Position-dependent sleep breathing disorders: Current state of the problem and prospects of positional therapy

Position-dependent sleep breathing disorders, primarily positional obstructive sleep apnea (OSA), is a special type of the disease that has significant variability in the severity of breathing problems depending on body position. Based on data collected over the past few decades, it has been found that up to 60% of OSA patients exhibit significant positional dependency, while 20–30% of cases are recorded exclusively in a supine position (isolated positional OSA). The article explores in detail the current concepts of epidemiology, pathophysiology, clinical characteristics, and risk factors for position-dependent sleep-related breathing disorders. It also focuses on the role of position therapy (PT) as a potential treatment option, especially for patients with mild to moderate forms of the condition. The article presents data on the high efficiency and tolerance of modern vibrotactile devices for sleep apnea, which can significantly reduce the severity of the condition. The results of randomized controlled trials and meta-analyses confirm the comparability of PT with other treatments, such as positive airway pressure therapy (PAP) and orthodontic devices. The article discusses the prospects of a combined approach and the need for individualized therapy, as well as the importance of further research to achieve long-term clinical effects, improve adherence to therapy, and enhance the quality of life for patients. The article is useful for both sleep medicine doctors and specialists in related fields who encounter snoring and sleep breathing disorders in their practice.