Thursday, December 27, 2018

The Role Of Head Position In Sleep Apnea

By Janet Green


Sleep apnea is a condition in which there is transient cessation if breathing while sleeping. There are three subtypes that have been identified. They include obstructive, central and complex types. The obstructive subtype is the commonest and is associated with excessive relation of throat muscles. The central type is caused by failure of the brain to send the signals necessary for the respiratory muscles to contract and relax. Several studies on head position in sleep apnea have been carried out.

Dynamics of air flow in the respiratory tract differ significantly when one moves from the vertical or lateral to the supine orientation. In the latter body orientation, one has to breath against gravity. The muscles fall back into the airway and result in obstruction. During sleep, the muscles are even more relaxed which makes the situation even worse.

Snoring, a common associated symptom of apnea is the result of vibration of relaxed tissues within the respiratory tract. If the restriction is too much it will result in complete blockage of air movement. It is important to note that not everyone with the condition snores so other signs and symptoms may be used in making the diagnosis. These include, among others, excessive sleepiness during the day, morning headache and difficulty in paying attention.

In a study published in 2017 it was shown that head position while asleep does indeed influence the severity of obstructive sleep apnea, OSA. In the 26 subjects studied, a less severe form of the condition was seen when they switched sleeping positions from supine (face up) to lateral (left or right). The reduction was only demonstrated in non-obese subjects while there was no significant change among those that were obese.

It is not easy to choose a position in which you will spend the entire sleeping time. This is because, adjustments tend to take place in the the night which alters the option selected initially. For one to have a fixed body orientation, a deliberate effort needs to be undertaken. We will look at examples of options that one may consider.

One of the most effective options is to use a contoured (or memory) pillow. Unlike the ordinary pillow, the contoured pillow maintains its shape at all times. This ensures that the initial sleeping orientation is maintained the entire night. The other major benefit of such pillows is that they maintain neck alignment neck and this serves to improve the quality of sleep.

Another possible solution is the use of what is referred to as the tennis ball T-shirt. This is a t-shirt that is modified by having a tennis ball sewn into it. The ball is strategically placed into a patch on the back such that it causes some discomfort when one lies on their back. They will naturally readjust into the lateral position which is what is desired. The results from the use of this t-shirt have been variable.

Changing sleeping position from the supine to the lateral is one of the conservative methods used in managing apnea. However, one must bear in mind that this method is only effective for the obstructive type. The central type often requires proper medication. It is necessary to see a physician so that they can identify the subtype and help in formulating the solutions.




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