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How can sleeping position influence obstructive sleep apnea

There are many positions a person can adopt to  sleep. This article will approach the back and stomach sleep positions (supine and prone), which influence breathing and quality of sleep.

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 https://www.nichd.nih.gov/sids/Pages/sids_qa.aspx.


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 since there are fewer episodes of airway obstruction in the prone position"

Airway malformations (such as large adenoids and tonsils) can, sometimes, be observed in babies with achondroplasia, causing obstructive sleep apnea (OSA) which could be reduced by sleeping in the prone position, without requiring tonsillectomy or adenoidectomy.

This is a very interesting article on the effects of sleep position in OSA: "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".


Another article: "Supine and Prone Infant Positioning: A Winning Combination" by Martha Wilson Jones, 2004, shows that many issues may have been caused by the back sleep campaign (mainly cranial deformations and gross motor skills delay).

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