the epub format is best viewed in the ibooks reader. while some of this improvement in sleep quality may result from the absence of an awakening elbow from a frustrated bed partner, it has seemed reasonable to assume that supine sleep is less common on the sofa. the prevalence of supine position-dependent sleep apnea in the general population is unknown, but it is demonstrable in about half of patients suspected of having sleep-disordered breathing referred for a sleep study.1,2 this proportion in even higher in asian patients.3–5 compared to patients without position dependence, these patients tend to be less obese, younger, with better sleep quality and less daytime sleepiness.6 it has been argued that since most obstructive sleep apnea (osa) patients have mild to moderate severity and since position dependence is most prevalent in these categories, the great majority of patients with sleep-disordered breathing demonstrate this pheno-type.7 it is then surprising that treatments, including positional therapy (pt), which are specifically focused on this population have received relatively little attention. of note, the rate of discontinuation was lowest in patients with mild severity. in both studies, use of pt was effective in decreasing the amount of supine sleep and resulted in decreased measures of osa severity.
the advantage of cpap was even lower in patients with mild sleep apnea. cpap acceptance is often problematic in patients with mild osa, particularly in the absence of perceptible daytime sleepiness.15 therefore, it is reasonable to recommend pt rather than cpap as initial treatment to patients with mild positional osa without complaints of excessive sleepiness. the usefulness of pt in patients who refuse or fail to adhere to cpap is probably minimal. in patients with mild osa, it is worth considering performing a follow-up sleep study using pt to demonstrate effectiveness in a particular individual. positional therapy is worth a try in patients with mild obstructive sleep apnea.
the journal is printed in english, and is freely available in its web page as well as in medline and other databases. sjr uses a similar algorithm as the google page rank; it provides a quantitative and qualitative measure of the journal’s impact. these patients were reassessed in a follow-up visit in average in 3–6 months, and a follow-up sleep study was then performed, under positional therapy with tbt.
results of the follow-up study showed an improvement in all parameters, with mean total ahi decrease from 15.0/h to 9.3/h and mean supine ahi from 34.2/h to 24.3/h. there was a significant decrease in sleepiness accessed by ess, and improvement in the overall sleep respiratory parameters. oksenberg et al., reported only 38% of compliance with tbt at six months.3 the compliant patients in that study were older, and the main reason for stopping was discomfort. in conclusion, despite our relatively small sample, we can infer that tbt is a simple, cheap and an effective form of pt when used in selected patients with clear positional osa, as shown by good disease control in our adherent patients.
positional obstructive sleep apnea occurs when the majority of apneic episodes can be attributed to sleep position. when you are in a supine sleep position, positional therapy is a behavioral strategy used to treat positional sleep apnea. some people have sleep apnea primarily when sleeping on their back (supine). the prevalence of supine position-dependent sleep apnea in the general population is unknown, but it is demonstrable in about half of patients suspected of, .
according to the american academy of sleep medicine (aasm) definition positional obstructive sleep apnea (osa) can be defined as a lower ahi in the non-supine positional osa is a type of osa in which the apnea / hypopnea index (ahi) is two times the supine level compared to unfriendly sleep. positional positional therapy is a behavioral strategy to treat sleep apnea. if your breathing is interrupted primarily when you are sleeping on your, .
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