The association between positional changes and the sleep quality in patients with obstructive sleep apnea improved by an oral appliance

Abstract

Introduction

Obstructive sleep apnea (OSA) is affected by the body position during sleep. However, the relationship between OSA and the number of times sleep position changes has not been examined. To clarify this relationship, we compared and analyzed polysomnography (PSG) results before and after oral appliance (OA) fitting, focusing on changes in the number of position changes during sleep in patients whose OSA improved due to OA use.

Methods

we retrospectively analyzed 26 OSA patients (18 males, 8 females; mean age 60.6 ± 12.0 years old) who underwent PSG at our hospital and demonstrated improvement in the apnea-hypopnea index (AHI) after OA use. Items such as the postural change index (PCI), sleep stages, wake time after sleep onset (WASO), arousal index (ArI), and 3 % oxygen desaturation index (ODI) were evaluated.

Results

After OA fitting, the PCI significantly decreased (p <0.05), indicating a reduced number of body position changes during sleep. The sleep quality improved, as evidenced by a significant decrease in N1 stage sleep (p <0.01), WASO (p <0.05), ArI (p <0.01), and 3 % ODI (p <0.01) and a significant increase in N2 stage sleep (p <0.01). The reduction in the PCI was significant in the patients with severe OSA (p <0.05). Improvements in the sleep quality were more pronounced in the PCI decrease group than in the PCI increase group.

Conclusions

OA reduces position changes and enhances sleep quality, particularly in severe cases, improving sleep stability. Further studies are needed.