How Reliable Is Self-Reported Body Position during Sleep?

Many patients with obstructive sleep apnea (OSA) exhibit worsening event indices while supine. Positional therapy is an option if indices normalize in non-supine sleep. Although several methods are available for patients choosing positional therapy, monitoring adherence remains challenging in part because the reliability of self-reported sleep position is uncertain. We analyzed self-reported sleep position in a sample of 300 patients who underwent clinical polysomnography (PSG) in our center. We found a broad range of discrepancy with objective body position, which was not correlated with demographics, PSG metrics, or confidence in the self-report. The results suggest that objective position monitoring can be an important complement to self-report in the management of patients opting for positional therapy.