Table of Contents

Part I General
Introduction ..................................................................................................... 3
Nico de Vries
OSAS: The Magnitude of the Problem ......................................................... 7
Johan A. Verbraecken
Compliance of Various Forms of Obstructive
Sleep Apnea Treatment ................................................................................... 39
Madeline Ravesloot
Part II Initial Work Up: Polysomnography
Prevalence of Positional Obstructive Sleep Apnea in Patients
Undergoing Polysomnography and the Effect of Sleep Stage ..................... 53
Mahesh Shetty and M. Jeffery Mador
The Contribution of Head Position to the Apnea/Hypopnea
Index in Patients with Position-Dependent Obstructive Sleep Apnea ....... 65
Ellen R. van Kesteren and Anthony A.J. Hilgevoord
Influence of Sleep Position on the Transition of Mild
to Moderate and Severe OSA ......................................................................... 81
Linda B. L. Benoist, Sharon Morong, and Nico de Vries
Clinical Characteristics of Positional Obstructive Sleep
Apnea Among Asians ...................................................................................... 85
Naricha Chirakalwasan
Positional Therapy: Left Lateral Decubitus Position
Versus Right Lateral Decubitus Position ...................................................... 95
Zhang Huankang, Huang Jingjing, Hou Xiaolin, J. Peter Van Maanen,
and Xiao Kuanlin

Part III Initial Work Up: Drug Induced Sleep Endoscopy
Drug-Induced Sleep Endoscopy and Sleep Position .................................... 107
Ioannis Koutsourelakis, Faiza Safi ruddin, and Nico de Vries
Changes in Site of Obstruction in Obstructive Sleep
Apnea Patients According to Sleep Position ................................................. 119
Tae-Bin Won, Chul Hee Lee, and Chae-Seo Rhee
Part IV Initial Work Up: General
Towards a Clinical Classification System
for Position-Dependent Obstructive Sleep Apnea ........................................ 131
Madeline Ravesloot, Michaël H. Frank, J. Peter van Maanen,
E.A. Verhagen, Jan de Lange, and Nico de Vries
Correlation Between Calculated/Predicted and Actual AHI
After Positional Therapy ................................................................................ 137
Linda B. L. Benoist and Anneclaire V. Vroegop
Part V Sleep Position in Specifi c Patient Groups
Influence of Sleep Position on Snoring .......................................................... 143
Linda B. L. Benoist, Sharon Morong, J. Peter van Maanen,
Anthony A. J. Hilgevoord, and Nico de Vries
The Effect of Body Position on Sleep Apnea in Children ............................ 151
Amal Isaiah and Kevin D. Pereira
Sleep Position and Pregnancy ........................................................................ 163
Sharon Morong, Brenda Hermsen, and Nico de Vries
Positional OSA in Down Syndrome ............................................................... 175
Marjolein A. J. van Looij
Positional OSA in the Morbidly Obese and the Effect
of Weight Loss on OSA Severity .................................................................... 185
Sharon Morong, Linda B. L. Benoist, and Nico de Vries
The Impact of Body Weight Changes on Body Posture Dominance
in Adult Obstructive Sleep Apnea Patients .................................................. 193
Arie Oksenberg, Aida Dynia, Khitam Nasser, Vlada Goizman,
Edith Eitan, and Natan Gadoth
Positional Central Sleep Apnea ..................................................................... 209
Hennie Janssen, Johan A. Verbraecken, Dirk Pevernagie,
and Sebastiaan Overeem

Part VI Treatment of Positional OSA
History of Positional Therapy: Transition from Tennis Balls
to New Devices ................................................................................................. 223
Madeline Ravesloot, Arjan van der Star,
and Eline C. Vrijland van Beest
Long-Term Results and Compliance of a Special Vest
Preventing the Supine Position ...................................................................... 237
Joachim T. Maurer
Results of a First-Generation New Device for Positional Therapy ............. 243
J. Peter van Maanen, Wietske Richard, Ellen R. van Kesteren,
Madeline Ravesloot, D. Martin Laman, Antonius A.J. Hilgevoord,
and Nico de Vries
Short-Term (4 Weeks) Results of the Sleep Position Trainer
for Positional Therapy .................................................................................... 253
J. Peter van Maanen, Kristel A.W. Meester, Lideke N. Dun,
Ioannis Koutsourelakis, Birgit I. Witte, D. Martin Laman,
Antonius A.J. Hilgevoord, and Nico de Vries
Long-Term (6 Months) Effectiveness, Compliance, and Subjective
Sleep Outcomes of Treatment with the Sleep Position Trainer
in a Large Cohort of Position-Dependent OSA Patients ............................. 265
J. Peter van Maanen, Arjan van der Star, and Nico de Vries
10 Problems and Solutions for Positional Therapy:
Technical Aspects of the Sleep Position Trainer ........................................... 279
Eline C. Vrijland van Beest
Prevalence and Effect of Supine-Dependent Obstructive
Sleep Apnea on Oral Appliance Therapy ..................................................... 289
Marijke Dieltjens, Anneclaire V. Vroegop, Annelies E. Verbruggen,
Marc Willemen, Johan A. Verbraecken, Wilfried A. de Backer,
Paul H. van de Heyning, Marc J. Braem, Nico de Vries,
and Olivier M. Vanderveken
Positional Therapy and Palatal Surgery ....................................................... 297
J. Peter van Maanen, Birgit I. Witte, and Nico de Vries
Positional Therapy and Tongue Base Surgery ............................................. 311
J. Peter van Maanen, Madeline Ravesloot, and Nico de Vries
Residual POSA After Maxillomandibular Advancement
in Patients with Severe OSA........................................................................... 321
Linda B.L. Benoist, Maurits H.T. de Ruiter, Jan de Lange,
and Nico de Vries

Impact of Upper Airway Surgery on Positional Change
During Sleep .................................................................................................... 331
Ji Ho Choi and Seung Hoon Lee
Comparison of Positional Therapy to CPAP in Patients
with Positional Obstructive Sleep Apnea ...................................................... 343
Samuel Krachman, Irene Swift, and Maria Elena Vega
Part VII Future Developments
Position Training: An Indispensable Therapy ............................................. 355
Piet-Heijn J.M. van Mechelen
Positional Therapy, Consequences for and Implementation
in OSA Guidelines ........................................................................................... 365
Nico de Vries and Madeline Ravesloot
Position-Dependent Sleep Apnea: Implications for Diagnosis
and Management ............................................................................................. 371
Matt T. Bianchi
Positional Therapy in Obstructive Sleep Apnea:
For Whom and for Whom Not ....................................................................... 383
Natan Gadoth and Arie Oksenberg
Summary and Future Perspectives ................................................................ 395
Nico de Vries, Madeline Ravesloot, and J. Peter van Maanen
Index ................................................................................................................. 401