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Sleep position and obstructive sleep apnea (OSA): Do we know how we sleep? A new explorative slee** questionnaire

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Abstract

Purpose

Positional obstructive sleep apnea (POSA) has been defined as a difference of 50% or more in Apnea–Hypopnea Index (AHI) between supine and non-supine position. Sleep position is fundamental in the evaluation of obstructive sleep apnea syndrome (OSAS) severity but most tools used in the diagnosis of OSAS are not free from potential bias in the evaluation of usual sleep positions. The aim of this investigation was to evaluate a novel sleep questionnaire with the purpose of exploring sleep habits and evaluating if sleep assessment can identify the usual body position assumed for sleep.

Materials and methods

The questionnaire was administered to patients recruited from October to November 2018. Questions concerned slee** positions and conditions that could influence slee** positions. Patients who had previously undergone polysomnography (PSG) were asked how they slept during the study night. Whenever present during the examination, the patient’s bed partner was also asked about the patient’s usual body positions during sleep.

Results

Of 315 patients (211 men) enrolled, 35% were affected by OSAS and 69% of patients with OSAS had POSA. POSA was more prevalent among men (75%) compared to women (43%). The new questionnaire provided a discordant result from PSG recordings about slee** positions and revealed a difference between usual slee** position and the position during PSG recording. Reported sleep quality was much worse on PSG than at home suggesting that the “first night effect” is real and may lead to over-estimation of POSA cases.

Conclusions

Information about slee** positions is fundamental to the assessment of OSAS severity. Knowledge gained from the new questionnaire as described may represent a valuable addendum to develop a more detailed polygraphic report. Such a tool may be used in practice with the aim of better identifying patients with true positional OSAS. Such patients may benefit from targeted positional therapy.

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Data availability

The data that support the findings of this study are not openly available due to human data and are available from the corresponding author upon reasonable request.

All subjects participating in the study provided their freely given, informed consent to participate in the study and for publication of the results.

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Authors and Affiliations

  1. ENT & Audiology Department, University Hospital of Ferrara, via Aldo Moro n. 8, Cona, 44124, Ferrara, Italy

    Luca Cerritelli, Alberto Caranti, Andrea Migliorelli, Giulia Bianchi, Luigi Marco Stringa, Anna Bonsembiante & Stefano Pelucchi

  2. ENT Department, Morgagni-Pierantoni Hospital, via Carlo Forlanini 34, FC, 47121, Forlì, Italy

    Giovanni Cammaroto & Claudio Vicini

Authors
  1. Luca Cerritelli
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  2. Alberto Caranti
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  3. Andrea Migliorelli
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  4. Giulia Bianchi
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Contributions

Luca Cerritelli, Giovanni Cammaroto, Stefano Pelucchi, Claudio Vicini: designed the work; Andrea Migliorelli, Giulia Bianchi, Luigi Marco Stringa, Anna Bonsembiante: acquired and analyzed data; Luca Cerritelli, Alberto Caranti, Giovanni Cammaroto, Stefano Pelucchi, Claudio Vicini: drafted, revised and approved the manuscript.

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Correspondence to Luca Cerritelli.

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The study protocol was approved by the University of Study of Ferrara.

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The authors declare no competing interests.

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Cerritelli, L., Caranti, A., Migliorelli, A. et al. Sleep position and obstructive sleep apnea (OSA): Do we know how we sleep? A new explorative slee** questionnaire. Sleep Breath 26, 1973–1981 (2022). https://doi.org/10.1007/s11325-022-02576-4

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