The effect of CPAP therapy on sleep posture.Sleep apnea sleep apnea, episodes of interrupted breathing during sleep. Obstructive sleep apnea is a common disorder in which relaxation of muscles in the throat repeatedly close off the airway during sleep; the person wakes just enough to take a gasping breath. is characterized by nocturnal snoring snoring, rough, vibratory sounds made in breathing during sleep or coma. The noisy breathing is the result of an open mouth and a relaxation of the palate; it is frequently induced by lying on one's back. , daytime hypersomnolence and repeated episodes of apneas during sleep. Because of a relapse of the soft palate and tongue in the supine posture, the upper airway becomes narrower, increasing the severity of sleep apnea. Most patients (and their elbow therapy-practicing bed partners) become aware of this and try to sleep more in the non-supine posture. Continuous positive airway pressure continuous positive airway pressure n. Abbr. CPAP A technique of respiratory therapy for individuals breathing with or without mechanical assistance in which airway pressure is maintained above atmospheric pressure throughout the therapy (CPAP CPAP abbr. continuous positive airway pressure Continuous positive airway pressure (CPAP) A ventilation device that blows a gentle stream of air into the nose during sleep to keep the airway open. ) pneumatically splints splints inflammation of the interosseous ligament between the small and large metacarpal bones of horses and an accompanying periostitis and exostosis production on the small metacarpal bone. The metatarsal bones are similarly but less frequently involved. and opens up the airway, thereby minimizing the need to sleep in the non-supine posture. This study was undertaken to determine if therapy with CPAP leads to a change in sleep posture. Patients diagnosed with sleep apnea by standard polysomnography were initiated on CPAP therapy. After two to three months of 8 cm[H.sub.2]O CPAP, sleep studies were performed again to determine the optimal CPAP level. In addition to the standard parameters of polysomnography, the percentage of sleep time spent in various postures was calculated. Multivariate analysis was performed to determine the effect of CPAP therapy and of other variables on sleep posture. 116 patients (87 males, 29 females) completed both the diagnostic and CPAP titration titration (tītrā`shən), gradual addition of an acidic solution to a basic solution or vice versa (see acids and bases); titrations are used to determine the concentration of acids or bases in solution. studies. There was a significantly greater percentage of time in the supine posture (42.7 + 35.8) during the CPAP studies compared to the diagnostic studies (36.1 + 32.7) (p:<0.001). Supine posture increased in both males and females; however, males exhibited a greater increase in the supine posture (from 33.9% to 41.9%) compared to female patients (42.7% to 45.2%). Increased supine posture was independent of age and body mass index (BMI BMI body mass index. BMI abbr. body mass index Body mass index (BMI) A measurement that has replaced weight as the preferred determinant of obesity. ). Sleep apnea patients spend more time in the supine posture when on CPAP therapy. This increase in supine posture is more in male patients compared to females. This increase in supine posture may be due either to the stabilizing effect of CPAP on the upper airway or to the physical presence of the CPAP mask restricting shifts into lateral posture. Bashir Chaudhary, MD, Usman Tahir, MS, Omar Chaudhary, MS, Rabea Chaudhary, MS, James Deas, PhD. Sleep Institute of Augusta, Augusta, GA. |
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