Even slight head rotation improves breathing in OSA

Even a small degree of head rotation helps improve airway patency and reduce obstruction in patients with obstructive sleep apnoea (OSA), reports a recent study.

The study included 221 patients (median age 52 years, 175 men) who underwent overnight polysomnography. Drug-induced sleep endoscopy was performed to assess airway patency and locate sites of collapse in the supine position, with head rotated at 0, 30, and 60 degrees.

At 0 degrees of rotation, 91.9 percent of participants had at least one anatomic site that was deemed completely obstructed; 38.0 percent (n=84) had multisite obstruction and 53.8 percent (n=119) had single-site obstruction.

Slight rotation to 30 degrees caused a change in the collapsibility score from 2 to 0 in 29 patients (14.3 percent; p<0.001), indicating no obstruction, and suggesting that even relatively limited rotation can significantly improve airway patency (p<0.001). Similarly, greater rotation to 60 degrees resolved obstruction in 13 more patients (p<0.015).

In terms of specific sites of obstruction, a 30-degree rotation resolved velum collapse in 24 patients (12.8 percent; p<0.001) while a 60-degree turn did so in 14 more patients (8.5 percent; p<0.001). Significant improvements were also reported in the oropharyngeal lateral walls, tongue, and epiglottis.

“These results inform how much the head should be rotated and to whom it should be applied. They may also enable the development of sleep aids targeting head rotation,” the researchers said.