Positional obstructive sleep apnea, commonly referred to as POSA, happens when people prone to sleep apnea in the first place lie flat on their back to sleep. This supine position makes it more likely that the upper airway will relax or even collapse.
According to the American Sleep Association, approximately 50 percent of people with obstructive sleep apnea have the positional type. The scope of just how may individuals live with sleep apnea in the United States alone is staggering:
“Twenty five million people in the United States have obstructive sleep apnea (OSA). If you have OSA, you might be surprised to learn that your sleep position can affect how many apneic episodes you have each night.”
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The Dangers of Untreated POSA
Most of the time, people with any type of sleep apnea condition fall back asleep after the episode without ever realizing that it took place. That is because the brain alerts the sleeper that something is wrong and to wake up. A sudden stopped breathing event, the subsequent awakening, and finally the almost instant process of falling back asleep all take place in a matter of seconds.
Unfortunately, it can occur several times per hour and seriously interfere with the quality and quantity of sleep. The more often episodes of stopped breathing that occur, the more likely it is that a person will experience one or more of these symptoms:
- Chronic headaches
- Cognitive challenges
- Daytime fatigue
- Irregular heartbeat
- Heart attack
- High blood pressure
Headaches, fatigue, and a risk of heart attack are all valid reasons to look for ways to stop sleeping on your back.
Snoring and Added Strain on Relationships
While not considered a serious health risk, snoring is an extremely common side affect of sleep apnea and positional obstructive sleep apnea in particular. Additionally, the impact of constant snoring on marriages and relationships can be severe.
According to a recent article by Verily, snoring by one partner often leads to sleep deprivation for the other partner, and over time this strain can have very real and lasting consequences:
“When you’re young and in love, planning on building a life together, a little thing like snoring may not be on the top of your list of things to discuss before the wedding day. But the National Sleep Foundation survey found that nearly 25 percent of couples sleep separately as a result of sleep issues. For many of us searching for lasting love and intimacy, that doesn’t sound like a very romantic prospect.”
When snoring leads to arguments, sleeping in separate beds, and ultimately a loss of intimacy in a relationship, it’s definitely a problem worth addressing.
Exploring the Link Between Obstructive and Positional Sleep Apnea
Age, obesity, and having the genetic trait of a thick neck can all increase the likelihood of developing obstructive sleep apnea. Changing sleeping positions to the side, stomach, or another common way to sleep can help to reduce the sleep apnea symptoms related to lying flat on the back. People who find they cannot do this on their own can benefit from sleep therapy and/or products designed to help people start sleeping in a new position.
Obesity, clinically defined as having a body mass index greater than 30, increases the likelihood of developing sleep apnea by four times. It can also be a problem for overweight women going through menopause. It’s important to note, however, that not all overweight or obese people have sleep apnea and that the condition can affect people with a lower body weight as well.
Neck circumference, along with the size of airways, adenoids, and tonsils, all tend to be inherited traits. Women whose neck circumference measures greater than 15 inches and men with a neck size greater than 17 inches are at higher risk of developing sleep apnea than people with smaller necks. Having a very long neck can also increase the risk.
Treatment Methods for POSA
Sleeping on one’s side is the most basic way to alleviate the severity and occurrence of POSA. So-called “positional therapy” aims to help patients train their bodies to sleep in more favorable positions for steady breathing. Recent studies have shown that after 3 months of ongoing positional therapy work, patients not only experienced a reduction in sleep apnea, but higher oxygen counts in their bloodstream.
The tennis ball technique is one of the most common ways that people treat their POSA at home. This involves placing several tennis balls into a sock and then placing the sock under a shirt when going to bed. When the person starts to roll into position to lie flat on the back, the tennis balls prevent movement and cause the sleeper to stay in position. One major drawback to this method is that many people find it uncomfortable.
Another potential drawback is that a surprisingly high percentage of people are able simply sleep right on top of the tennis ball without experiencing sufficient discomfort to move their bodies or to be woken up. As Arie Oksenberg, PhD, director of the Sleep Disorders Unit in the Loewenstein Hospital for the Rehabilitation Center in Raanana, Israel recently told Sleep Review Magazine:
“During the night, the ball can move to the side and some patients—up to 25%—still sleep in the supine position in spite of having the tennis ball technique. They may wake up with some back pain in the morning, although I have had some patients that enjoyed feeling the tennis ball in their back. Thus, the main issues for a low compliance with the tennis ball technique are discomfort and not being able to provide a radical solution. It is clear that any treatment that is not comfortable enough will not succeed in the long term.”
Several other methods involving greater use of technology can also be useful. A device worn around the chest, for example, records the sleeper’s movements and sends a signal to move back into a safe position when necessary. To learn about other treatment methods, people suffering from POSA should visit a sleep specialist.