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Positional Asphyxiation
Could this be why some people have more apneas while in certain positions, or is that generally accepted as a Duh kind of thing when talking about sleep apnea.
I saw the term used on a TV program last night and got to thinking about it in terms of sleep apnea. It seems that people sometimes die from it when they struggle with the police and are put in a face down position to be subdued. It seems to me that if a person is very heavy it could be the same as having a cop sitting on your back while you are face down thus causing a lack of oxygen. I can also see how it could happen in almost any position according to how the fat is distributed on the person. Any thoughts on this?
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Replies to This Discussion
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Permalink Reply by Mary Z on
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In positional sleep apnea it is worse on the supine. Some people have nonpostional sleep apnea. In some cases positional sleep apnea can change to non positional apnea with wt. loss is an over weight patient. The article went on to say that UARS may be treated with positional therapy. Also important is the position of the neck in order not to compromise the airway. I think certain pillows can help with this, also there has been a dicsussion here about the use of a 33" foam cervial collar. At least one person swears by it. I don't think many of us have tried it. I haven't had a consistent run of numbers so I have not tried this as a comparison to sleeping without the collar (actually I'm embarrased to add a cervical collar to the mask ), but believe it may be worth a try.. The collar is supposed to keep the neck in an extended position, much like what is used in CPR. (By the way, with those who are sqeamish about CPR, chest compressions only are now recommended, though I'm not sure the Red Cross has endorsed this position.) The article explains it better than I do and a google search turned up a lot of articles on positional sleep apnea. I know during my first sleep study they had me sleep on my back for quite awhile. I would think you would need a sleep study in a different sleep positions to provide the answer to whether you have positional apnea or not.
What position do you sleep in? I believe the side lying position to be the best.
Joe, I hope this is of some help, I'm sure others will have opinions.
http://www.talkaboutsleep.com/sleep-disorders/archives/Snoring_apne...
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Permalink Reply by Banyon on
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Good post Mary Z.
I will add that the article did not consider tummy sleeping. Tummy sleeping is every bit as effective as side sleeping in patients with positional sleep apnea.
As a bonus, sleeping on your tummy in the "half-swastika" position is very good for health of the spine and back muscles.
The authors of the study also failed to mention that significant reduction in CPAP pressure requirements may be possible by avoiding back sleeping. To me they overlooked the most important implication of their study. I think a small fraction of the patients could effectively treat their apnea by avoiding back sleeping, however there is likely quite a large segment who could reduce their CPAP pressure requirements to more comfortable levels.
Joe, I believe positional asphyxiation is quite different from positional sleep apnea (PSA). When sleeping on your back, gravity is working directly on the tongue and the soft palate to pull them into the airway. Switch to side or tummy sleeping and the force of gravity is not pulling the tongue and soft palate directly into the airway.
On the other hand, positional asphyxiation includes pressure to the neck region, restriction of the chest wall and impairments of the diaphragm. When the head is forced below the level of the heart, drainage of the blood from the head is reduced. Swelling and bloodspots to the head and neck are signs of increased pressure to the head and neck which are often seen in asphyxiation.
Note also there is considerable controversy about death from positional asphyxiation. Almost all subjects who have died during restraint by law enforcement officers have engaged in extreme levels of physical resistance against the restraint for a prolonged period of time and many of them had been using illegal drugs, particularly cocaine.
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