Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Jul;280(7):3279-3285.
doi: 10.1007/s00405-023-07860-x. Epub 2023 Feb 4.

The effect of head rotation on OSA is associated with disease severity: a cross-sectional study

Jiajia Dong  1   2 , Haili Sun  3 , Honglei Zhang  1 , Rui Guo  4
Affiliations

The effect of head rotation on OSA is associated with disease severity: a cross-sectional study

Jiajia Dong et al. Eur Arch Otorhinolaryngol. 2023 Jul.

Abstract

Purpose: Head rotation is an effective positional therapy for obstructive sleep apnea (OSA). However, not all OSA patients benefit from head rotation. This study aimed to explore the clinical phenotype of OSA patients who can benefit from head rotation.

Methods: We performed a retrospective review of 184 consecutive OSA patients who underwent polysomnography. Head rotation in supine position was determined by high-quality video recording. According to the changes in apnea-hypopnea index (AHI) after head rotation, OSA patients were divided into two groups: patients with response to head rotation(HR) and patients without response to head rotation(NHR). Demographic factors and overnight polysomnography were analyzed.

Results: Compared with NHR group, HR group showed significantly lower AHI (51.8 vs 31.5, p < 0.01), time spent with oxygen saturation below 90%(5.3% vs 0.51%, p < 0.01), and higher lowest oxygen saturation(80% vs 86%, p < 0.05). Logistic regression showed that AHI was an independent factor to predict the decrease of AHI in head rotation (OR 0.985, 95% CI 0.970-0.979, p < 0.05). Among mild to moderate group (AHI < 30/h), severe group (30/h ≤ AHI < 60/h), and extremely severe group (AHI ≥ 60/h), the percentage decrease of AHI in head rotation was 18.5%, 9.5%, and 2.6%, respectively. Surprisingly, the percentage decrease of AHI of 6 responders in mild to moderate group was more than 50%.

Conclusion: OSA patients who respond well to head rotation have less severe disease, and patients with mild to moderate OSA are more likely to improve and benefit from this position. Our research provides potential strategies and insights into the individual treatment of OSA patients.

Keywords: Apnea hypopnea index; Body position; Head rotation; Obstructive sleep apnea.

PubMed Disclaimer

References

    1. Benjafield AV, Ayas NT et al (2019) Estimation of the global prevalence and burden of obstructive sleep apnoea: a literature-based analysis. Lancet Respir Med 7:687–698. https://doi.org/10.1016/s2213-2600(19)30198-5 - DOI - PubMed - PMC
    1. Vries GED, Hoekema A et al (2015) Usage of positional therapy in adults with obstructive sleep apnea. J Clin Sleep Med 11:131–137. https://doi.org/10.5664/jcsm.4458 - DOI - PubMed - PMC
    1. Permut I, Diaz-Abad M et al (2010) Comparison of positional therapy to CPAP in patients with positional obstructive sleep apnea. J Clin Sleep Med JCSM 6:238–243 - DOI - PubMed
    1. Dauvilliers Y, Verbraecken J et al (2020) Pitolisant for daytime sleepiness in patients with obstructive sleep apnea who refuse continuous positive airway pressure treatment. a randomized trial. Am J Respir Crit Care Med 201:1135–1145. https://doi.org/10.1164/rccm.201907-1284OC - DOI - PubMed - PMC
    1. Joosten SA, O’Driscoll DM et al (2014) Supine position related obstructive sleep apnea in adults: pathogenesis and treatment. Sleep Med Rev 18:7–17. https://doi.org/10.1016/j.smrv.2013.01.005 - DOI - PubMed

LinkOut - more resources