alexa Comparison of positional therapy to CPAP in patients with positional obstructive sleep apnea.
Neurology

Neurology

Journal of Sleep Disorders & Therapy

Author(s): Permut I, DiazAbad M, Chatila W, Crocetti J, Gaughan JP,

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Abstract STUDY OBJECTIVES: We hypothesized that positional therapy would be equivalent to continuous positive airway pressure (CPAP) at normalizing the apnea-hypopnea index (AHI) in patients with positional obstructive sleep apnea (OSA). METHODS: Thirty-eight patients (25 men, 49 +/- 12 years of age, body mass index 31 +/- 5 kg/m2) with positional OSA (nonsupine AHI <5 events/h) identified on a baseline polysomnogram were studied. Patients were randomly assigned to a night with a positional device (PD) and a night on CPAP (10 +/- 3 cm H2O). RESULTS: Positional therapy was equivalent to CPAP at normalizing the AHI to less than 5 events per hour (92\% and 97\%, respectively [p = 0.16]). The AHI decreased from a median of 11 events per hour (interquartile range 9-15, range 6-26) to 2 (1-4, 0-8) and 0 events per hour (0-2, 0-7) with the PD and CPAP, respectively; the difference between treatments was significant (p < 0.001). The percentage of total sleep time in the supine position decreased from 40\% (23\%-67\%, 7\%-82\%) to 0\% (0\%-0\%, 0\%-27\%) with the PD (p < 0.001) but was unchanged with CPAP (51\% [36\%-69\%, 0\%-100\%]). The lowest SaO2 increased with the PD and CPAP therapy, from 85\% (83\%-89\%, 76\%-93\%) to 89\% (86\%-9\%1, 78\%-95\%) and 89\% (87\%-91\%, 81\%-95\%), respectively (p < 0.001). The total sleep time was unchanged with the PD, but decreased with CPAP, from 338 (303-374, 159-449) minutes to 334 (287-366, 194-397) and 319 (266-343, 170-386) minutes, respectively (p = 0.02). Sleep efficiency, spontaneous arousal index, and sleep architecture were unchanged with both therapies. CONCLUSION: Positional therapy is equivalent to CPAP at normalizing the AHI in patients with positional OSA, with similar effects on sleep quality and nocturnal oxygenation.
This article was published in J Clin Sleep Med and referenced in Journal of Sleep Disorders & Therapy

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