Body posture as a factor determining sleep quality in patients using non-invasive ventilation

Alfaiate, Daniel; Pereira, Alexandre; Guerra, Patricia; Pinto, Nuno

doi:10.1007/s11325-023-02817-0

Cited by 7 publications

(4 citation statements)

References 19 publications

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“…Positional dependency is a common phenotype. It is reported that the supine position impairs sleep quality primarily through increased respiratory events and sleep fragmentation [ 13 ]. The primary pathophysiology of positional dependence is regarded as an anatomical issue [ 14 ].…”

Section: Discussionmentioning

confidence: 99%

Exploring the dynamics of snoring in relation to sleep stages: Implications for gender differences, sleep position, and upper airway collapsibility

Suzuki,

Kawai,

Funayama

2024

PLoS ONE

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Objective The purpose of this study was to determine the sleep stage during which isolated snoring occurs in children and adults, and to analyze changes after treatment of obstructive sleep apnea (OSA). Methods This retrospective study examined duration of snoring time and respiratory events during each sleep stage in adults and children who underwent polysomnography, had an apnea-hypopnea index (AHI) < 15/h and had snoring time ≥ 10% of total sleep time. Changes in duration of snoring time were also examined in adult patients after treatment with an oral appliance (OA). Results Snoring time was shown to be predominant during N3 and N2 sleep and less dominant during REM sleep in both children (n = 47) and adults (n = 93). These results were seen even in children with REM dependency. The percentage of snoring time during N3 sleep was more pronounced in women than in men among young adult patients aged < 40 years but was not significantly different between men and women overall. There were no significant differences in the percentage of snoring time in each sleep stage between young women with mild OSA and non-OSA. In children, there were no significant differences between boys and girls in the percentage of snoring time in any sleep stage. The percentage of snoring time during N3 was significantly higher sleep in the non-supine position than in the supine position in children, whereas no significant differences were noted between the supine and non-supine positions in any sleep stage in adults. OA treatment for adult patients (n = 20) significantly increased the percentage of snoring time during N3 sleep, although it significantly decreased AHI, total snoring time, and snoring time during N1 sleep and REM sleep. Conclusions Snoring presented exclusively during the N3 sleep stage, especially in young women with mild OSA, and in children with OSA, especially in the non-supine position. Snoring time during N3 sleep increased during OA treatment for OSA.

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Section: Discussionmentioning

confidence: 99%

Exploring the dynamics of snoring in relation to sleep stages: Implications for gender differences, sleep position, and upper airway collapsibility

Suzuki,

Kawai,

Funayama

2024

PLoS ONE

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“…PAP compliance is considered adequate if it is used at least 5 nights per week for at least 4 h per night. 75 16.…”

Section: 5mentioning

confidence: 99%

“…It is common practice to discuss non-surgical treatments with snoring and OSA patients. These treatments include weight loss, sleep hygiene, the use of oral appliances, and undergoing myofunctional therapy [14][15][16][17][18]. Positive airway pressure therapy (PAP) represents the first-line treatment option for moderate to severe OSA under indications and is followed by PAP titration [19].…”

Section: Introductionmentioning

confidence: 99%

“…Detailed documentation of all the elements of decision-making, the patient's expectations, and the information given by the surgeon is an essential part of the management of snoring/OSA. 100 75 16. In patients with non-compliance, the following causes of non-compliance should be investigated and addressed: a. mask size/shape and mask fitting on the face; b. PAP settings; c. nasal obstruction, and if present, the cause of the nasal obstruction.…”

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confidence: 99%

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Consensus Statements among European Sleep Surgery Experts on Snoring and Obstructive Sleep Apnea: Part 2 Decision-Making in Surgical Management and Peri-Operative Considerations

Olszewska,

De Vito,

O’Connor-Reina

et al. 2024

JCM

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Background: Reaching consensus on decision-making in surgical management and peri-operative considerations regarding snoring and obstructive sleep apnea (OSA) among sleep surgeons is critical in the management of patients with such conditions, where there is a large degree of variability. Methods: A set of statements was developed based on the literature and circulated among eight panel members of European experts, utilizing the Delphi method. Responses were provided as agree and disagree on each statement, and the comments were used to assess the level of consensus and develop a revised version. The new version, with the level of consensus and anonymized comments, was sent to each panel member as the second round. This was repeated for a total of five rounds. Results: The final set included a total of 71 statements: 29 stand-alone and 11 with 42 sub-statements. On the 33 statements regarding decision-making in surgical management, there was 60.6%, 27.3%, and 6.1% consensus among all eight, seven, and six panelists, respectively. On the 38 statements regarding the peri-operative considerations, there was 55.3%, 18.4%, and 15.8% consensus among all eight, seven, and six panelists, respectively. Conclusions: These results indicate the need for an expanded review of the literature and discussion to enhance consensus among the sleep surgeons that consider surgical management in patients with snoring and OSA.

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Phrenic nerve stimulation for central sleep apnea: a single institution experience

Mease,

Augostini,

McKane

et al. 2024

Sleep Breath

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Purpose Phrenic nerve stimulation (PNS) was approved by the Food and Drug Administration (FDA) to treat moderate to severe central sleep apnea. We report here, results of a retrospective study regarding our institutional outcomes at one year. In this study we evaluated the change in the apnea hypopnea index, epworth sleepiness score, and functional outcomes of sleep score at one year post implant. Methods This is a retrospective analysis of patients ≥ 18 years of age who had PNS implanted for moderate to severe CSA at the Ohio State University Wexner Medical Center apnea between Feb 1, 2018 to July 1, 2021. Sleep disordered breathing parameters and objective sleepiness as measured by the Epworth Sleepiness Scale (ESS) scores, and Functional Outcomes of Sleep Questionnaire (FOSQ) scores were assessed at baseline and one-year post-implant. Results Twenty-two patients were implanted with PNS at OSU between February 1, 2018 and May, 31, 2022. The AHI showed a statistically significant decrease from a median of 40 events/hour at baseline to 18 at follow-up (p-value = 0.003). The CAI decreased from 16 events/hour to 2 events/hour (p-value of 0.001). The obstructive apnea index, mixed apnea index, and hypopnea index did not significantly change. The ESS scores had a statistically significant improvement from a median score of 12 to 9 (p-value = 0.028). While the FOSQ showed a trend to improvement from 15.0 to 17.8, it was not statistically significant (p-value of 0.086). Conclusion Our study found that PNS therapy for moderate to severe CSA improves overall AHI and CAI. Objective sleepiness as measured by the ESS also improved at one-year post implant.

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Body posture as a factor determining sleep quality in patients using non-invasive ventilation

Cited by 7 publications

References 19 publications

Exploring the dynamics of snoring in relation to sleep stages: Implications for gender differences, sleep position, and upper airway collapsibility

Exploring the dynamics of snoring in relation to sleep stages: Implications for gender differences, sleep position, and upper airway collapsibility

Consensus Statements among European Sleep Surgery Experts on Snoring and Obstructive Sleep Apnea: Part 2 Decision-Making in Surgical Management and Peri-Operative Considerations

Phrenic nerve stimulation for central sleep apnea: a single institution experience

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