Scientific studies indicate that over 50% of people with light to moderate OSA who sleep on their back are more likely to suffer increased airway obstruction during sleep. If a person diagnosed with OSA experiences an increased airway obstruction as he sleeps in a supine position than when he is sleeping on his side, chances are he is has Positional Obstruction Sleep Apnoea or POSA.

What is POSA?

POSA is scientifically defined as OSA with apnoea/hypopnoea index or AHI level that is at least two times higher when the patient is sleeping on his back than when he is sleeping on his side or on his stomach. The formula clearly explains it: AHI supine > 2x AHI other position.
The upper airway of an OSA patient collapses when sleeps on his back. Counting gravity, the tongue is often displaced in the posterior pharynx area. When this happens, the pharyngeal area is reduces when a person sleeps on his back.

According to the American College of Chest Physicians, close to 60% of OSA patients exhibit fewer symptoms when they sleep on their side. It has also been noted that over 50% of OSA patients find relief if they opt for positional therapy.

Efficiency of OSA Positional Therapy

By sleeping on their side, POSA patients will experience less airway blockage. The solution seems to be easy but is it effective?
There are scientific studies that indicate the efficiency of positional therapy. A recent study (2012) published in ncbi.nlm.nih.gov studied the long term efficacy of positional therapy on POSA patients. Sixteen OSA patients who are CPAP intolerant were tested with a positional therapy device. After three months of test, it was concluded that positional therapy can effectively manage positional OSA.

The Journal of Clinical Sleep Medicine compared CPAP to positional therapy in POSA patient. The conclusion is that CPAP and positional therapy are comparable in managing and normalizing apnoea/hypopnoea index (AHI) in patients with POSA. In both therapies, nocturnal oxygenation and sleep quality are equal.

Positional Therapy Methods

There are many techniques to help a POSA patient maintain sleeping on his side. The most popular home-remedy is putting at least three tennis balls in a pocket or old sock sew is on the top back of the patient’s sleepwear. Some POSA patients sleep wearing a filled backpack. Another method is to elevate the head at a 30 to 60 degree angle. Also available are bumper belts, anti-snore shirts, and posture alarms that are triggered when a patient sleeps on his back.

Currently, the most efficient solution is a product called Nightshift, a positional therapy device that prods a POSA patient to sleep on his side every time he reverts to a supine position during sleep. With this device a POSA patient can enjoy a peaceful night’s sleep. However, there are some indications that POSA patients with acute neck, shoulder or back pain and those with artificial pacemaker are not suitable to use such device.

It is always best to consult a qualified doctor is POSA is suspected.
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