and sleep stage on the collapsibility of the upper airways in patients with sleep apnea. Sleep 24(1):90–5

    Google Scholar 

  33. Remmers JE, DeGroot WJ, Sauerland EK, Anch AM (1978) Pathogenesis of upper airway occulsion during sleep. J Appl Physiol 44:931–8

    Google Scholar 

  34. McEvoy RD, Sharp DJ, Thornton AT (1986) The effects of posture on obstructive sleep apnea. Am Rev Respir Dis 133:662–6

    Google Scholar 

  35. Skinner M, Kingshott R, Jones D, Homan S, Taylor D (2004) Elevated posture for the management of obstructive sleep apnea. Sleep Breath 8:193–200

    Article  Google Scholar 

  36. Zuberi N, Rekab K, Nguyen H (2004) Sleep apnea avoidance pillow effects on obstructive sleep apnea syndrome and snoring. Sleep Breath 8:201–7

    Article  Google Scholar 

  37. Choi J, Goldman M, Koyal S, Clark G (2000) Effect of jaw and head position on airway resistance in obstructive sleep apnea. Sleep Breath 4:163–8

    Article  Google Scholar 

  38. Hiyama S, Ono T, Ishiwata Y, Kuroda T (2000) Supine cephalopmetric study on sleep-related changes in upper-airway structures in normal subjects. Sleep 23:783–90

    Google Scholar 

  39. Kushida CA, Sherrill CM, Hong SC, Palombini L, Hyde P, Dement WC (2001) Cervical positioning for reduction of sleep disorder breathing in mild to moderate obstructive sleep apnea syndrome. Sleep Breath 5:71–8

    Article  Google Scholar 

  40. Bliwise DL, Irbe D, Schulman DA (2004) Improvement in obstructive sleep apnea in the supine “knees-up” position. Sleep Breath 8:43–7

    Article  Google Scholar 

  41. Geer S, Straight LB, Schulman DA, Bliwise DL (2006) Effect of supine knee position on obstructive sleep apnea. Sleep Breath 10:98–101

    Article  Google Scholar 

  42. Lee JB, Park YH, Hong JH, Lee SH, Jung KH, Kim JH, Yi H, Shin C (2009) Determining optimal sleep position in patients with positional sleep-disordered breathing using response surface analysis. J Sleep Res 18:26–35

    Article  Google Scholar 

  43. Cartwright R, Ristanovic R, Diaz F, Caldarelli D, Alder G (1991) A comparative study of treatments for positional sleep apnea. Sleep 14(6):546–52

    Google Scholar 

  44. Loord H, Hultcrantz E (2007) Positioner–a method for preventing sleep apnea. Acta Otolarygol 127(8):861–8

    Article  Google Scholar 

  45. Rajagopal KR, Bennett LL, Dillard TA, Tellis CJ, Tenholder MF (1986) Overnight nasal CPAP improves hypersomnolence in sleep apnea. Chest 90(2):172–6

    Article  Google Scholar 

  46. Engleman HM, Martin SE, Deary IJ, Douglas NJ (1994) Effect of continuous positive airway pressure treatment on daytime function in sleep apnoea/hypopnoea syndrome. Lancet 343(8897):572–5

    Article  Google Scholar 

  47. Bignoid JJ, Deans-Costi G, Goldsworthy MR, Robertson CA, McEvoy D, Catcheside PG, Mercer JD (2009) Poor long-term patients compliance with the tennis ball technique for treating positional obstructive sleep apnea. J Clin Sleep Med 5(5):428–30

    Google Scholar 

  48. Braver HM, Block AJ, Perri MJ (1995) Treatment for snoring. Combined weight loss, sleeping on side and nasal spray. Chest 107(5):1283–8

    Article  Google Scholar 

  49. Chung JW, Enciso R, Levendowski DJ, Morgan TD, Westbrook PR, Clark GT (2010) Treatment outcomes of mandibular advancement devices in positional and nonpositional PSA patients. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 109(5):724–31

    Article  Google Scholar 

  50. Bradley TD, Floras JS (2003) Sleep apnea and heart failure: part II: central sleep apnea. Circulation 107:1822

    Article  Google Scholar 

  51. Bradley TD, Logan AG, Kimoff RJ, Sériès F, Morrison D, Ferguson K, Belenkie I, Pfeifer M, Fleetham J, Hanly P, Smilovitch M, Tomlinson G, Floras JS, Investigators CANPAP (2005) Continuous positive airway pressure for central sleep apnea and heart failure. N Eng J Med 353(19):2025–33

    Article  Google Scholar 

  52. Szollosi I, Roebuck T, Thompson B, Naughton MT (2006) Lateral sleeping position reduces severity of central sleep apnea/cheyne-stroke respiration. Sleep 29(8):1045–51

    Google Scholar 

  53. Joho S, Oda Y, Hirai T, Inoue H (2010) Impact of sleeping position on central sleep apnea/Cheyne-stokes respiration in patients with heart failure. Sleep Med 11(2):143–8

    Article  Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Internal Medicine, College of Medicine, Korea University, Seoul, South Korea

    Chol Shin M.D., Ph.D.

  2. Department of Clinical Epidemiology and Biostatistics, Asan Medical Center University of Ulsan College of Medicine, Seoul, Korea

    Jung Bok Lee Ph.D.

Authors
  1. Chol Shin M.D., Ph.D.
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  2. Jung Bok Lee Ph.D.
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Correspondence to Chol Shin M.D., Ph.D. .

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Editors and Affiliations

  1. , School of Medicine, Fu Jen Catholic University, Wen Chang Road, Shih Lin District 95, Taipei, -, Taiwan R.O.C.

    Rayleigh Ping-Ying Chiang

  2. , Department of Civil Engineering, National Taiwan University, No. 1, Sec. 4, Roosevelt Road, Taipei, 10617, Taiwan R.O.C.

    Shih-Chun (Jessy) Kang

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Shin, C., Lee, J.B. (2012). Management of Sleep Disorders-Sleep Technology on Positional Therapy. In: Chiang, RY., Kang, SC. (eds) Introduction to Modern Sleep Technology. Intelligent Systems, Control and Automation: Science and Engineering, vol 64. Springer, Dordrecht. https://doi.org/10.1007/978-94-007-5470-6_6

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  • DOI: https://doi.org/10.1007/978-94-007-5470-6_6

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  • Publisher Name: Springer, Dordrecht

  • Print ISBN: 978-94-007-5469-0

  • Online ISBN: 978-94-007-5470-6

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