Sunday, November 8, 2009

Sleep apnea and positional therapy

I read something interesting on one of the sleep apnea forums the other day. Someone wrote about how much better they slept when sleeping in a recliner. It seems that there may be some connection between sleep apnea and positional therapy.
Positional sleep apnea can sometimes be cured by sleeping on your side. If you find that it relieves your apnea then you probably didn’t have that severe a case of OSA. Another possible consideration for positional sleep apnea is having a
foam pillow made specifically for sleep apnea patients. Once again I don’t know how effective that would be with severe sleep apnea.

It seems when you are sleeping in a recliner you are bend forward from your waist up which supposedly helps keep the airway open. I might give it a try but sleeping in a recliner all night doesn’t sound appealing.

As I have
written before I used to sleep on my stomach until a back injury forced me to sleep on my back. I don’t think that was the only reason that I started to have sleep apnea problems. I also gained weight at the time. Another reason is the shape of my face and the size of my tongue which is very thick. But the way that I position my self in bed, pillows prop my head up (mostly because of acid reflux) doesn’t seem to be a particularly good way to sleep if you have sleep apnea. But unfortunately if I didn’t sleep that way the acid reflux would be gagging me every night.

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  1. David,

    Your situation is not too uncommon. Lifelong stomach sleepers that are suddenly forced to sleep on their backs begin to have major sleep issues. There are two types of forces that close the throat: the front to back forces, mainly affected by gravity. Most people with small jaws and (relatively) large tongues are more affected by this, since the tongue falls back more due to gravity when you're on your back. Most people with these issues compensate by sleeping on the side or stomach.

    There's also the circumferential closing of the soft palate and the rest of the throat due to muscle relaxation (the tongue is affected too). Suddenly sleeping on your back caused poor quality sleep, which over the long run, can cause hormonal and metabolic changes to make you gain weight. Lack of proper exercise due to injury only aggravates this problem.

    Positional therapy works to various degrees in different people. For some, it's a difference between night and day, whereas in others, it makes no difference. You can usually tell from your sleep study.

    Sleeping in a recliner helps by taking away the forces of gravity, but only somewhat.

    If you must sleep on your back, a contour-type pillow that tilts your head back slightly will in theory open your airway while you're sleeping. This maneuver pulls the tongue away from the back of the throat. If you recall from basic CPR training, this is the first step you take to open the airway.

  2. thanks again Dr. Park for the very informative comment!