J Rhinol.  2017 Nov;24(2):94-103. 10.18787/jr.2017.24.2.94.

Effect of Positional therapy on Patients with Obstructive Sleep Apnea: Meta-Analysis

• Lee E
• Choi JH
• Lee B
• Jung JH
• Seon SW
• Lee S
• Kim HJ
• Lee JY

• KMID: 2398827
• DOI: http://doi.org/10.18787/jr.2017.24.2.94

Abstract

BACKGROUND AND OBJECTIVES
Positional therapy is a therapeutic method for obstructive sleep apnea (OSA). However, little is known about the effectiveness of positional OSA treatment based on meta-analysis. Therefore, we undertook a review and meta-analysis of studies to assess the effect of positional therapy on OSA.
SUBJECTS AND METHOD
We searched PubMed (Medline), OVID Medline, EMBASE, Cochrane Library, SCOPUS, KoreaMed, MedRIC, and KSI KISS using the key words "obstructive sleep apnea" and "positional therapy". To estimate the effect of positional OSA therapy, we analyzed the ratio of means (ROM) for pre- and post-treatment polysomnographic data including apnea-hypopnea index (AHI), lowest oxygen saturation, arousal index, and sleep efficiency.
RESULTS
Finally, twenty two studies from 21 papers were included in the meta-analysis. Positional therapy significantly decreased AHI by 54.1% [ROM, 0.459; 95% confidence interval (CI), 0.394 to 0.534] and increased lowest oxygen saturation by 3.3% (ROM, 1.033; 95% CI, 1.020 to 1.046). However, positional therapy did not significantly change arousal index (ROM, 0.846; 95% CI, 0.662 to 1.081) or sleep efficiency (ROM, 1.008; 95% CI, 0.990 to 1.027).
CONCLUSION
Positional therapy significantly improves respiratory parameters including AHI and lowest oxygen saturation in patients with OSA.

Keyword

Obstructive sleep apnea; Positional therapy; Polysomnography; Apnea-hypopnea index; Lowest oxygen saturation

MeSH Terms

Arousal
Humans
Methods
Oxygen
Polysomnography
Sleep Apnea, Obstructive*
Oxygen

Figure

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  Fig. 1. Forest plots for the effectiveness of positional therapy on respiratory and sleep parameters.

• 

  Fig. 2. Funnel plots for respiratory and sleep parameters.

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