SLEEP 2011 Abstract Supplement

B. Clinical Sleep Science I. Sleep Disorders – Breathing
actigraphy, and subjective sleep quality was assessed with the Pittsburgh
Sleep Quality Index (PSQI).
Results: EX resulted in a significant reduction in AHI relative to STR
(EX: 32.2±5.6 [mean±standard error] to 24.6±4.4, STR: 24.4±5.6
to 28.9±6.4; P= 30, and the AHIn for 4(7%) was in the moderate group and for 5 (9%)
in the mild group and 5(9%) in not-OSAHS group. For 40 in the moderate
group, 17 (43%) had AHIn in the mild category and 7 (18%) were in
the not-OSAHS group. For 58 in the mild group, 32 (55%) had AHIn in
not-OSAHS category.
Conclusion: Individuals with OSAHS based on AHI >= 5, having
slept both supine and in other positions, overwhelmingly show a higher
prevalence of obstructive events while supine. Our data suggest that by
avoiding the supine position, 2 out of 5 individuals with mild or moderate
OSAHS (including over half with mild) no longer would meet criteria
for diagnosis. One in 4 with severe OSAHS would come to a lower
severity designation. Accordingly, avoiding sleeping supine could be
expected to benefit well over half of individuals with mild to moderate
OSAHS and remove the diagnosis entirely from one in three with mild
severity. Awareness of these data may be helpful in treating patients and
in supporting public health advisories about OSAHS.
0420
OBSTRUCTIVE SLEEP APNEA IN ADULTS: BODY
POSTURES AND WEIGHT CHANGES INTERACTIONS
Oksenberg A 1 , Arons E 1 , Dynia A 2 , Nasser K 1 , Vander T 1 , Gadoth N 1
1
Sleep Disorders Unit, Loewenstein Hospital Rehabilitation Center,
Raanana, Israel, 2 Fleischman Unit for the Study of Disability,
Loewenstein Hospital - Rehabilitation Center, Raanana, Israel
Introduction: Body postures changes as well as weight changes have a
major influence on the severity of Obstructive Sleep Apnea (OSA). The
aim of the present study was to assess the interactions between changes
in body posture and body weight changes in adult OSA patients.
Methods: For the purpose of this study, we analyzed demographic and
polysomnographic data of 112 non-treated adults with OSA who underwent
two polysomnographic (PSG) evaluations at our Sleep Disorders
Unit. The average time interval between the first and the second PSG
was 6.2±3.7 years.
Results: Positional Patients (PP) - having most of their breathing abnormalities
in the supine posture, who became Non Positional Patients
(NPP) - having apneas and hypopneas unrelated to body posture, had a
significant weight gain and a significant increase in Apnea Hypopnea
Index (AHI), but mainly in Lateral AHI. On the contrary, NPP who became
PP had a significant decrease in weight (but less than the increase
in weight of PP who became NPP) and showed a significant improvement
in AHI, again mainly in Lateral AHI. These NPP who became PP
had initially a less severe disease as judged by AHI, Lateral AHI and
minimum SaO2 during NREM sleep and were less obese than NPP
who remained NPP. The later were the patients who showed initially the
worst condition and were more obese than the rest of the patients. After
5 years on average their condition did not change significantly.
Conclusion: NPP who became PP showed a decrease in body weight
and improvement of OSA while PP who became NPP showed an increase
in body weight and worsening of OSA. It appears that weight
changes have a modulatory effect on positional dominance, and Lateral
AHI seems to be a sensitive parameter of these changes.
0421
THE INFLUENCE OF SLEEP POSITION ON GLUCOSE
INTOLERANCE IN POSITIONAL OBSTRUCTIVE SLEEP
APNEA SYNDROME
Shin W 1 , Cho Y 2 , Yoon J 1 , Sung M 1 , Hwang K 1 , Chang E 1
1
Neurology, KyungHee Medical Center at Kangdong, Seoul, Republic
of Korea, 2 Neurology, Dongsan Medical Center, Daegu, Republic of
Korea
Introduction: It is well known that patient with positional obstructive
sleep apnea-hypopnea syndrome(OSAHS) have less severe respiratory
disturbance and less obesity than in patient with nonpositional OSAHS
and obstructive sleep apnea-hypopnea syndrome (OSAHS) is associated
with impaired glucose intolerance. We investigated that pattern of
impaired glucose intolerance differs among patient with non-positional
OSAHS and positional OSAHS.
Methods: We diagnosed OSAHS by overnight polysomnography study.
And we assessed severity apnea-hypopnea index (AHI) and positonal
apnea-hypopnea index difference. We defined positional OSAHS when
supine-lateral index [(supine AHI- lateral AHI)/supine AHI] is more
than 0.5. Insulin resistance was assessed with fasting plasma blood glucose,
plasma insulin and homeostatic model assessment of insulin resistance
index (HOMA-IR), leptin.
Results: 72 OSAHS patients included. Positional OSAHS were 50 and
nonpositional OSAHS 22. The body mass index, respiratory disturbance
index, waist circumference, glucose were higher in severe OSAHS.
Compared with positional and nonpositional OSAHS group, there were
noted that impaired glucose tolerance and HOMA-IR were significantly
increased in non-positional OSAHS group.
Conclusion: We found that that severe OSAHS is associated with
glucose intolerance and non-positional OSAHS has a poor control of
glucose than positional OSAHS group. It is suggest that the positional
change during sleep in OSAHS could compensate the aggravation of
metabolic consequence by OSAHS.
A145
SLEEP, Volume 34, Abstract Supplement, 2011