ENT & Audiology Department, University Hospital of Ferrara, via Aldo Moro n. 8, Cona, 44124, Ferrara, Italy.
ENT Department, Morgagni-Pierantoni Hospital, via Carlo Forlanini 34, FC, 47121, Forlì, Italy.
Sleep Breath. 2022 Dec;26(4):1973-1981. doi: 10.1007/s11325-022-02576-4. Epub 2022 Feb 7.
Positional obstructive sleep apnea (POSA) has been defined as a difference of 50% or more in Apnea-Hypopnea Index (AHI) between supine and non-supine position. Sleep position is fundamental in the evaluation of obstructive sleep apnea syndrome (OSAS) severity but most tools used in the diagnosis of OSAS are not free from potential bias in the evaluation of usual sleep positions. The aim of this investigation was to evaluate a novel sleep questionnaire with the purpose of exploring sleep habits and evaluating if sleep assessment can identify the usual body position assumed for sleep.
The questionnaire was administered to patients recruited from October to November 2018. Questions concerned sleeping positions and conditions that could influence sleeping positions. Patients who had previously undergone polysomnography (PSG) were asked how they slept during the study night. Whenever present during the examination, the patient's bed partner was also asked about the patient's usual body positions during sleep.
Of 315 patients (211 men) enrolled, 35% were affected by OSAS and 69% of patients with OSAS had POSA. POSA was more prevalent among men (75%) compared to women (43%). The new questionnaire provided a discordant result from PSG recordings about sleeping positions and revealed a difference between usual sleeping position and the position during PSG recording. Reported sleep quality was much worse on PSG than at home suggesting that the "first night effect" is real and may lead to over-estimation of POSA cases.
Information about sleeping positions is fundamental to the assessment of OSAS severity. Knowledge gained from the new questionnaire as described may represent a valuable addendum to develop a more detailed polygraphic report. Such a tool may be used in practice with the aim of better identifying patients with true positional OSAS. Such patients may benefit from targeted positional therapy.
体位性阻塞性睡眠呼吸暂停（POSA）定义为仰卧位和非仰卧位之间的呼吸暂停低通气指数（AHI）差异≥50%。睡眠体位在评估阻塞性睡眠呼吸暂停综合征（OSAS）严重程度方面起着重要作用，但用于诊断 OSAS 的大多数工具在评估通常的睡眠体位时都存在潜在的偏差。本研究旨在评估一种新的睡眠问卷，旨在探讨睡眠习惯，并评估睡眠评估是否能识别通常的睡眠体位。
该问卷于 2018 年 10 月至 11 月期间对招募的患者进行了调查。问题涉及睡眠姿势和可能影响睡眠姿势的条件。对先前进行过多导睡眠图（PSG）检查的患者，询问他们在研究夜间的睡眠方式。在检查过程中，如果患者的床伴在场，也会询问他们患者在睡眠期间通常的身体姿势。
在 315 名患者（211 名男性）中，35%患有 OSAS，69%的 OSAS 患者有 POSA。POSA 在男性（75%）中比女性（43%）更为常见。新问卷提供的睡眠姿势结果与 PSG 记录不一致，显示了通常的睡眠姿势与 PSG 记录期间的姿势之间的差异。在 PSG 上报告的睡眠质量比在家时差得多，这表明“第一晚效应”是真实存在的，可能导致 POSA 病例的高估。
关于睡眠姿势的信息是评估 OSAS 严重程度的基础。从新问卷中获得的知识可能是描述性的，可以代表一个有价值的附加内容，以制定更详细的多导睡眠图报告。这种工具可以在实践中使用，旨在更好地识别真正的体位性 OSAS 患者。这些患者可能受益于有针对性的体位治疗。
