閉塞性睡眠時呼吸障害と体位の影響

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Polysomnography was carried out to evaluate the effect of sleeping posture on obstructive sleep dyspnea. Twelve patients who complained of snoring or obstructive sleep apnea were examined for supine and lateral decubitus sleeping postures. Their mean age was 52.2 years (range 38 to 66 years). Intraesophageal pressure was monitored to assess the respiratory effort, in addition to the measurement of apnea plus hypopnea index and oxygen saturation in polysomnography. In the lateral decubitus position, the apnea plus hypopnea index was decreased (supine,55.6±27.0, lateral,34.9 ±31.3; p <0.01) and the mean decrease in oxygen saturation was improved (supine,10.7±4.45%, lateral,8.05 ±2.17%; p <0.05). In the lateral decubitus position, the amplitude of intraesophageal pressure was decreased but not significantly (supine,40.0±19.7 cmH2O, lateral,33.5±15.9 cmH2O; N. S. ). This suggests that sleep position adjustment may be a useful treatment for obstructive sleep apnea. However, as the amplitude of intraesophageal pressure remained high on the lateral decubitus position, the position changes may not be so benificial for some patients with severe respiratory disturbance during sleep.
耳鼻咽喉科臨床学会の論文