Obstructive Sleep Apnea: Causes, Risk Factors and Positional Therapy Treatment

According to the National Institute of Health, sleep apnea is a disease that affects at least 12 million Americans and is as common as diabetes. It occurs when there is decreased airflow to the lungs during sleep.

There are three types; central, obstructive and mixed. The most common is the obstructive type which is usually caused by the opening and closing of soft tissue in the throat during sleep. Mild cases can sometimes be treated with positional therapy.

Treatment of snoring with devices such as a CPAP machine are beyond the scope of this article, but visit the links below for more information regarding snoring.

The respiratory disturbance index (RDI), also known as the apnea-hypopnea index, is used to measure the number of apneic events during sleep studies. A study published in CHEST (September 1997 vol. 112  no. 3  629-639), the official publication of the American College of Chest Physicians, used the RDI to observe differences in positional versus nonpositional sleep apnea patients.

The data showed that 574 out of 666 clinical participants had nearly twice as many incidents of apneic disturbances while sleeping on their backs, also known as the supine position, than those who slept on their sides.

Other reasons for the prevalence of positional sleep apnea is that while lying supine, the tongue falls back into the mouth and blocks the airway to the lungs. Other soft tissues such as the tonsils and airway muscles can block air flow.

It can be difficult to stay in a supine position all through the night. Some doctors recommend sewing one or more tennis balls into the back of pajamas. The theory is that rolling onto the back and feeling the tennis balls will force apnea sufferers to sleep on their sides. A less jarring option would be to sleep with several body sized pillows behind the back while sleeping on the side.

There are companies that develop pillows to keep the neck in a position that keeps the airways open. Some people will still sleep on their backs but position pillows so that their back is elevated at a much higher level than the lower body.

Untreated sleep apnea can lead to heart disease, high blood pressure and weight gain. The loss of sleep because of apneic episodes can cause fatigue, depression and lead to problems performing normal daily activities.

Weight is one of the biggest risk factors in developing sleep apnea. A higher instance of nonpositional sleep apnea is present in patients who are closer to their ideal weight. The disease can affect men, women and children, though it is more common in men over age 30. Other risks include a genetic predisposition and upper airway abnormalities.

Smoking decreases lung capacity which makes sleep apnea even worse. Alcohol decreases muscle reflexivity and should be avoided, especially before going to bed. Consulting with a physician will help determine if positional therapy can play a significant role in the relief of your mild obstructive sleep apnea.

References:

• Treatment Options for Adults with Obstructive Sleep Apnea. American Sleep Apnea Association. 12/2007. Retrieved July 2009.
• Arie Oksenberg, Donald S. Silverberg. Elena Arons, Henryk Radwan. Positional vs. Nonpositional Obstructive Sleep Apnea Patients. CHEST. February 12, 1997. Retrieved July 2009.