Journal of Otolaryngology and Ophthalmology of Shandong University ›› 2023, Vol. 37 ›› Issue (6): 101-105.doi: 10.6040/j.issn.1673-3770.0.2023.173

• Clinical Study • Previous Articles     Next Articles

Clinical characteristics of patients with positional obstructive sleep apnea and their correlations with low arousal threshold

WANG Yuyu, ZHU Mei   

  1. Department of Otorhinolaryngology & Head and Neck Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
  • Published:2023-12-15

PDF (PC)

409

Abstract: Objective To evaluate the clinical features and arousal threshold of patients with positional and non-positional obstructive sleep apnea. Methods All patients who underwent polysomnography(PSG)were enrolled, their demographic and polysomnographic data were collected, and arousal thresholds were calculated. These data were compared between the positional obstructive sleep apnea(POSA)and non-positional obstructive sleep apnea(NPOSA)groups. Results Among all the 322 patients with OSA, the prevalence of POSA was 48.8%. Patients with POSA had lower BMI, AHI and CT90(26.3 vs. 27.2, P=0.02; 23.2 vs. 56.2, P<0.001; 1.8 vs. 4.9, P=0.044), as well as higher lowest and average oxygen saturation(82.0 vs. 79.0, P=0.038; 95.0 vs. 94.1, P=0.019)compared to patients with NPOSA. Furthermore, a higher percentage of patients with POSA had a low arousal threshold compared to patients with NPOSA(29.3% vs. 8.5%, P<0.001). Conclusion POSA was associated with lower BMI and AHI. Low arousal threshold may play a role in the development of positional OSA.

Key words: Obstructive sleep apnea, Positional OSA, Clinical features, Arousal, Affect factor

CLC Number: 

  • R766
[1] Lee JJ, Sundar KM. Evaluation and management of adults with obstructive sleep apnea syndrome[J].Lung, 2021, 199(2): 87-101. doi:10.1007/s00408-021-00426-w
[2] Senaratna CV, Perret JL, Lodge CJ, et al. Prevalence of obstructive sleep apnea in the general population: a systematic review[J]. Sleep Med Rev, 2017, 34: 70-81. doi:10.1016/j.smrv.2016.07.002
[3] Joosten SA, O'Driscoll DM, Berger PJ, et al. Supine position related obstructive sleep apnea in adults: Pathogenesis and treatment[J]. Sleep Med Rev, 2014, 18(1): 7-17. doi:10.1016/j.smrv.2013.01.005
[4] Cartwright RD. Effect of sleep position on sleep apnea severity[J]. Sleep, 1984, 7(2): 110-114. doi:10.1093/sleep/7.2.110
[5] Frank MH, Ravesloot MJL, van Maanen JP, et al. Positional OSA part 1: towards a clinical classification system for position-dependent obstructive sleep apnoea[J]. Sleep Breath, 2015, 19(2): 473-480. doi:10.1007/s11325-014-1022-9
[6] Oksenberg A, Gadoth N, Töyräs J, et al. Prevalence and characteristics of positional obstructive sleep apnea(POSA)in patients with severe OSA[J].Sleep Breath, 2020, 24(2): 551-559. doi:10.1007/s11325-019-01897-1
[7] Heinzer R, Petitpierre NJ, Marti-Soler H, et al. Prevalence and characteristics of positional sleep apnea in the HypnoLaus population-based cohort[J]. Sleep Med, 2018, 48: 157-162. doi:10.1016/j.sleep.2018.02.011
[8] Garg H, ER XIN yi, Howarth T, et al. Positional sleep apnea among regional and remote Australian population and simulated positional treatment effects[J]. Nat Sci Sleep, 2020, 12: 1123-1135. doi:10.2147/nss.s286403
[9] Sabil A, Blanchard M, Trzepizur W, et al. Positional obstructive sleep apnea within a large multicenter French cohort: prevalence, characteristics, and treatment outcomes[J]. J Clin Sleep Med, 2020, 16(12): 2037-2046. doi:10.5664/jcsm.8752
[10] 李丹阳, 梁辉. 口面肌功能治疗对阻塞性睡眠呼吸暂停研究进展[J]. 山东大学耳鼻喉眼学报, 2021, 35(4): 108-114. doi: 10.6040/j.issn.1673-3770.0.2020.286 LI Danyang, LIANG Hui. Advancements in orofacial myofunctional therapy for obstructive sleep apnea[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2021, 35(4): 108-114. doi: 10.6040/j.issn.1673-3770.0.2020.286
[11] Yingjuan M, Siang WH, Leong Alvin TK, et al. Positional therapy for positional obstructive sleep apnea[J]. Sleep Med Clin, 2020, 15(2): 261-275. doi:10.1016/j.jsmc.2020.02.012
[12] 陈坤, 冯晶, 徐云霞, 等. 体位性睡眠呼吸暂停患者临床与多导睡眠图特征分析[J]. 中风与神经疾病杂志, 2022, 39(3): 196-201. doi: 10.19845/j.cnki.zfysjjbzz.2022.0051 CHEN Kun, FENG Jing, XU Yunxia, et al. Clinical and polysomnogram characteristics of postural sleep apnea patients[J]. Journal of Apoplexy and Nervous Diseases, 2022, 39(3): 196-201. doi: 10.19845/j.cnki.zfysjjbzz.2022.0051
[13] Huang W, Wang X, Xu C, et al. Prevalence, characteristics, and respiratory arousal threshold of positional obstructive sleep apnea in China: a large scale study from Shanghai Sleep Health Study cohort[J]. Respir Res, 2022, 23(1): 240. doi: 10.1186/s12931-022-02141-3
[14] Edwards BA, Eckert DJ, McSharry DG, et al. Clinical predictors of the respiratory arousal threshold in patients with obstructive sleep apnea[J]. Am J Respir Crit Care Med, 2014, 190(11): 1293-1300. doi:10.1164/rccm.201404-0718oc
[15] Wang XN, Luo JM, Huang R, et al. Preliminary study on clinical characteristics of Chinese patients with positional obstructive sleep apnea[J].Sleep Breath, 2022, 26(1): 67-74. doi:10.1007/s11325-021-02346-8
[16] 韩莹莹, 李延忠. 阻塞性睡眠呼吸暂停低通气综合征与亚临床动脉粥样硬化[J]. 山东大学耳鼻喉眼学报, 2022, 36(2): 126-132. doi: 10.6040/j.issn.1673-3770.0.2022.011 HAN Yingying, LI Yanzhong. Obstructive sleep apnea hypopnea syndrome and subclinical arteriosclerosis[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(2): 126-132. doi: 10.6040/j.issn.1673-3770.0.2022.011
[17] 杨晰珺, 关建, 吴海莺. 阻塞性睡眠呼吸暂停低通气综合征与血脂紊乱关系的研究进展[J]. 山东大学耳鼻喉眼学报, 2022, 36(2): 133-138. doi: 10.6040/j.issn.1673-3770.0.2021.078 YANG Xijun, GUAN Jian,WU Haiying. Research progress on the relationship between obstructive sleep apnea-hypopnea syndrome and dyslipidemia[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(2): 133-138. doi: 10.6040/j.issn.1673-3770.0.2021.078
[18] Carberry JC, Jordan AS, White DP, et al. Upper airway collapsibility(pcrit)and pharyngeal dilator muscle activity are sleep stage dependent[J]. Sleep, 2016, 39(3): 511-521. doi:10.5665/sleep.5516
[19] Malhotra A, Trinder J, Fogel R, et al. Postural effects on pharyngeal protective reflex mechanisms[J]. Sleep, 2004, 27(6): 1105-1112. doi:10.1093/sleep/27.6.1105
[20] Joosten SA, Landry SA, Sands SA, et al. Dynamic loop gain increases upon adopting the supine body position during sleep in patients with obstructive sleep apnoea[J]. Respirology, 2017, 22(8): 1662-1669. doi:10.1111/resp.13108
[21] Ong JSL, Touyz G, Tanner S, et al. Variability of human upper airway collapsibility during sleep and the influence of body posture and sleep stage[J]. J Sleep Res, 2011, 20(4): 533-537. doi:10.1111/j.1365-2869.2011.00925.x
[22] Oksenberg A, Goizman V, Eitan E, et al. Obstructive sleep apnea: do positional patients become nonpositional patients with time?[J]. Laryngoscope, 2020, 130(9): 2263-2268. doi:10.1002/lary.28387
[23] 李卓君, 宋西成, 陈秀梅. 阻塞性睡眠呼吸暂停低通气综合征患者的肺功能变化分析[J]. 山东大学耳鼻喉眼学报, 2023, 37(2): 45-50. doi:10.6040/j.issn.1673-3770.0.2022.043 LI Zhuojun, SONG Xicheng, CHEN Xiumei. Analysis of pulmonary function changes in patients with obstructive sleep apnea hypopnea syndrome[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2023, 37(2): 45-50. doi:10.6040/j.issn.1673-3770.0.2022.043
[24] 杜剑霞, 王彦, 曹洁, 等. 阻塞性睡眠呼吸暂停低通气综合征觉醒机制的研究进展[J]. 中华结核和呼吸杂志, 2019, 42(8): 604-608. doi: 10.3760/cma.j.issn.1001-0939.2019.08.009 DU Jianxia, WANG Yan, CAO Jie, et al. The mechanism of arousal in patients with obstructive sleep apnea-hypopnea syndrome[J]. Chinese Journal of Tuberculosis and Respiratory Diseases, 2019, 42(8): 604-608. doi: 10.3760/cma.j.issn.1001-0939.2019.08.009
[25] Wu H, Fang F, Wu C, et al. Low arousal threshold is associated with unfavorable shift of PAP compliance over time in patients withOSA[J].Sleep Breath, 2021, 25(2): 887-895. doi:10.1007/s11325-020-02197-9
[26] Smales ET, Edwards BA, Deyoung PN, et al. Trazodone effects on obstructive sleep apnea and non-REM arousal threshold[J]. Ann Am Thorac Soc, 2015, 12(5): 758-764. doi:10.1513/AnnalsATS.201408-399OC
[1] XIONG Qin, ZHANG Yan, WU Rina, LI Feng, TANG Lixing. Application of intranasal corticosteroids in pediatrics [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2025, 39(6): 160-167.
[2] WEI Zhicheng, PENG Yu, LI Lilin, SHEN Hangdong, LI Xinyi, XU Huajun, GUAN Jian. Kynurenine mediates liver injury induced by obstructive sleep apnea: a cross-sectional study [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2025, 39(3): 38-44.
[3] MA Xin, DONG Lingkang, WU Hongmin, YI Hongliang, ZOU Jianyin. Modifications and applications of lateral expansion abduction suspension suture technique in the treatment of obstructive sleep apnea [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2025, 39(3): 81-88.
[4] LI Lilin, LI Xinyi, GUAN Jian. Research progress on the mechanism of comorbidity between obstructive sleep apnea and depression [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2025, 39(3): 89-96.
[5] WANG Xiaoqing, WANG Yuyu, QIU Jinwei, XU Jinxia, ZHU Mei. The effect of orofacial muscle functional training on snoring indicators and sleep quality in patients with snoring [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2025, 39(2): 101-107.
[6] LIU Lianlian, LI Jinrang. Obstructive sleep apnea and laryngopharyngeal reflux [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2024, 38(6): 15-22.
[7] LIU Chang, FANG Hongyan, LIU Xiao, FU Dongna, WANG He, WANG Jing, YANG Jingpu. Analysis of sensitization characteristics of Artemisia pollen in autumn allergic rhinitis in the Changchun area of China [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2024, 38(5): 13-19.
[8] LUO Lu, ZHOU En, XIAO Xuping, LIN Zhiqiang, FANG Zhijie, LYU Xiaohong. Application of plasma pointlike excitation technology in children with obstructive sleep apnea undergoing tonsillectomy and adenoidectomy combined with perioperative enhanced recovery after surgery program [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2024, 38(5): 26-30.
[9] ZHAO Yun, TENG Zhipan, LI Qi, SHEN Xiaofei. Twenty-six cases of tubal torus hyperplasia after adenoid tonsillectomy in children [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2024, 38(3): 43-48.
[10] WANG Guifang, LI Rengao, MA Qing. Effects of H-UPPP combined with radiofrequency ablation of tongue root with low temperature plasma on oxygen saturation and arterial oxygen partial pressure in patients with OSAHS [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2024, 38(3): 49-54.
[11] ZHANG Jiajia, SHI Anni, XING Yu, HONG Yuying, BAI Peng. Acupuncture combined with western medicine for the treatment of total deafness in sudden sensorineural hearing loss: a case report and literature review [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2024, 38(3): 88-92.
[12] REN Xiaoyong. Current status and future perspectives of research on obstructive sleep apnea comorbidities [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2023, 37(6): 1-5.
[13] HU Tingting, WANG Yuehua. Advances in research on the relationship between obstructive sleep apnea and breast cancer [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2023, 37(6): 41-45.
[14] ZHU Yaxin,LIU Feng,GUAN Jian,YIN Shankai. Advances in the changes of lymphocytes in pediatric adenoid and tonsil hypertrophy [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2023, 37(6): 62-67.
[15] WANG Lu, ZHANG Yunyun, GUO Hua, CUI Xiaochuan. Application value of lipid metabolism markers for the early screening of Alzheimer's disease in obstructive sleep apnea patients [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2023, 37(6): 68-74.
Viewed
Full text


Abstract

Cited
  Shared   
  Discussed   
No Suggested Reading articles found!
Website Copyright: Editorial Office of Journal of Otolaryngology and Ophthalmology of Shandong University
Address: No.27 Shanda South Road, Jinan, Shandong, China. Post code: 250100 Tel: +86-0531-88366912 Email: ebhxb@sdu.edu.cn Supported by Beijing Magtech Co.Ltd