Thursday, 3 January 2019

The Effect Of Head Position In Sleep Apnea

By Janet Green


Sleep apnea occurs when breathing is interrupted transiently during sleep from time to time. It is categorized into three types depending on the cause. They include the central, obstructive and complex types. The cause of the central type is the inability of the brain to send the signals needed for respiration to the breathing muscles. The obstructive type occurs when tissues in the throat relax excessively and collapse on themselves leading to a restriction in flow of air. A number of studies on the role of head position in sleep apnea have been done in the past.

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 is a common symptom of apnea. It has been identified as resulting from the vibration of relaxed tissues in the respiratory tract. If the restriction to air is too much, there complete cessation of breathing and one has to wake up to restore their breathing pattern. It is worth noting that snoring is not always present and so a diagnosis of the condition will be based on other signs and symptoms. Such include difficulties in paying attention when one is awake, morning headaches and increased sleepiness.

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.

It is not easy to choose a position in which you will spend the entire sleeping time. This is because, adjustments tend to take place in the the night which alters the option selected initially. For one to have a fixed body orientation, a deliberate effort needs to be undertaken. We will look at examples of options that one may consider.

One of the most effective options is to use a contoured (or memory) pillow. Unlike the ordinary pillow, the contoured pillow maintains its shape at all times. This ensures that the initial sleeping orientation is maintained the entire night. The other major benefit of such pillows is that they maintain neck alignment neck and this serves to improve the quality of sleep.

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.

The adoption of an appropriate sleeping position has been suggested as one of the strategies that can be used in controlling the symptoms of sleep apnea. It may be used as a standalone intervention or alongside other forms of managing the condition. One must bear in mind that this option only works for the obstructive and not the central and mixed types. If you have features suggestive of the condition, you need to see a doctor so that the right classification and appropriate management can be done.




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