P142 Head flexion has the greatest impact on OSA severity during REM sleep. (7th October 2021)

• Record Type: Journal Article
• Authors: Tate, A; Kurup, V; Shenoy, B; Freakley, C; Eastwood, P; Walsh, J; Terrill, P
• Is Part Of: Sleep advances. Volume 2:Supplement 1(2021)
• Page Start: A67
• Page End: A68
• Publication Date: 2021-10-07
• Subjects: Sleep disorders -- Periodicals; Circadian rhythms -- Periodicals; 616.8498
• DOI: 10.1093/sleepadvances/zpab014.183
• Languages: English
• ISSNs: 2632-5012

Abstract

Abstract: Introduction: Recent work has shown that head flexion has a modest worsening effect and head rotation has a modest protective effect on OSA severity. However, there is substantial variability both within and between individuals. In this analysis we aimed to identify if this variability is explained by sleep-state, BMI, age or sex. Methods: 28 participants provided informed consent and were studied using diagnostic polysomnography with the addition of a customised, accelerometry based, head posture measurement device. For each epoch during supine sleep, the sleep state (NREM/REM), average head flexion (degrees) and average head rotation (degrees) were recorded. A logistic mixed effects model was fit across all epochs with the anthropometrics (BMI, sex, age), sleep state, average head flexion and average head rotation as explanatory variables with the absence/presence of one or more respiratory event(s) as the binary outcome variable. Results: In total, 2122 of 5369 supine sleep epochs had a respiratory event. Three participants had no supine sleep. There were significant interaction effects for flexion-rotation, BMI-rotation and REM-flexion. The REM-flexion interaction effect was the strongest interaction effect with an odds ratio per 5 degrees of head flexion in REM sleep of 1.47 (95% CI: 1.13 – 1.86). Discussion: Head flexion related worsening of OSA severity is greatest during REM sleep. This may be explained by attenuated upper airway neuromuscular activation in REM sleep compared with NREM sleep.