Format

Send to

Choose Destination
Sleep Breath. 2017 Dec;21(4):815-820. doi: 10.1007/s11325-017-1524-3. Epub 2017 Jun 24.

The influence of head-of-bed elevation in patients with obstructive sleep apnea.

Author information

1
Pulmonary Division - Hospital São José, Pulmonar Sleep Laboratory and Universidade do Extremo Sul Catarinense, Antônio de Lucca 91, 4th floor, Pio Correa, Criciúma, Santa Catarina, Brazil. fsouzapneumo@hotmail.com.
2
Sleep Laboratory, Pulmonary Division, Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil.
3
Pulmonary Division, Hospital São José and Pulmonar Sleep Laboratory, Criciúma, Santa Catarina, Brazil.
4
Division of Sleep Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.

Abstract

PURPOSE:

The purpose of this study is to test the effects of a mild degree of head-of-bed elevation (HOBE) (7.5°) on obstructive sleep apnea (OSA) severity and sleep quality.

METHODS:

OSA patients were recruited from a single sleep clinic (Criciúma, Santa Catarina, Brazil). Following a baseline polysomnography (PSG), all patients underwent a PSG with HOBE (within 2 weeks). In addition, a subset of patients performed a third PSG without HOBE.

RESULTS:

Fifty-two patients were included in the study (age 53.2 ± 9.1 years; BMI 29.6 ± 4.8 kg/m2, neck circumference 38.9 ± 3.8 cm, and Epworth Sleepiness Scale 15 ± 7). Compared to baseline, HOBE significantly decreased the apnea-hypopnea index (AHI) from 15.7 [11.3-22.5] to 10.7 [6.6-16.5] events/h; p < 0.001 and increased minimum oxygen saturation from 83.5 [77.5-87] to 87 [81-90]%; p = 0.003. The sleep architecture at baseline and HOBE were similar. However, sleep efficiency increased slightly but significantly with HOBE (87.2 [76.7-90.7] vs 88.8 [81.6-93.3]; p = 0.005). The AHI obtained at the third PSG without HOBE (n = 7) returned to baseline values.

CONCLUSIONS:

Mild HOBE significantly improves OSA severity without interfering in sleep architecture and therefore is a simple alternative treatment to ameliorate OSA.

KEYWORDS:

Obstructive sleep apnea; Patient positioning; Polysomnography; Therapy

Supplemental Content

Full text links

Icon for Springer Icon for PubMed Central
Loading ...
Support Center