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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.

The position in which an individual sleeps may not be very easy to determine. Left on its own, the body will find the most comfortable position and will keep making adjustments throughout the night. To achieve a particular head orientation, therefore, requires a deliberate effort. There are several suggestions that have been advanced.

One of the solutions that have been proposed in maintaining sleeping position is the memory or contoured pillow. Such a pillow maintains its shape throughout the course of sleep thus also maintains the orientation of the body . This is in contrast to ordinary pillows that tend to change shape from time to time. Contoured pillows also assist with keeping the neck and spine in place.

Another solution that has been tried with variable success is the what is known as the tennis ball T-shirt. The way this works is that a tennis ball is sewn into a patch that is in turn fixed to the back of a T-shirt. The idea is to prevent the wearer from lying on their back. Any time they assume the supine body orientation, pressure from the ball causes discomfort and they have to readjust. This ensures that they sleep mainly in lateral orientation.

Adopting an appropriate sleeping position is vital in the management of sleep apnea when used on its own or alongside other measures. The method is, however, only effective for the obstructive type and not the central central and complex types. If you suspect to be suffering from this condition, you will be well advised to see a physician for a proper diagnosis and treatment.




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