Long-Term Effectiveness and Compliance of Positional Therapy with the Sleep Position Trainer in the Treatment of Positional Obstructive Sleep Apnea Syndrome

Maanen, J. Peter van; Vries, Nico de

doi:10.5665/sleep.3840

Cited by 108 publications

(68 citation statements)

References 38 publications

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“…After 6 months, compliance was 64.4%. 22 This type of device, a chest-or neck-worn vibrator, could be a solution for positional OSA as this device might be more comfortable to wear than a device using the tennis ball technique. Compliance with PT using the tennis ball technique could, for example, be limited as a result of the bulkiness of the device resulting in back pain and discomfort, which could lead to disruption of sleep and low sleep quality.…”

Section: A B Cmentioning

confidence: 99%

“…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. While most devices appear effective in the beginning and compliance on a short-term (< 3 months) seems satisfactory, long-term (> 6 months) efficacy is unknown and compliance is poor.…”

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confidence: 99%

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Usage of Positional Therapy in Adults with Obstructive Sleep Apnea

Vries

Hoekema

Doff

et al. 2015

Journal of Clinical Sleep Medicine

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Section: A B Cmentioning

confidence: 99%

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confidence: 99%

Usage of Positional Therapy in Adults with Obstructive Sleep Apnea

Vries

Hoekema

Doff

et al. 2015

Journal of Clinical Sleep Medicine

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“…Although the contribution of SDB to daytime sleepiness has been questioned in PD, a recent randomized placebo-controlled study in PD patients with SDB demonstrated a significant improvement of both nocturnal sleep consolidation and objective daytime sleepiness in those receiving CPAP treatment [10]. Thus, feasability and efficacy of positional treatment -already a well established alternative to CPAP in patients with positional SDB [11] -need to be evaluated also in PD patients.…”

Section: Discussionmentioning

confidence: 99%

Bound to supine sleep: Parkinson's disease and the impact of nocturnal immobility

Sommerauer

Werth

Poryazova

et al. 2015

Parkinsonism & Related Disorders

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BACKGROUND Impaired nocturnal mobility is a well-known problem in Parkinson's disease (PD), and clinical experience suggests a predominance of supine body position during sleep. However, this assumption -and potential consequences -still awaits objective validation by a polysomnography-based and adequately controlled study. METHODS Clinical and polysomnographical analysis of 80 consecutive PD patients and 80 control subjects carefully matched for age, sex, body mass index and apnea-hypopnea index. RESULTS PD patients slept twice as much in supine position than control subjects (62.2 ± 32.9% vs. 34.2 ± 28.5%, p < 0.001). In PD, but not in control subjects, more supine sleep correlated with fewer changes in body position (rho = -0.434, p < 0.001). Longer PD disease duration was an independent predictor of more supine sleep in multiple linear regression analysis ( = 0.389, p < 0.001); conversely, more supine sleep was associated with higher apnea-hypopnea index and daytime sleepiness. CONCLUSIONS We confirmed that supine sleep is common in PD, and increases with longer disease duration. Our findings indicate that supine sleep may contribute to the overall disease burden by deteriorating sleep-disordered breathing and daytime vigilance. Author DeclarationParkinsonism & Related Disorders is committed to proper scientific conduct and the protection of animal and human research subjects. Submission of this manuscript implies compliance with the following ethical requirements. Please affirm that you are representing all of the authors in stating compliance with these policies by checking the box at the end of this section.1. Studies with human subjects must have been conducted in accordance with the Declaration of Helsinki. All persons must have provided informed consent prior to being included in the study.2. Studies with animal subjects must have been conducted in accordance with the Guide for the Care and Use of Laboratory Subjects as adopted by the US National Institutes of Health and/or according to the requirements of all applicable local, national and international standards.3. Protocols with animal or human subjects must have been approved by the relevant local committee(s) charged with ensuring subject protection. Studies that entail pain or distress will be assessed in terms of the balance between the distress inflicted and the likelihood of benefit.4. The authors declare that the manuscript is original, that it is not being considered for publication elsewhere, and that it will not be submitted elsewhere while still under consideration for Parkinsonism & Related Disorders or after it has been accepted by Parkinsonism & Related Disorders.5. All authors have seen and approved the manuscript in the form submitted to the journal. The authors declare that they have conformed to the highest standards of ethical conduct in the submission of accurate data and that they acknowledge the work of others when applicable.6. All sources of financial support for the work have been declared in the Acknowledgements ...

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“…Both devices have the capacity to store and register data, such as sleeping posture, that can be uploaded through custom software via a USB connection and personal computer. 6,11,30,34,35 Concerning the neck-worn devices, the device (see Figure 4) described by van Maanen et al 28 consisted of a small vibrating apparatus (30 × 30 × 10 mm, powered by three small batteries). The position sensor provides a vibrating stimulus with a delay of 10 seconds after the supine position is detected, causing the device to vibrate with gradual incremental strength until a different sleeping position is detected, in which case the vibrations ceased immediately.…”

Section: Control Tbtmentioning

confidence: 99%

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

Ravesloot¹,

White

Heinzer

et al. 2017

Journal of Clinical Sleep Medicine

108

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Study Objectives:In approximately 56% to 75% of patients with obstructive sleep apnea (OSA), the frequency and duration of apneas are influenced by body position. This is referred to as position-dependent OSA or POSA. Patients with POSA can be treated with a small device attached to either the neck or chest. These devices-a new generation of devices for positional therapy (PT)-provide a subtle vibrating stimulus that prevents patients adopting the supine position. The objectives of this study were to determine whether PT is effective in improving sleep study variables and sleepiness, and to assess compliance. Methods: A systematic review and meta-analysis. Results: Three prospective cohort studies and four randomized controlled trials were included in this review. Combined data for studies reporting on the effect of PT show that there was a mean difference of 11.3 events/h (54% reduction) in apnea-hypopnea index and 33.6% (84% reduction) in percentage total sleeping time in the supine position. The standardized mean difference for both parameters demonstrated a large magnitude of effect (> 0.8 in both cases). Conclusions: There is strong evidence that the new generation of devices for PT are effective in reducing the apnea-hypopnea index during short-term follow-up. These devices are simple-to-use for patients and clinicians and are reversible. Under study conditions with short-term follow-up, compliance is high; however, long-term compliance cannot be assessed because of lack of reliable data. Additional long-term, high-quality studies are needed to confirm the role of PT as a single or as a combination treatment modality for OSA patients and to assess long-term compliance. Keywords: compliance, meta-analysis, obstructive sleep apnea, positional, positional therapy, systematic review Citation: Ravesloot MJ, White D, Heinzer R, Oksenberg A, Pépin JL. 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. J Clin Sleep Med. 2017;13(6):813-824. I NTRO DUCTI O NIn approximately 56% to 75% of patients with obstructive sleep apnea (OSA), the frequency and duration of apneas are influenced by body position.1-5 Various definitions of positiondependent obstructive sleep apnea (POSA) have been applied in literature, but the most common classification system and definition marks a distinction between two groups of patients: positional patients (PP) 6 and nonpositional patients (NPP). 3,4,7In PP, desaturations, cyclic variations in heart rate, loud snoring, and apneas and hypopneas appear almost exclusively in the supine position. 8 Cartwright first described the arbitrary cutoff point of a difference of 50% or more in apnea index between supine and nonsupine positions. In the medical literature many have applied modified versions of Cartwright's criteria. In 1998, Marklund et al. defined supine-dependent sleep apnea as a supine apnea-hypopnea index (AHI) ≥ 10 events/h, together with a lateral AHI < 10 ev...

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Long-Term Effectiveness and Compliance of Positional Therapy with the Sleep Position Trainer in the Treatment of Positional Obstructive Sleep Apnea Syndrome

Abstract: van Maamen JP, de Vries N. Long-term effectiveness and compliance of positional therapy with the Sleep Position Trainer in the treatment of positional obstructive sleep apnea syndrome.

Cited by 108 publications

References 38 publications

Usage of Positional Therapy in Adults with Obstructive Sleep Apnea

Usage of Positional Therapy in Adults with Obstructive Sleep Apnea

Bound to supine sleep: Parkinson's disease and the impact of nocturnal immobility

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

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