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Otolaryngol Head Neck Surg. 2009 Apr;140(4):531-5. doi: 10.1016/j.otohns.2008.12.023.

The implication of sleep position in the evaluation of surgical outcomes in obstructive sleep apnea.

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  • 1Department of Otorhinolaryngology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Bundang-Gu, Seongnam, Korea.

Abstract

OBJECTIVE:

To investigate the effect of sleep position on surgical outcomes in obstructive sleep apnea (OSA).

STUDY DESIGN:

Retrospective review of 69 consecutive patients.

SUBJECTS AND METHODS:

Preoperative and postoperative polysomnographic data and Epworth sleepiness scale were obtained. Patients were categorized into success, response, no response, and failure groups according to apnea-hypopnea index (AHI) after uvulopalatopharyngoplasty. Proportions of supine or lateral position and AHI of each position were evaluated. Position-corrected AHI was developed in order to eliminate the effect of sleep position.

RESULTS:

Preoperative proportion of supine position in the failure group (n = 26) was 41.3 percent, which was the lowest among four groups (P = 0.010), and increased to 60.8 percent postoperatively (P = 0.028). Twenty-two (84.6%) among the failure group had supine position dependency. Regrouped by position-corrected AHI, 15 patients moved into different groups. Postoperative AHI showed positive correlation with increased supine position when BMI was controlled (r = 0.515, P = 0.006).

CONCLUSION:

Without appropriate correction based on the change of sleep position, the fluctuation of sleep position in each polysomnography might confound surgical outcomes in OSA patients. Thus, it is a substantial issue how to control or reflect the positional effect on AHI when treatment results are evaluated.

[PubMed - indexed for MEDLINE]
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