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Abstract Details

Proposal of a New Definition for Positional Obstructive Sleep Apnea
Sleep
P05 - (-)
015
BACKGROUND: Conventional definition of p-OSA defined by ratio of supine and nonsupine apnea-hypopnea index (AHI) being greater than two, does not have clinical implication as most OSA patients have more severe obstruction during supine sleep. We propose a new defition of requiring AHI during non-supine sleep being less than five, so that the patient with p-OSA will have no OSA when sleeping exclusively non-supine.
DESIGN/METHODS: We analyzed diagnostic polysomnograms (PSG) of adults who were referred for evaluation of OSA and calculated the proportion of p-OSA patients using two different definitions of p-OSA. Sleep related parameters and characteristics of subjects with p-OSA were evaluated in comparison to np-OSA patients.
RESULTS: Out of 121 patients with OSA, 109 (50 females, 59 males) slept both supine and non-supine. Using conventional definition, 81.7% (38 females, 44 males) had p-OSA. Using our proposed definition, 54.1% (27 females, 28 males) had p-OSA. In comparing the characteristics between p-OSA and np-OSA grouped per our criteria, BMI (31.5 vs.34.4; p < 0.05), neck circumference (40.3 vs. 42.1; p<0.05. 3), sleep efficiency (78.4% vs. 72.5%; p<0.05) were significantly different (p-OSA vs np-OSA respectively). Age, Epworth Sleepiness Scale, lowest oxygen saturation were not significantly different. The proportion of supine sleep was higher in p-OSA versus np-OSA (49% vs. 33%; p<0.01). AHI was lower in p-OSA vs. np-OSA (11.6 vs. 16.7; p< 0.05). Supine AHI was also lowere in p-OSA (24.2 vs. 37.6; p<0.05).
CONCLUSIONS: More than half of OSA patients can be treated using positional therapy based on our definiton of p-OSA. p-OSA patients are less obese, with lower neck circumference and showed higher sleep efficiency and less severe OSA including during supine sleep compared to np-OSA.
Authors/Disclosures
Atif Zafar, MD (TeleSpecialists)
PRESENTER 		Dr. Zafar has nothing to disclose.
No disclosure on file
No disclosure on file
Kyoungbin Im (University of Iowa) No disclosure on file
No disclosure on file