Evaluation of a new simple treatment for positional sleep apnoea patients

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.

[1]  H. Inoue,et al.  Impact of sleeping position on central sleep apnea/Cheyne-Stokes respiration in patients with heart failure. , 2010, Sleep medicine.

[2]  M. Goldsworthy,et al.  Poor long-term patient compliance with the tennis ball technique for treating positional obstructive sleep apnea. , 2009, Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine.

[3]  H. Tinteren,et al.  The role of sleep position in obstructive sleep apnea syndrome , 2006, European Archives of Oto-Rhino-Laryngology and Head & Neck.

[4]  T. Young,et al.  Estimation of the clinically diagnosed proportion of sleep apnea syndrome in middle-aged men and women. , 1997, Sleep.

[5]  Daniel J Buysse,et al.  Sleep-related breathing disorders in adults: recommendations for syndrome definition and measurement techniques in clinical research. The Report of an American Academy of Sleep Medicine Task Force. , 1999, Sleep.

[6]  A. Oksenberg,et al.  Positional vs Nonpositional Obstructive Sleep Apnea Patients* Anthropomorphic, Nocturnal Polysomnographic, and Multiple Sleep Latency Test Data , 1997 .

[7]  R. Cartwright,et al.  The effects of sleep posture and sleep stage on apnea frequency. , 1991, Sleep.

[8]  W. Schmidt-Nowara,et al.  Oral appliances for the treatment of snoring and obstructive sleep apnea: a review. , 1995, Sleep.

[9]  Jose M Marin,et al.  Long-term cardiovascular outcomes in men with obstructive sleep apnoea-hypopnoea with or without treatment with continuous positive airway pressure: an observational study , 2005, The Lancet.

[10]  M. Kryger,et al.  Sleep apnea and body position during sleep. , 1988, Sleep.

[11]  E. Phillipson,et al.  Sleep apnea--a major public health problem. , 1993, The New England journal of medicine.

[12]  N. de Vries,et al.  Reliable calculation of the efficacy of non-surgical and surgical treatment of obstructive sleep apnea revisited. , 2011, Sleep.

[13]  T. Young,et al.  The occurrence of sleep-disordered breathing among middle-aged adults. , 1993, The New England journal of medicine.

[14]  C W Whitney,et al.  Sleep-disordered breathing and cardiovascular disease: cross-sectional results of the Sleep Heart Health Study. , 2001, American journal of respiratory and critical care medicine.

[15]  J. Piccirillo,et al.  The efficacy of surgical modifications of the upper airway in adults with obstructive sleep apnea syndrome. , 1996, Sleep.

[16]  A. Smiley,et al.  Sleep apnea & automobile crashes. , 1999, Sleep.

[17]  J. Pépin,et al.  Mandibular advancement devices: rate of contraindications in 100 consecutive obstructive sleep apnea patients. , 2002, American journal of respiratory and critical care medicine.

[18]  R. Leiacker,et al.  [Efficacy and longterm compliance of the vest preventing the supine position in patients with obstructive sleep apnea]. , 2007, Laryngo- rhino- otologie.

[19]  Crispin Jenkinson,et al.  Comparison of therapeutic and subtherapeutic nasal continuous positive airway pressure for obstructive sleep apnoea: a randomised prospective parallel trial , 1999, The Lancet.

[20]  W. Flemons Clinical practice. Obstructive sleep apnea. , 2002, The New England journal of medicine.

[21]  J. Gaughan,et al.  Comparison of positional therapy to CPAP in patients with positional obstructive sleep apnea. , 2010, Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine.

[22]  B. Gersh,et al.  Obstructive sleep apnea: implications for cardiac and vascular disease. , 2003, JAMA.

[23]  Y. Fischer,et al.  Effektivität und Langzeit-Compliance der Therapie mit Rückenlage-Verhinderungsweste bei obstruktiver Schlafapnoe , 2007 .

[24]  Tadao Nishimura,et al.  Posture of Patients with Sleep Apnea During Sleep , 2003, Acta oto-laryngologica.

[25]  Daniel J Buysse,et al.  Sleep–Related Breathing Disorders in Adults: Recommendations for Syndrome Definition and Measurement Techniques in Clinical Research , 2000 .

[26]  A. Oksenberg,et al.  Positional Therapy for Obstructive Sleep Apnea Patients: A 6‐Month Follow‐Up Study , 2006, The Laryngoscope.

[27]  Erry,et al.  Prospective study of the association between sleep-disordered breathing and hypertension. , 2000, The New England journal of medicine.

[28]  A. Oksenberg,et al.  Association of body position with severity of apneic events in patients with severe nonpositional obstructive sleep apnea. , 2000, Chest.

[29]  V. Somers,et al.  Investigating the relationship between stroke and obstructive sleep apnea. , 1996, Stroke.

[30]  M. Naughton,et al.  Lateral sleeping position reduces severity of central sleep apnea / Cheyne-Stokes respiration. , 2006, Sleep.

[31]  N. de Vries,et al.  Quantitative effects of trunk and head position on the apnea hypopnea index in obstructive sleep apnea. , 2011, Sleep.

[32]  W. Flemons,et al.  Obstructive Sleep Apnea , 2002 .

[33]  H. Tinteren,et al.  Acceptance and long-term compliance of nCPAP in obstructive sleep apnea , 2007, European Archives of Oto-Rhino-Laryngology.

[34]  David Watts Apnea , 1997, The Lancet.

[35]  R. Cartwright,et al.  Effect of sleep position on sleep apnea severity. , 1984, Sleep.

[36]  Y. Itasaka,et al.  The influence of sleep position and obesity on sleep apnea , 2000, Psychiatry and clinical neurosciences.