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  • Title: Two subtypes of positional obstructive sleep apnea: Supine-predominant and supine-isolated.
    Author: Kim KT, Cho YW, Kim DE, Hwang SH, Song ML, Motamedi GK.
    Journal: Clin Neurophysiol; 2016 Jan; 127(1):565-570. PubMed ID: 26116298.
    Abstract:
    OBJECTIVES: The body position has a strong influence on obstructive sleep apnea (OSA). The purpose of this study is to compare the clinical features of two subtypes of positional OSA (POSA), namely supine-predominant OSA (spOSA) and supine-isolated OSA (siOSA), so as to discuss whether the two groups can be classified separately. METHODS: A total of 279 consecutive patients with OSA were enrolled. The POSA was defined as having an overall apnea-hypopnea index (AHI) ⩾ 5 with supine AHI > 2 times the non-supine AHI. Only those with ⩾ 30 min spent in the supine and non-supine sleeping positions were included, and split night studies were excluded from the study. Patients were considered spOSA unless their non-supine AHI was negligible (<5) (siOSA). The clinical and polysomnographic characteristics of both groups were compared. RESULTS: Two hundred and sixteen subjects (77.4%) met the criteria for POSA, with 158 (73.1%) of them classified as spOSA, and 58 (26.9%) as siOSA. The siOSA patients had lower arousal indices, but poorer quality of sleep, and were more depressed and anxious compared with the spOSA subjects. CONCLUSIONS: Those with siOSA and spOSA show different clinical features. SIGNIFICANCE: These findings suggest that a more detailed sub-classification of POSA is needed.
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