Determining optimal sleep position in patients with positional sleep-disordered breathing using response surface analysis

Jung Bok Lee, Young Hwan Park, Jung Hwa Hong, Seung Hoon Lee, Ki Hwan Jung, Je Hyung Kim, Hyeryeon Yi, Chol Shin

Research output: Contribution to journalArticlepeer-review

29 Citations (Scopus)


A lateral position (LP) during sleep is effective in reducing sleep disorder symptoms in mild or moderate sleep apnea patients. However, the effect of head and shoulder posture in LP on reducing sleep disorders has not been reported. In this study, effective sleeping positions and a combination of sleep position determinants were evaluated with respect to their ability to reduce snoring and apnea. The positions evaluated included the following: cervical vertebrae support with head tilting (CVS-HT), scapula support (SS), and LP. A central composite design was applied for response surface analysis (RSA). Sixteen patients with mild or moderate positional sleep apnea and snoring who underwent polysomnography for two nights were evaluated. Based on an estimated RSA equation, LP (with a rotation of at least 30°) had the most dominant effect [P = 0.0057 for snoring rate, P = 0.0319 for apnea-hypopnea index (AHI)]. In addition, the LP was found to interact with CVS-HT (P = 0.0423) for snoring rate and CVS-HT (P = 0.0310) and SS (P = 0.0265) for AHI. The optimal sleep position reduced mild snoring by more than 80% (i.e. snoring rate in the supine position was <20%) and the snoring rate was approximately zero with a 40° rotation. To achieve at least 80% reduction of AHI, LP and SS should be >30° and/or 20 mm respectively. To determine an effective sleep position, CVS-HT and SS, as well as the degree of the LP, should be concurrently considered in patients with positional sleep apnea or snoring.

Original languageEnglish
Pages (from-to)26-35
Number of pages10
JournalJournal of Sleep Research
Issue number1
Publication statusPublished - 2009 Mar


  • Positional sleep apnea and snoring
  • Positional therapy
  • Response surface analysis

ASJC Scopus subject areas

  • Cognitive Neuroscience
  • Behavioral Neuroscience


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