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Vol. 57. Issue 6.
Pages 393-398 (June 2021)
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Vol. 57. Issue 6.
Pages 393-398 (June 2021)
Original Article
DOI: 10.1016/j.arbr.2020.03.030
Evaluation of the Impact of Body Position on Primary Central Sleep Apnea Syndrome
Evaluación del impacto de la posición corporal en el síndrome de apnea central del sueño primaria
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Burcu Oktay Arslana,
Corresponding author
dr.arslanburcu@gmail.com

Corresponding author.
, Zeynep Zeren Ucar Hosgora, Selim Ekincib, Isil Cetinkolc
a University of Health Science, Dr. Suat Seren Chest Diseases and Chest Surgery Training and Research Hospital, Department of Chest Medicine and Sleep Disorders Center, Izmir, Turkey
b University of Health Science, Tepecik Training and Research Hospital, Department of Cardiology, Izmir, Turkey
c University of Health Science, Dr. Suat Seren Chest Diseases and Chest Surgery Training and Research Hospital, Department of Neurology, Izmir, Turkey
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Figures (2)
Tables (4)
Table 1. Demographic Data of the Study Population (n=39).
Table 2. Comparison of the Baseline Characteristics of the Primary PCSA and Non-PCSA Groups.
Table 3. Comparison of the Sleep Study Data of the Primary PCSA and Non-PCSA Groups.
Table 4. Treatment Modalities Applied to the Subjects.
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Abstract
Objective

To evaluate the impact of the body position on primary central sleep apnea syndrome.

Methods

Fifty-five subjects diagnosed with central sleep apnea (CSA) through polysomnographic examinations were prospectively enrolled in the study. All patients underwent cardiologic and neurologic examinations. Primary positional central sleep apnea (PCSA) was determined when the supine Apnea–Hypopnea Index (AHI) was greater than two times the non-supine AHI. The primary PCSA and non-PCSA groups were compared in terms of demographic characteristics, sleep parameters, and treatment approaches.

Results

Overall, 39 subjects diagnosed with primary CSA were included in the study; 61.5% of the subjects had primary PCSA. There were no differences between the primary PCSA and non-PCSA groups regarding age, sex, body mass index (BMI), co-morbidities, and history of septoplasty. In terms of polysomnography parameters, AHI (P=.001), oxygen desaturation index (P=.002), the time spent under 88% saturation during sleep (P=.003), number of obstructive apnea (P=.011), mixed apnea (P=.009), and central apnea (P=.007) was lower in the primary PCSA group than in the non-PCSA group. Twenty-nine percent of the patients in the primary PCSA group were recommended position treatment and 71% were recommended positive airway pressure (PAP) therapy; all patients in the non-PCSA group were recommended PAP therapy.

Conclusions

Our results demonstrated that the rate of primary PCSA was high (61.5%) and primary PCSA was associated with milder disease severity compared with non-PCSA. The classification of patients with primary CSA regarding positional dependency may be helpful in terms of developing clinical approaches and treatment recommendations.

Keywords:
Primary central apnea
Central sleep apnea
Body position
Central apnea
Resumen
Objetivo

Evaluar el impacto de la posición del cuerpo en el síndrome de apnea central del sueño primaria.

Métodos

En el estudio se incluyeron prospectivamente 55 sujetos con diagnóstico de apnea central del sueño (ACS) a través de sus estudios polisomnográficos. Todos los pacientes fueron sometidos a exámenes cardiológicos y neurológicos. La apnea central del sueño posicional (ACSP) se estableció cuando el índice de apnea-hipopnea (IAH) en posición supina fue más de dos veces mayor que el IAH en posición no supina. Se compararon los grupos de pacientes con ACSP primaria y sin ACSP en función de las características demográficas, los parámetros del sueño y los enfoques de tratamiento.

Resultados

En total, se incluyeron en el estudio 39 sujetos con diagnóstico de ACS primaria. El 61,5% de los sujetos presentaban ACSP primaria. No hubo diferencias entre los grupos de ACSP primaria y sin ACSP con respecto a la edad, el sexo, el índice de masa corporal (IMC), las comorbilidades y los antecedentes de septoplastia. En cuanto a los parámetros de polisomnografía, el IAH (p=0,001), el índice de desaturación de oxígeno (p=0,002), el tiempo transcurrido con una saturación por debajo del 88% durante el sueño (p=0,003) y el número de apneas obstructivas (p=0,011), de apneas mixtas (p=0,009) y de apneas centrales (p=0,007) fueron menores en el grupo con ACSP primaria que en el grupo sin ACSP. Al 29% de los pacientes en el grupo de ACSP primaria se les recomendó tratamiento posicional y al 71% se les recomendó tratamiento de presión positiva de la vía aérea (PAP); a todos los pacientes del grupo sin ACSP se les aconsejó tratamiento PAP.

Conclusiones

Nuestros resultados demostraron que la tasa de ACSP primaria fue alta (61,5%) y la ACSP primaria se asoció con una enfermedad más leve en comparación con la ACS no posicional. La clasificación de pacientes con ACS primaria dependiente de la posición puede ser útil a la hora de desarrollar enfoques clínicos y recomendaciones de tratamiento.

Palabras clave:
Apnea central primaria
Apnea del sueño primaria
Posición del cuerpo
Apnea central

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