McEvoy R D, Sharp D J, Thornton A T
Am Rev Respir Dis. 1986 Apr;133(4):662-6. doi: 10.1164/arrd.1986.133.4.662.
To determine whether the adoption of a more upright sleep posture would improve breathing and gas exchange in patients with obstructive sleep apnea syndrome (OSAS), 13 male patients with OSAS were studied during an all-night polysomnographic study while lying supine or sitting at a 60-degree angle. In the upright posture, the frequency of obstructive apnea was decreased (lying, 48.9 +/- 5.4/h; sitting, 19.6 +/- 6.9/h; p less than 0.0005) and arterial oxyhemoglobulin saturation (Sao2) was increased (nREM; mean lying, 90.6 +/- 0.8%; mean sitting, 92.1 +/- 0.5%, p less than 0.005; minimum lying, 64.8 +/- 3.2%, minimum sitting, 80.8 +/- 2.1%, p less than 0.005). In approximately half the patients studied, obstructive sleep apnea was essentially abolished by the postural intervention. These patients were more obese and had lower Pao2 and higher Paco2 values awake than the remaining patients in whom the response was either incomplete or absent. Arousal from sleep was less frequent in the upright posture, but sleep efficiency and overall sleep architecture were unchanged. This simple maneuver may be useful for treating some patients with OSAS.
为了确定采用更直立的睡眠姿势是否会改善阻塞性睡眠呼吸暂停综合征（OSAS）患者的呼吸和气体交换，对13名男性OSAS患者进行了整夜多导睡眠图研究，分别记录他们仰卧位和以60度角坐姿时的情况。在直立姿势下，阻塞性呼吸暂停的频率降低（仰卧位时为48.9±5.4次/小时；坐姿时为19.6±6.9次/小时；p<0.0005），动脉氧合血红蛋白饱和度（Sao2）增加（非快速眼动睡眠期；仰卧位平均为90.6±0.8%；坐姿平均为92.1±0.5%，p<0.005；仰卧位最低为64.8±3.2%，坐姿最低为80.8±2.1%，p<0.005）。在大约一半的研究患者中，姿势干预基本消除了阻塞性睡眠呼吸暂停。这些患者比其余反应不完全或无反应的患者更肥胖，清醒时Pao2更低，Paco2更高。在直立姿势下，睡眠中觉醒的频率较低，但睡眠效率和整体睡眠结构未改变。这种简单的方法可能对治疗一些OSAS患者有用。
