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0562 Postural Therapy Mitigates Sleep Disordered Breathing in Andean Highlanders
Abstract
Introduction
In Andean highlanders, sleep disordered breathing (SDB) is highly prevalent and is associated with cardiometabolic disturbances. Postural therapy can alleviate nocturnal oxyhemoglobin desaturation and SDB. Our objective was to examine the tolerability and effectiveness sleeping on an incline in native highlanders.
Methods
Subjects without significant cardiopulmonary disease or sleep disorders were recruited from the high altitude arm (Puno, Peru (3825m)) of CRONICAS cohort study, an ongoing epidemiologic study. We targeted subjects with age ≥ 40 years and BMI ≥ 25 mg/kg2 to enrich the severity of SDB. Subjects were randomized to spend a single night sleeping flat and at 15° incline (on a foam wedge mattress) while undergoing a home sleep study (HST, WatchPAT), which provided validated estimates of sleep time and stages along with SDB severity. Studies were over-read to remove artifacts. Primary outcomes were mean oxyhemoglobin saturation (SPO2) during sleep, PAT respiratory disturbance index (pRDI), defined as the frequency of ≥4% desaturations associated with indicators of arousals or reductions in chest wall movements, and the frequency of 4% desaturations (ODI).
Results
11 subjects (8 female, age 62.3 ± 8.9 years, BMI 30.5 ± 41 kg/m2) underwent HST in both postures. Compared to sleeping flat, sleeping on an inclined improved SPO2 (mean± standard error) during sleep from 82.7 ± 1.0% to 84.0 ± 0.9% (p=0.01). The inclined posture did not significantly affect pRDI (32.0 ± 4.3 vs. 33.7 ± 4.3, p=NS) or ODI (30.1 ± 7.8 vs. 32.7 ± 4.1, p=NS). Sleeping on incline was well tolerated and total sleep time was comparable to sleeping flat (355 ± 25 vs 357 ± 28 minutes).
Conclusion
Sleeping on incline was well-tolerated and improved oxygenation during sleep. Postural therapy could provide a simple, inexpensive and scalable public health intervention that may mitigate the cardiometabolic consequences of nocturnal hypoxemia. Postural therapy is alleviate nocturnal cardiopulmonary stress, and address a therapeutic gap with an inexpensive readily deployable SDB treatment in low/middle income countries (LMICs).
Support (If Any)
This work is supported by NHLBI 1R34HL135360, AMSF 159-PA-16 and Itamar Medical, Ltd.
Journal Article
The posture workbook : free yourself from back, neck and shoulder pain with the Alexander technique
Illustrates 5 key exercises to improve posture, awareness, flexibility, and mobility. These exercises will teach you how to move more easily and freely, and avoid such consequences of poor posture as overuse injuries to hands, arms, and shoulders.
Book
EFECTO DE EJERCICIOS FIFA 11+ SOBRE EL BALANCE POSTURAL ESTÁTICO EN FUTBOLISTAS
Se determinó el efecto de los ejercicios FIFA 11+ sobre el balance postural estático en futbolistas juveniles. Se incluyeron 20 futbolistas juveniles que fueron evaluados usando el test de Romberg con ojos abiertos y cerrados sobre una plataforma de fuerza. Los jugadores fueron divididos aleatoriamente en un grupo control (n=10), quienes continuaron sus sesiones de práctica de fútbol y un grupo intervención (n=10), quienes continuaron sus sesiones de practica de fútbol y a quienes se les realizaron los ejercicios FIFA11+, supervisado, durante de 22 sesiones. En los resultados del estudio no se encontraron cambios estadísticamente significativos en el Centro de Presión Plantar (COP), el p-valor promedio obtenido en dos ejes fue de 0,7869 (p<0.05), evidenciado a partir de las pruebas estadísticas Mann-Withney, Wilcoxon y Kolmogorov Smirnov. La aplicación del programa de prevención de lesiones deportivas 11+ en 22 sesiones no desarrolla mejoras importantes en el balance postural estático.
Journal Article
Stand up straight! : a history of posture
Our bodies change over time; posture is ambiguous in a number of cultural and disciplinary realms. Your posture can denote you as healthy or ill, elegant or slovenly, beautiful or ugly. Gilman examines the history and sociology of posture: how society views who we are and what we are able to do by how our bodies appear. -- adapted from jacket and preface.
Book
Efectos del entrenamiento en slackline sobre la resistencia del core y el equilibrio dinámico (Effects of slackline training on core endurance and dynamic balance)
Slackline challenges balance by walking on a tensioned strap, where the trunk muscles help to maintain or regain balance. This study aimed to compare a cohort of individuals who regularly practiced slackline and physically inactive individuals on core endurance (CE) and dynamic balance (DB) and to determine whether CE is associated with years of slackline practice. Nine individuals (7 men) who practiced slackline regularly (SG; age= 24.5±3.6 years) and nine physically inactive individuals (7 men) (CG; age= 23.2±3.3 years) were compared. CE was assessed with the McGill battery (trunk flexor, extensor, and side-bridge test) and the plank test. DB was measured with the modified star excursion balance test in stable and unstable conditions. The SG maintained a 36.2% and 45% longer time in left lateral bridge (p=.049) and plank (p=.031), respectively, compared to the CG. The distance achieved in the stable DB test was similar between groups, but in unstable condition was 37.8% greater (p=.016) in SG in both legs and 46.6% greater in the non-dominant leg (p=.039) compared to CG. The SG showed a correlation between years of slackline practice and flexor (r=.674; p=.046), right lateral (r=.765; p=.016) and left (r=.730; p=.026) trunk endurance. In conclusion, those who practice slackline maintain a longer time in the plank and left lateral bridge test and achieve a higher reach distance in unstable DB compared to physically inactive individuals who do not practice slackline.
Journal Article
