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

Lee, Eunsang; Choi, Ji Ho; Lee, Bora; Jung, Jae Hyun; Seon, Sang Woo; Lee, Seungjae; Kim, Hyo Jun; Lee, Jae Yong

doi:2017.24.2.94

J Rhinol > Volume 24(2); 2017

Meta-Analysis

Journal of Rhinology 2017;24(2):94-103.
Published online November 30, 2017.
DOI: https://doi.org/10.18787/jr.2017.24.2.94

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

Eunsang Lee, Ji Ho Choi, Bora Lee, Jae Hyun Jung, Sang Woo Seon, Seungjae Lee, Hyo Jun Kim, Jae Yong Lee

¹Department of Otorhinolaryngology-Head and Neck Surgery, Soonchunhyang University College of Medicine, Bucheon Hospital, Bucheon, Korea. handsomemd@hanmail.net
²Department of Biostatistics, Clinical Trial Center, Soonchunhyang Medical Center, Bucheon, Korea.

폐쇄성수면무호흡증 환자에서 시행된 자세치료의 효과: 메타분석

이은상, 최지호, 이보라, 정재현, 선상우, 이승재, 김효준, 이재용

순천향대학교 의과대학 부천병원 이비인후-두경부외과학교실,¹ 순천향대학교 부천병원 임상시험센터 의학통계상담실²

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.

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