Evaluation of a new simple treatment for positional sleep apnoea patients

Abstract

Summary Obstructive sleep apnoea syndrome is a common clinical problem. Positional sleep apnoea syndrome, defined as having a supine apnoea–hypopnoea index of twice or more compared to the apnoea–hypopnoea index in the other positions, occurs in 56% of obstructive sleep apnoea patients. A limited number of studies focus on decreasing the severity of sleep apnoea by influencing sleep position. In these studies an object was strapped to the back (tennis balls, squash balls, special vests), preventing patients from sleeping in the supine position. Frequently, this was not successful due to arousals while turning from one lateral position to the other, thereby disturbing sleep architecture and sleep quality. We developed a new neck‐worn device which influences sleep position by offering a vibration when in supine position, without significantly reducing total sleep time. Thirty patients with positional sleep apnoea were included in this study. No side effects were reported. The mean apnoea–hypopnoea index dropped from 27.7 ± 2.4 to 12.8 ± 2.2. Seven patients developed an overall apnoea–hypopnoea index below 5 when using the device in ON modus. We expect that positional therapy with such a device can be applied as a single treatment in many patients with mild to moderate position‐dependent obstructive sleep apnoea, while in patients with a more severe obstructive sleep apnoea such a device could be used in combination with other treatment modalities.

Usage of Positional Therapy in Adults with Obstructive Sleep Apnea

“…Van Maanen et al 19 tried to develop a more comfortable device not disturbing sleep architecture and sleep quality. However, the total sleep time of the patients significantly decreased when using the neck-worn vibrating device.…”

“…Most studies report positive results on the time spent in supine sleeping position, severity of the respiratory events, and a significant reduction in AHI. 14,16,18,19,21,[28][29][30] In our study, a commercial waistband or a self-made construction was used by patients. As far as we know, there are no other studies comparing self-made constructions with commercially fabricated devices.…”

“…8 In practice positional OSA is defi ned as an AHI at least twice as high in supine position as in other positions. 1,4 ; Johannes H. van der Hoeven, MD, PhD 5 ; Peter J. Wijkstra, MD, PhD an alarm system, 13 a backpack with ball, 14 behavioral therapy, 15 a pillow with straps, 16 the so-called tennis ball technique, 17,18 a recently developed neck-worn vibrating device, 19,20 and a chestworn vibrating device. 21,22 Oksenberg and Gadoth 23 argue that PT might be a simple solution for patients with mild to moderate positional OSA.…”

User Compliance and Behavioral Adaptation Associated With Supine Avoidance Therapy

“…More recently, vibrotactile positional therapy has been introduced to restrict supine sleep by delivering feedback, a vibratory or haptic stimulus similar to a cell phone vibration, to the neck (Levendowski et al, 2014;Levendowski, Veljkovic, Seagraves, & Westbrook, 2015;van Maanen et al, 2012) or chest (Bignold, Mercer, Antic, McEvoy, & Catcheside, 2011;van Maanen et al, 2013;van Maanen and de Vries, 2014). Vibrotactile positional therapy was found to be effective in improving sleep quality (Levendowski et al, 2014) and reducing the number of arousals per hour (Levendowski et al, 2014;van Maanen et al, 2012). After 30 nights of use, vibrotactile positional therapy reduced complaints of depression and insomnia (Levendowski et al, 2014).…”

Efficacy of the New Generation of Devices for Positional Therapy for Patients With Positional Obstructive Sleep Apnea: A Systematic Review of the Literature and Meta-Analysis

“…1,16,26,27 Recent developments have seen the introduction of a new generation of devices for PT, a small device attached to either the neck or chest, that prevents the patient from adopting the supine position through a subtle vibrating stimulus. 1,11,28,29 Encouraging data have been published suggesting that this simple therapy has good compliance and successfully prevents PP from adopting the supine position without negatively influencing sleep efficiency. Of additional value, the new generation of devices for PT, unlike TBT, provide objective compliance data.…”