Impact of Upper Airway Surgery on Positional Change During Sleep

Frequent positional change during sleep or restless sleep is one of the common clinical manifestations in children and adults with obstructive sleep apnea syndrome (OSAS). However, there is little literature about positional change during sleep in OSAS. It is not yet known whether upper airway surgery for OSAS influences positional change during sleep. In addition, it is not well recognized what the effect of OSAS surgery is on the distribution of the different sleep positions during sleep. In children with OSAS, frequent positional change during sleep significantly decreased with the improvement of respiratory disturbances and arousals, while the proportion of sleep time spent in the supine position significantly increased after adenotonsillectomy. In adults with OSAS, frequent positional change during sleep also significantly reduced with the alleviation of respiratory parameters after successful upper airway surgery. However, no consistent outcomes related to the distribution of sleep position before and after OSAS surgery were found. Although it seems that there were no significant postoperative changes in supine sleep time in most adults with OSAS, postoperative changes in the proportion of sleep time spent in the supine position may occur in some patient groups. Further studies are required to confirm the effect of surgery on positional change during sleep and distribution of sleep position.