Exploring the Impact of Positional Sleep Apnea in a Turkish Population: Unveiling the Untold Story.

Makbule Ozlem Akbay, Canan Gunduz Gurkan, Ayse Ezgi Ak, Sema Sarac
Author Information
  1. Makbule Ozlem Akbay: Department of Chest Diseases, University of Health Sciences Istanbul Sureyyapasa Chest Diseases and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey. ORCID
  2. Canan Gunduz Gurkan: Department of Chest Diseases, University of Health Sciences Istanbul Sureyyapasa Chest Diseases and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey. ORCID
  3. Ayse Ezgi Ak: Department of Chest Diseases, University of Health Sciences Istanbul Sureyyapasa Chest Diseases and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey. ORCID
  4. Sema Sarac: Department of Chest Diseases, University of Health Sciences Istanbul Sureyyapasa Chest Diseases and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey. ORCID

Abstract

BACKGROUND The present study aimed to investigate the risk factors associated with demographical, clinical and polysomnographic features of positional sleep apnea through different criterion of positional sleep apnea (POSA vs e-POSA) in a large patient cohort from a tertiary referral center MATERIAL AND METHODS A total of 782 OSA patients who were further diagnosed with POSA (total: n=470, e-POSA: n=204) or non-POSA (n=312) based on apnea-hypopnea index (AHI) events by overnight polysomnography were included. Demographical, clinical, and polysomnographic characteristics were recorded, while independent predictors of POSA and e-POSA were determined via linear regression analysis. RESULTS Severe OSA (AHI ≥30/h) was less common in the POSA (33.4% vs 71.5%, P<0.001) and e-POSA (9.8% vs 62.3%, P<0.001) groups than in the non-POSA and non-e-POSA groups, respectively. For POSA and e-POSA, male sex (OR 2.195, P<0.001 and OR 2.021, P=0.004, respectively), low body mass index (BMI; OR 0.932, P<0.001 and OR 0.948, P=0.006), low AHI (OR 0.954 and OR 0.902, P<0.001 for each), and less desaturation (T90%, OR 0.972 and OR 0.968, P<0.001 for each) were the common statistically significant predictors. Younger age was an independent predictor of POSA (OR 0.97, P=0.003). POSA (median 20.4 s) and e-POSA (20.5 s) groups demonstrated similar apnea-hypopnea durations (min) as the non-POSA (median 21.1 s) group. CONCLUSIONS Our findings revealed that male sex and lower values of BMI, AHI, and desaturation were common determinants of POSA and e-POSA, while younger age independently predicted POSA. POSA and e-POSA had similar clinical and polysomnographic characteristics and shared the unvaried hypoxic burden.

References

  1. Lancet Respir Med. 2013 Mar;1(1):61-72 [PMID: 24321805]
  2. N Engl J Med. 2019 Apr 11;380(15):1442-1449 [PMID: 30970189]
  3. Nat Sci Sleep. 2020 Dec 04;12:1123-1135 [PMID: 33304112]
  4. Ann Thorac Med. 2022 Oct-Dec;17(4):207-213 [PMID: 36387756]
  5. Sleep Med. 2019 Dec;64:101-105 [PMID: 31677484]
  6. Sleep Breath. 2017 Dec;21(4):877-884 [PMID: 28425082]
  7. Sleep Med. 2018 Oct;50:145-151 [PMID: 30055481]
  8. J Clin Sleep Med. 2017 Mar 15;13(3):479-504 [PMID: 28162150]
  9. Sleep Breath. 2013 Mar;17(1):39-49 [PMID: 22441662]
  10. Sleep Breath. 2022 Mar;26(1):67-74 [PMID: 33786692]
  11. Annu Int Conf IEEE Eng Med Biol Soc. 2014;2014:270-3 [PMID: 25569949]
  12. Sleep Breath. 2015 May;19(2):637-44 [PMID: 25335642]
  13. Sleep Med. 2018 Aug;48:157-162 [PMID: 29957486]
  14. Sleep Breath. 2020 Jun;24(2):551-559 [PMID: 31325020]
  15. Med Biol Eng Comput. 2013 Jun;51(6):697-708 [PMID: 23417543]
  16. Laryngoscope. 2020 Sep;130(9):2263-2268 [PMID: 31721222]
  17. Sleep. 2017 May 1;40(5): [PMID: 28444355]
  18. Medicine (Baltimore). 2016 Nov;95(48):e5493 [PMID: 27902610]
  19. Proc Am Thorac Soc. 2008 Feb 15;5(2):173-8 [PMID: 18250209]
  20. Chest. 2005 Oct;128(4):2130-7 [PMID: 16236865]
  21. Sleep. 1984;7(2):110-4 [PMID: 6740055]
  22. J Clin Sleep Med. 2020 Dec 15;16(12):2037-2046 [PMID: 32804071]
  23. Sleep Breath. 2022 Jun;26(2):675-680 [PMID: 34278514]
  24. J Sleep Res. 2014 Apr;23(2):204-10 [PMID: 24118690]
  25. Clin Neurophysiol. 2016 Jan;127(1):565-570 [PMID: 26116298]
  26. Cureus. 2022 Jun 14;14(6):e25946 [PMID: 35855223]
  27. J Epidemiol Glob Health. 2023 Mar;13(1):129-139 [PMID: 36705890]
  28. Medicina (Kaunas). 2021 Apr 01;57(4): [PMID: 33915973]
  29. Entropy (Basel). 2020 Dec 12;22(12): [PMID: 33322747]
  30. Cochrane Database Syst Rev. 2019 May 01;5:CD010990 [PMID: 31041813]

MeSH Term

Humans
Male
Hypoxia
Linear Models
Polysomnography
Sleep Apnea Syndromes
Ubiquitin-Protein Ligases
Sleep Apnea, Obstructive

Chemicals

Ubiquitin-Protein Ligases

Word Cloud

Created with Highcharts 10.0.0POSAORe-POSA0P<0001AHIclinicalpolysomnographicvsnon-POSAcommongroupsP=0spositionalsleepapneaOSAapnea-hypopneaindexcharacteristicsindependentpredictorslessrespectivelymalesex2lowBMIdesaturationagemedian20similarBACKGROUNDpresentstudyaimedinvestigateriskfactorsassociateddemographicalfeaturesdifferentcriterionlargepatientcohorttertiaryreferralcenterMATERIALANDMETHODStotal782patientsdiagnosedtotal:n=470e-POSA:n=204n=312basedeventsovernightpolysomnographyincludedDemographicalrecordeddeterminedvialinearregressionanalysisRESULTSSevere≥30/h334%715%98%623%non-e-POSA195021004bodymass932948006954902T90%972968statisticallysignificantYoungerpredictor9700345demonstrateddurationsmin211groupCONCLUSIONSfindingsrevealedlowervaluesdeterminantsyoungerindependentlypredictedsharedunvariedhypoxicburdenExploringImpactPositionalSleepApneaTurkishPopulation:UnveilingUntoldStory

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