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体位对阻塞性睡眠呼吸暂停综合征患者鼻腔通畅度的影响。

Effects of sitting, supine, and prone postures on nasal patency in individuals with obstructive sleep apnea syndrome.

机构信息

Department of Traditional Chinese Medicine, Chang Gung Memorial Hospital, Chiayi, Taiwan.

School of Traditional Chinese Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan.

出版信息

BMC Pulm Med. 2024 Sep 11;24(1):445. doi: 10.1186/s12890-024-03278-1.

Abstract

BACKGROUND

Studies have found that in healthy individuals without nasal disease, changes in posture cause an increase in nasal resistance, especially in the prone posture. Many patients with obstructive sleep apnea syndrome (OSAS) sleep in a prone posture, but no studies have examined the effect of this change in posture on nasal resistance in patients with OSAS. Therefore, we conducted this study to investigate this posture-related physical phenomenon in individuals with OSAS.

METHODS

We evaluated the nasal patency of 29 patients diagnosed with OSAS using the visual analog scale (VAS), acoustic rhinometry, and video-endoscopy in the sitting, supine, and prone postures.

RESULTS

In the OSAS group, both supine and prone postures significantly influenced subjective nasal blockage and led to a notable reduction in the minimal cross-sectional area (mCSA) as determined by acoustic rhinometry, compared to the sitting posture. The prone posture exhibited a more pronounced effect than the supine posture. Endoscopic evaluations further revealed increased hypertrophy of the inferior turbinate in the supine posture for the right nasal passage and the prone posture for the left. However, no significant differences were observed between the prone and supine postures.

CONCLUSION

In OSAS patients, nasal resistance significantly increased in supine and prone postures compared to sitting, with the prone posture showing a greater effect. Clinicians should consider a patient's habitual sleep posture and the effects of postural changes when assessing OSAS severity and devising treatment plans.

摘要

背景

研究发现,在无鼻部疾病的健康个体中,体位变化会导致鼻阻力增加,尤其是在俯卧位。许多阻塞性睡眠呼吸暂停综合征(OSAS)患者以俯卧位睡眠,但尚无研究探讨这种体位变化对 OSAS 患者鼻阻力的影响。因此,我们进行了这项研究,以调查 OSAS 患者中与体位相关的这种物理现象。

方法

我们使用视觉模拟量表(VAS)、鼻声反射和视频内镜评估了 29 例被诊断为 OSAS 的患者的鼻腔通畅度,评估体位分别为坐姿、仰卧位和俯卧位。

结果

在 OSAS 组中,仰卧位和俯卧位均显著影响主观鼻塞,并导致鼻声反射测量的最小横截面积(mCSA)明显减小,与坐姿相比。俯卧位的影响比仰卧位更明显。内镜评估进一步显示,右侧鼻腔在仰卧位和左侧鼻腔在俯卧位时下鼻甲出现更大的增生。然而,俯卧位和仰卧位之间没有观察到显著差异。

结论

与坐姿相比,OSAS 患者在仰卧位和俯卧位时鼻阻力明显增加,且俯卧位的影响更大。临床医生在评估 OSAS 严重程度和制定治疗计划时,应考虑患者的习惯性睡眠体位和体位变化的影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7adc/11391716/322ec6569b31/12890_2024_3278_Fig1_HTML.jpg

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