Beyond Achondroplasia

Growing together with Clara

How can sleeping position influence obstructive sleep apnea

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There are many positions a person can adopt to sleep. This article will make the approach to back and stomach sleep positions (supine and prone).

Supine_and_prone_2012-02-20

Image from wikipedia.org

In 1992, the American Academy of Pediatrics released a statement recommending that all healthy infants be placed down for sleep on their backs (Pediatrics, 1992;89: 1120-1126). This recommendation was based on numerous reports that babies who sleep prone have a significantly increased likelihood of dying of sudden infant death syndrome (SIDS). The recommendation was reaffirmed in 1994 (Pediatrics, 1994;93:820). Health care professionals are encouraged to read both publications for a review of the evidence that led to the recommendation.

A national campaign (the “Back to Sleep” campaign) was launched in 1994 to promote supine positioning during sleep. Periodic surveys have confirmed that the prevalence of prone sleeping among infants in the United States has decreased from approximately 75% in 1992 to less than 25% in 1995. Provisional mortality statistics suggest that the death rate from SIDS has simultaneously decreased by over 25% — by far the largest decrease in SIDS rates since such statistics have been compiled.

Although the recommendation appears simple (most babies should be put to sleep on their backs), a variety of questions have arisen about the practicalities of implementation. The AAP Task Force on Infant Sleep Position and SIDS has considered these questions and prepared the following responses. It should be emphasized, however, that for most of these questions there are not sufficient data to provide definitive answers.”

From http://www.nih.gov/nichd/docs/news/SIDS_HP_2/quan.html

infant_respiratory

“Are there any babies who should be placed prone for sleep?

In published studies, the vast majority of babies examined were born at term and had no known medical problems. Babies with certain disorders have been shown to have fewer problems when lying prone. These babies include:
– infants with symptomatic gastroesophageal reflux (reflux is usually less in the prone position).
babies with certain upper airway malformations once there are fewer episodes of airway obstruction in the prone position”

This situation became very clear to me when Clara, at 9 months-old, started changing by herself her sleep position, chosing the sleep in a prone position. At that time, she was still using the CPAP device and was hard to put the mask, that I had to put on her when her oxygen saturation dropped below 90%. But I observed that her oxygen saturation improved tremendously in that time she was sleeping with her stomach done. After that, and with the published article, I realised that a child with a obstrutive sleep apnea could improve very much just changing from the advised back sleep position (just for the SIDS) to a stomach position.

Clara was diagnosed with severe sleep apnea at 3 months-old and never did a tonsillectomy or adenoidectomy and she sleeps very well, making almost no noise while breathing if lying in her stomach or in her side. When she sleeps lying in her back, I can easily hear her breathing (no snoring whoever)

This is a very interesting article “Effect of prone positioning in mild to moderate obstructive sleep apnea syndrome“, Uccar ZZ, 2015

In the abstract of this article, the author says that “sleeping in prone position could be effective in the management of obstructive sleep apnea (OSA) syndrome by reducing the gravity effect on the upper airway and hence collapsibility”

And the next article :”Supine and Prone Infant Positioning: A Winning Combination” by Martha Wilson Jones, 2004, many issues are rose from the back sleep campaign, mainly cranial deformations and gross motor skills delay.

2 Comments

  1. Makes total sense – my son slept on his side when breastfed (we were co-sleeping so he just slept on the boob!) but he continues to prefer side position now that he sleps in his own bed. I agree the breathing is much quieter than when lying supine. Interesting artictle, thank you for sharing!

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