Positional Sleep Apnea Among Regional and Remote Australian Population and Simulated Positional Treatment Effects

Himanshu Garg,1 Xin Yi Er,1 Timothy Howarth,2,3 Subash S Heraganahally1,3,4 1Department of Respiratory and Sleep Medicine, Royal Darwin Hospital, Darwin, Northern Territory, Australia; 2College of Health and Human Sciences, Charles Darwin University, Darwin, Northern Territory, Australia; 3Darwin Re...

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Autores principales:	Garg H, Er XY, Howarth T, Heraganahally SS
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2020
Materias:	adherence: apnea hypopnea index body mass index continuous positive airway pressure obstructive sleep apnea positional therapy Psychiatry RC435-571 Neurophysiology and neuropsychology QP351-495
Acceso en línea:	https://doaj.org/article/70fe6ed625144178a3b9c5c6ba17c824
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spelling	oai:doaj.org-article:70fe6ed625144178a3b9c5c6ba17c8242021-12-02T15:18:25ZPositional Sleep Apnea Among Regional and Remote Australian Population and Simulated Positional Treatment Effects1179-1608https://doaj.org/article/70fe6ed625144178a3b9c5c6ba17c8242020-12-01T00:00:00Zhttps://www.dovepress.com/positional-sleep-apnea-among-regional-and-remote-australian-population-peer-reviewed-article-NSShttps://doaj.org/toc/1179-1608Himanshu Garg,1 Xin Yi Er,1 Timothy Howarth,2,3 Subash S Heraganahally1,3,4 1Department of Respiratory and Sleep Medicine, Royal Darwin Hospital, Darwin, Northern Territory, Australia; 2College of Health and Human Sciences, Charles Darwin University, Darwin, Northern Territory, Australia; 3Darwin Respiratory and Sleep Health, Darwin Private Hospital, Tiwi, Darwin, Northern Territory, Australia; 4Flinders University – College of Medicine and Public Health, Adelaide, South AustraliaCorrespondence: Subash S HeraganahallyDepartment of Respiratory and Sleep Medicine, Royal Darwin Hospital, 105, Rocklands Drive, Tiwi, Darwin, NT, AustraliaTel +61-8-89228888Fax +61-8-89206309Email hssubhashcmc@hotmail.comPurpose: To assess the prevalence of positional sleep apnea (POSA) and its predictors in patients diagnosed to have obstructive sleep apnea (OSA) in the regional and remote population of the Northern Territory of Australia over a two-year study period (2018 and 2019).Patients and Methods: Of the total 1463 adult patients who underwent a diagnostic polysomnography (PSG), 946 patients were eligible to be included in the study, of them, 810 consecutive patients with OSA (Apnea-Hypopnea Index (AHI) ≥ 5) who slept > 4 h and had ≥ 30 min sleep in both supine and lateral positions were assessed. Patients were considered to have POSA if supine AHI to lateral AHI ratio ≥ 2. The likely comparative impact of use of continuous positive airway therapy (CPAP) or positional therapy (PT) on disease severity was evaluated using model simulation.Results: A total of 495/810 (61%) patients had POSA, the majority were males (68% vs 60%, p=0.013) and non-Indigenous Australians (93% vs 87%, p=0.004). POSA patients were younger (mean difference 2.23 years (95% CI 0.27, 4.19)), less obese (BMI mean difference 3.06 (95% CI 2.11, 4.01)), demonstrated less severe OSA (p < 0.001) and a greater proportion reported alcohol consumption (72% vs 62%, p=0.001) as compared to those with non-POSA. Using the simulation model, if patients with POSA use PT two-thirds (323/495, 65%) would obtain significant improvement of their OSA severity, with one in five (92/495, 19%) displaying complete resolution. Comparing this to simulated CPAP therapy, where the majority (444/495, 90%) will show significant improvement, and one-third (162/495, 33%) will display complete resolution.Conclusion: POSA needs to be routinely recognised and positional therapy integrated in practice especially in the remote regions and in the developing world when effective methods are in place to monitor positional therapy.Keywords: adherence: apnea hypopnea index, body mass index, continuous positive airway pressure, obstructive sleep apnea, positional therapyGarg HEr XYHowarth THeraganahally SSDove Medical Pressarticleadherence: apnea hypopnea indexbody mass indexcontinuous positive airway pressureobstructive sleep apneapositional therapyPsychiatryRC435-571Neurophysiology and neuropsychologyQP351-495ENNature and Science of Sleep, Vol Volume 12, Pp 1123-1135 (2020)
institution	DOAJ
collection	DOAJ
language	EN
topic	adherence: apnea hypopnea index body mass index continuous positive airway pressure obstructive sleep apnea positional therapy Psychiatry RC435-571 Neurophysiology and neuropsychology QP351-495
spellingShingle	adherence: apnea hypopnea index body mass index continuous positive airway pressure obstructive sleep apnea positional therapy Psychiatry RC435-571 Neurophysiology and neuropsychology QP351-495 Garg H Er XY Howarth T Heraganahally SS Positional Sleep Apnea Among Regional and Remote Australian Population and Simulated Positional Treatment Effects
description	Himanshu Garg,1 Xin Yi Er,1 Timothy Howarth,2,3 Subash S Heraganahally1,3,4 1Department of Respiratory and Sleep Medicine, Royal Darwin Hospital, Darwin, Northern Territory, Australia; 2College of Health and Human Sciences, Charles Darwin University, Darwin, Northern Territory, Australia; 3Darwin Respiratory and Sleep Health, Darwin Private Hospital, Tiwi, Darwin, Northern Territory, Australia; 4Flinders University – College of Medicine and Public Health, Adelaide, South AustraliaCorrespondence: Subash S HeraganahallyDepartment of Respiratory and Sleep Medicine, Royal Darwin Hospital, 105, Rocklands Drive, Tiwi, Darwin, NT, AustraliaTel +61-8-89228888Fax +61-8-89206309Email hssubhashcmc@hotmail.comPurpose: To assess the prevalence of positional sleep apnea (POSA) and its predictors in patients diagnosed to have obstructive sleep apnea (OSA) in the regional and remote population of the Northern Territory of Australia over a two-year study period (2018 and 2019).Patients and Methods: Of the total 1463 adult patients who underwent a diagnostic polysomnography (PSG), 946 patients were eligible to be included in the study, of them, 810 consecutive patients with OSA (Apnea-Hypopnea Index (AHI) ≥ 5) who slept > 4 h and had ≥ 30 min sleep in both supine and lateral positions were assessed. Patients were considered to have POSA if supine AHI to lateral AHI ratio ≥ 2. The likely comparative impact of use of continuous positive airway therapy (CPAP) or positional therapy (PT) on disease severity was evaluated using model simulation.Results: A total of 495/810 (61%) patients had POSA, the majority were males (68% vs 60%, p=0.013) and non-Indigenous Australians (93% vs 87%, p=0.004). POSA patients were younger (mean difference 2.23 years (95% CI 0.27, 4.19)), less obese (BMI mean difference 3.06 (95% CI 2.11, 4.01)), demonstrated less severe OSA (p < 0.001) and a greater proportion reported alcohol consumption (72% vs 62%, p=0.001) as compared to those with non-POSA. Using the simulation model, if patients with POSA use PT two-thirds (323/495, 65%) would obtain significant improvement of their OSA severity, with one in five (92/495, 19%) displaying complete resolution. Comparing this to simulated CPAP therapy, where the majority (444/495, 90%) will show significant improvement, and one-third (162/495, 33%) will display complete resolution.Conclusion: POSA needs to be routinely recognised and positional therapy integrated in practice especially in the remote regions and in the developing world when effective methods are in place to monitor positional therapy.Keywords: adherence: apnea hypopnea index, body mass index, continuous positive airway pressure, obstructive sleep apnea, positional therapy
format	article
author	Garg H Er XY Howarth T Heraganahally SS
author_facet	Garg H Er XY Howarth T Heraganahally SS
author_sort	Garg H
title	Positional Sleep Apnea Among Regional and Remote Australian Population and Simulated Positional Treatment Effects
title_short	Positional Sleep Apnea Among Regional and Remote Australian Population and Simulated Positional Treatment Effects
title_full	Positional Sleep Apnea Among Regional and Remote Australian Population and Simulated Positional Treatment Effects
title_fullStr	Positional Sleep Apnea Among Regional and Remote Australian Population and Simulated Positional Treatment Effects
title_full_unstemmed	Positional Sleep Apnea Among Regional and Remote Australian Population and Simulated Positional Treatment Effects
title_sort	positional sleep apnea among regional and remote australian population and simulated positional treatment effects
publisher	Dove Medical Press
publishDate	2020
url	https://doaj.org/article/70fe6ed625144178a3b9c5c6ba17c824
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Positional Sleep Apnea Among Regional and Remote Australian Population and Simulated Positional Treatment Effects

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