Oksenberg Arie, Silverberg Donald, Offenbach Dalia, Arons Elena
Sleep Disorders Unit, Loewenstein Hospital, Rehabilitation Center, Raanana, Israel.
Laryngoscope. 2006 Nov;116(11):1995-2000. doi: 10.1097/01.mlg.0000237674.66716.a7.
Approximately half of obstructive sleep apnea (OSA) patients are positional (i.e., the majority of their breathing abnormalities during sleep appear in the supine posture). Little information exists as to whether avoiding the supine posture during sleep (positional therapy) is a valuable form of therapy for these patients.
To assess the use of positional therapy (by the tennis ball technique [TBT]) during a 6 month period in 78 consecutive positional OSA patients.
Demographic, polysomnographic, and self-reported questionnaire data on the use of the TBT were analyzed.
Of the 50 patients who returned the questionnaire, 19 (38%) (group A) said they were still using the TBT, and 12 (24%) (group B) said they used it initially and stopped using it within a few months but were still avoiding the supine position during sleep. Nineteen patients (38%) (group C) stopped using the TBT within a few months but did not learn how to avoid the sleep supine posture. Patients still using the TBT showed a significant improvement in their self-reported sleep quality (P < .005) and daytime alertness (P < .046) and a decrease in snoring loudness (P < .001). Patients of groups A and B were older than patients who did not comply with this therapy (P < .001). The main reason for patients stopping the use of the TBT in group C was that using it was uncomfortable.
Positional therapy appears to be a valuable form of therapy mainly for some older aged positional OSA patients.
约一半的阻塞性睡眠呼吸暂停(OSA)患者具有体位相关性(即他们睡眠期间的大多数呼吸异常出现在仰卧位时)。关于睡眠期间避免仰卧位(体位治疗)对这些患者是否是一种有价值的治疗方式,目前所知甚少。
评估连续78例体位相关性OSA患者在6个月期间使用体位治疗(通过网球技术 [TBT])的情况。
分析了关于TBT使用情况的人口统计学、多导睡眠图和自我报告问卷数据。
在50例回复问卷的患者中,19例(38%)(A组)表示仍在使用TBT,12例(24%)(B组)表示最初使用过,但在几个月内停止使用,但睡眠期间仍避免仰卧位。19例患者(38%)(C组)在几个月内停止使用TBT,但未学会如何避免睡眠仰卧位。仍在使用TBT的患者自我报告的睡眠质量有显著改善(P < .005),白天警觉性提高(P < .046),打鼾响度降低(P < .001)。A组和B组患者比未遵循该治疗的患者年龄更大(P < .001)。C组患者停止使用TBT的主要原因是使用起来不舒服。
体位治疗似乎是一种有价值的治疗方式,主要适用于一些老年体位相关性OSA患者。