Body Position and Obstructive Sleep Apnea in Children

STUDY OBJECTIVES: In adults, sleep apnea is worse when the patient is in the supine position. However, the relationship between sleep position and obstructive apnea in children is unknown. The objective of this study was to evaluate the relationship between obstructive apnea and body position during sleep in children. DESIGN: Retrospective analysis of the relationship between body position and obstructive apnea in obese and non-obese children. SETTING: Tertiary care pediatric sleep center. PATIENTS: Otherwise healthy children, aged 1-10 years, undergoing polysomnography for suspected obstructive sleep apnea syndrome. Obese and non-obese children were evaluated separately. INTERVENTIONS: Retrospective review of the relationship between sleep position and obstructive apnea during polysomnography. MEASUREMENTS AND RESULTS: Eighty polysomnograms from 56 non-obese and 24 obese children were analyzed. Body position was determined by a sensor during polysomnography, and confirmed by review of videotapes. Children had a lower obstructive apnea hypopnea index when supine vs. prone, and shorter apneas when supine then when on their side. There was no difference in apnea duration between the supine and prone positions. Obese and non-obese children showed similar positional changes. CONCLUSIONS: Children with obstructive sleep apnea, in contrast to adults, breathe best when in the supine position.