Improvement in obstructive sleep apnea in the supine knees-up position.
We report a 38-year-old man with obstructive sleep apnea whose sleep-disordered breathing was substantially reduced by sleep in the supine, "knees-up" position, relative to his sleep in the customary supine, "knees-down" position. No obvious anatomic or pathophysiologic alterations explained this phenomenon. The effect was reproducible in the patient 4 years later. Potential mechanisms underlying such improvement, including alterations in upper airway/lung volume dependence and venous supply to upper airway vasculature, are discussed. This manipulation could be an important adjunctive treatment for a subset of obstructive sleep apnea patients demonstrating such an effect.
Bliwise
Donald L
DL
Sleep Disorders Center, Emory University Medical School, Atlanta, Georgia 30329, USA. dbliwis@emory.edu
Irbe
Dainis
D
Schulman
David A
DA
D000328:Adult; D006801:Humans; D007717:Knee; D008297:Male; D017286:Polysomnography; D011175:Positive-Pressure Respiration / Q000379:methods; D012891:Sleep Apnea Syndromes / Q000150:complications; D020181:Sleep Apnea, Obstructive / Q000150:complications / Q000517:prevention & control*; D012895:Sleep, REM / Q000502:physiology; D016683:Supine Position