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Preliminary study on clinical characteristics of Chinese patients with positional obstructive sleep apnea

  • Sleep Breathing Physiology and Disorders • Original Article
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Abstract

Purpose

The objective of this study was to evaluate the prevalence, the clinical characteristics, and the possible predictors of Chinese patients with positional obstructive sleep apnea (POSA) according to the Amsterdam Positional Obstructive Sleep Apnea Classification (APOC).

Methods

A retrospective study in the sleep unit of Peking Union Medical College Hospital was conducted to analyze the clinical and polysomnography data of Chinese patients with obstructive sleep apnea (OSA).

Results

Of 372 patients with OSA, 54% met the APOC criteria for POSA. The prevalence of POSA was significantly higher in women with OSA than in men. Chinese patients with POSA had a lower apnea–hypopnea index, oxygen desaturation index, and the percentage of time spent at oxygen saturation below 90% in total sleep time; and a higher mean oxygen saturation (SaO2) and minimum SaO2 during sleep, which were remarkable in the APOC I group. By multivariate logistic regression analyses, the higher mean SaO2 (≥95%) during sleep and mild and moderate OSA were positive predictors of POSA. Mild and moderate OSA was the independent predictor of POSA in women. Higher mean SaO2 (≥95%) during sleep was the independent predictor of POSA in men.

Conclusion

According to the APOC, the prevalence of POSA is high in Chinese patients with OSA, especially in women. Chinese patients with POSA had less severe OSA and a lower degree of nocturnal hypoxia, which was remarkable in the APOC I group.

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Abbreviations

OSA:

Obstructive sleep apnea

POSA:

Positional obstructive sleep apnea

BMI:

Body mass index

NPOSA:

Nonpositional obstructive sleep apnea

AHI:

Apnea-hypopnea index

APOC:

Amsterdam Positional Obstructive Sleep Apnea Classification

TST:

Total sleep time

BSP:

Best sleeping position

WSP:

Worst sleeping position

PT:

Positional therapy

CPAP:

Continuous positive airway pressure

PSG:

Polysomnography

AASM:

American Academy of Sleep Medicine criteria

ODI:

Oxygen desaturation index

SIT90% :

The percentage of time spent at oxygen saturation below 90% in total sleep time

SaO2 :

Oxygen saturation

REM:

Rapid eye movement sleep

NREM:

Non-rapid eye movement sleep

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Acknowledgments

The authors would like to thank Hairong Zhang and Shuning Li for their help in collecting data.

Availability of data and material

The data used or analyzed during the current study are available from the corresponding author on reasonable request.

Code availability

Not applicable.

Funding

The National Key Research and Development Project (No. SQ2018YFC200148) and the National Natural Science Foundation of China (No. 81570085) funded this study.

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Authors and Affiliations

  1. Department of Respiratory and Critical Care Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, No.1 Shuaifuyuan Street, Dongcheng District, Beijing, 100730, China

    Xiaona Wang, Jinmei Luo, Rong Huang & Xiao Yi

Authors
  1. Xiaona Wang
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  2. Jinmei Luo
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  3. Rong Huang
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  4. Xiao Yi
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by Xiaona Wang, Rong Huang, and Jinmei Luo. The first draft of the manuscript was written by Xiaona Wang and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Rong Huang.

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Ethics approval

This retrospective chart review study involving human participants was in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The Research Ethics Committee of Peking Union Medical College Hospital approved this study with a waiver of patient consent (protocol number S-K1190).

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The authors declare no competing interests.

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Wang, X., Luo, J., Huang, R. et al. Preliminary study on clinical characteristics of Chinese patients with positional obstructive sleep apnea. Sleep Breath 26, 67–74 (2022). https://doi.org/10.1007/s11325-021-02346-8

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