The effect of the prone sleeping position on obstructive sleep apnoea

Abstract

Conclusions: Prone positioning reveals promising results in improving the apnoea-hypopnoea index (AHI) and oxygen desaturation index (ODI) in patients with obstructive sleep apnoea (OSA). Objective: To evaluate the effect of the prone position on OSA. Methods: Thirty-two patients with mild to severe OSA were included in the study. This was a two-night study to evaluate the effect of the prone position on OSA; a first night in a normal bed with optional positioning and a second night on a mattress and pillow facilitating prone positioning. Results: A total of 27 patients, 22 males and 5 females, with a mean age of 51 years, 15 patients with positional OSA (POSA) and 12 patients with non-POSA with a total median AHI of 23 (min 5, max 93) completed the study protocol. The median AHI decreased from 23 to 7 (p < 0.001) and the median ODI from 21 to 6 (p < 0.001). The median time spent in the supine position decreased from 142 to <1 min (p < 0.0001) and the median time in the prone position increased from <1 to 330 min (p < 0.0001). In all, 17 of 27 patients (63%) were considered to be responders to prone positioning, 12 of 15 (80%) with POSA and 5 of 12 (42%) with non-POSA. Five patients did not complete the study protocol due to sleep time <4 h.

Keywords:

• Positional treatment
• prone
• lateral and supine sleep positions
• non-invasive
• conservative
• non-surgical treatment
• mattress and pillow for prone positioning
• polysomnographic sleep study
• respiratory parameters

Acknowledgments

We would like to thank Raquel Praça Silva and Arash Bidarian-Moniri for their important contributions to the design and the development of the MPP, Christopher Oldmeadow for his valuable feedback on the final draft, Carlos Praça for drawing the 3D models of the MPP, Fernando Molina for the production of the instruction video, Ann-Christin Mjörnheim and Henrik Söderström for their assistance in performance of the PSG registrations and the participating patients for their valuable feedback.

Declaration of interest: This study was partially financed by Acta Otolaryngologica Foundation, Sweden. The sponsor had no role whatsoever in the study design, in the collection, analysis and interpretation of data, or in the writing of the manuscript and the decision to submit the manuscript for publication. Armin Bidarian Moniri is the patent-holder for the ‘Pillow and Mattress for Reducing Snoring and Sleep Apnoea’.