Abstract Details

Title Supine Sleep, Sleep Apnea and Sleep Architecture: A Cross-sectional Study in Adults

Topic Sleep

Presentation(s) Sleep Posters (7:00 AM-5:00 PM)

Poster/Presentation
Number 021

Background

OSA is associated with abnormal pauses in breathing during sleep, and has been shown to be independently associated with stroke, motor vehicle collisions, hypertension, diabetes, and increased all-cause mortality. OSA severity is known to worsen in the supine position. However, the physiological degree to which supine sleep worsens OSA and impacts sleep architecture has not been quantified in a dose-dependent manner.

Objective

To quantify the impact of supine sleep on obstructive sleep apnea (OSA) severity and markers of sleep architecture.

Design/Methods

We retrospectively evaluated diagnostic in-laboratory polysomnography recorded during 2010-2015 at our sleep laboratory. Multivariable linear regression models with splines were used to account for non-linear relationships between duration of supine sleep with OSA severity and markers of sleep architecture.

Results A total of 2848 patients were evaluated (48% male, median age was 53 years). There were linear relationships between supine sleep and the apnea-hypopnea index (AHI), respiratory disturbance index (RDI), and lowest oxygen saturation(p <0.0001, <0.0001, and =0.0017 respectfully); for every 10% increase in duration of supine sleep, there was a 0.66 increase in AHI, 0.65 increase in RDI , and 0.19% decrease in oxygen saturation. The non-linear relationship between supine sleep and N2 was “u”-shaped (p=0.005) and the non-linear relationship between supine sleep and REM was upside-down “u”-shaped (p=0.037). Reduced supine sleep showed a positive nonlinear relationship with both total sleep time and sleep efficiency, and a negative nonlinear relationship with wake after sleep onset (p =0.0001, <0.0001, and <0.0001 respectfully).

Conclusions

To our knowledge, our study is the first to (1) quantify the dose-dependent relationship between duration of supine sleep and OSA severity and (2) report a non-linear relationship between supine sleep and markers of sleep architecture. These findings further strengthen the recommendation that patients should be advised to avoid supine sleep in order to reduce OSA severity and improve sleep quality.

Authors/Disclosures
Kathy K. Xiong, MD PRESENTER	Miss Xiong has nothing to disclose.
Trevor Jairam, MD (Azure Condominium)	Trevor Jairam has nothing to disclose.
Brian J. Murray, MD, FAAN	The institution of Dr. Murray has received research support from Wake Up Narcolepsy. Dr. Murray has received publishing royalties from a publication relating to health care.
Mark Boulos, MD (Sunnybrook Health Sciences Centre)	Dr. Boulos has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Jazz Pharmaceuticals. Dr. Boulos has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Paladin Labs. Dr. Boulos has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Eisai. The institution of Dr. Boulos has received research support from Canadian Institutes of Health Research. The institution of Dr. Boulos has received research support from Slamen-Fast New Initiatives in Neurology Award. The institution of Dr. Boulos has received research support from Green Mountain . The institution of Dr. Boulos has received research support from RLS Foundation. The institution of Dr. Boulos has received research support from Temerty Centre for AI Research and Education in Medicine (T-CAIREM). The institution of Dr. Boulos has received research support from Heart & Stroke Foundation of Canada. The institution of Dr. Boulos has received research support from Alternative Funding Plan from the Academic Health Sciences Centres of Ontario. Dr. Boulos has received personal compensation in the range of $5,000-$9,999 for serving as a speaker with Jazz Pharmaceuticals.