The Effect of Positioning on the Severity Of Sleep Apnea Syndrome and Its Relevance In the Avoidance of Hypoxia in Acute Stroke

Abstract

The aim of the current systematic review was to investigate the effect of positioning on the severity of sleep apnea syndrome (SAS), in order to identify which subjects will show this effect and to establish the efficacy of positioning as a treatment. Databases searched were: Premedline and Medline, Psychinfo, Embase, CINAHL, PEDro, all EMB Reviews and the Scottish Intercollegiate Guidelines Network plus hand searching. All study types, except case studies, were included and the methodological quality was evaluated using a tool designed by Downes and Black. Twenty papers were included. Taken together they suggested that less obese SAS patients have fewer apneic attacks when sleeping on their side and very obese patients when sleeping sitting up. Treatments that avoid supine lying reduce the incidence of apneic attacks, and positioning may be useful in avoiding hypoxaemia in stroke. Generally the papers were of poor quality, thus highlighting the need for further studies.