P032 Prospective Crossover Trial of Positional and Continuous Positive Airway Pressure Therapy (PaCT) for the Treatment of Mild-to-Moderate Positional Obstructive Sleep Apnoea

• Published in: Sleep advances. 2023-10, Vol.4 (Supplement_1), p.A46-A46
• Main Authors: Kinder, S, Ryan, A, Carroll, R, Duce, B, Ellender, C, Wilson, M
• Format: Article
• Language: English
• Subjects: Poster Discussion Presentations
• ISSN: 2632-5012; 2632-5012
• DOI: 10.1093/sleepadvances/zpad035.117

Abstract Introduction Positional obstructive sleep apnoea (pOSA), defined by a supine-to-non-supine AHI ratio ≥2, is a phenotype present in a significant subset of patients with sleep-disordered breathing. CPAP has been the gold standard for OSA treatment since its first description in clinical use, although various practical and patient factors may preclude its use. Positional therapy (PT) provides an alternative for pOSA – shown to be effective in restricting supine sleep, thereby reducing the frequency of events and improving outcomes. Methods Prospective, single-centre crossover trial of consecutive, treatment-naïve participants with symptomatic, mild-to-moderate pOSA on diagnostic polysomnogram. Eligible participants were randomised to undergo paired treatment CPAP and PT polysomnography to assess efficacy. Participants thereafter received a two-month trial of each, according to randomisation. Adherence, symptom, quality of life (QoL) measures, and patient preference were assessed. Results 53 participants completed treatment and follow-up. Mean age was 55.1±12.7 years. 30 participants were male (56.6%). Median BMI was 30.1kg/m2 (27–34). Median baseline AHI was 14.4 (9.9–20.2). Median baseline Epworth Sleepiness Scale (ESS) was 12 (10–14) and improved after treatment with positional [8 (6–11); p=0.001] and CPAP [8 (6-11); p