The sleep position trainer: a new treatment for positional obstructive sleep apnoea

• Published in: Sleep & breathing Vol. 17; no. 2; pp. 771 - 779
• Main Authors: van Maanen, J. Peter, Meester, Kristel A. W., Dun, Lideke N., Koutsourelakis, Ioannis, Witte, Birgit I., Laman, D. Martin, Hilgevoord, Antonius A. J., de Vries, Nico
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer-Verlag 01-05-2013; Springer; Springer Nature B.V
• Subjects: Adult; Biological and medical sciences; Dentistry; Disorders of higher nervous function. Focal brain diseases. Central vestibular syndrome and deafness. Brain stem syndromes; Equipment Design; Female; Fundamental and applied biological sciences. Psychology; Head and neck surgery. Maxillofacial surgery. Dental surgery. Orthodontics; Humans; Internal Medicine; Male; Medical sciences; Medicine; Medicine & Public Health; Middle Aged; Nervous system (semeiology, syndromes); Neurology; Original Article; Otorhinolaryngology; Patient Compliance - psychology; Pediatrics; Pneumology/Respiratory System; Polysomnography; Posture; Signal Processing, Computer-Assisted; Sleep apnea; Sleep Apnea, Obstructive - etiology; Sleep Apnea, Obstructive - psychology; Sleep Apnea, Obstructive - therapy; Sleep. Vigilance; Supine Position; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the upper aerodigestive tract; Surveys and Questionnaires; Therapy; Treatment Outcome; Vertebrates: nervous system and sense organs; Vibration - therapeutic use; Obstructive sleep apnoea; OSA; Positional; Positional therapy; Nervous system diseases; Sleep apnea syndrome; Sleep; Treatment; Respiratory disease; Sleep disorder; Sleep wake cycle; Neurological disorder
• ISSN: 1520-9512; 1522-1709
• DOI: 10.1007/s11325-012-0764-5

Background
Positional obstructive sleep apnoea (POSA), defined as a supine apnoea–hypopnoea index (AHI) twice or more as compared to the AHI in the other positions, occurs in 56 % of obstructive sleep apnoea patients. Positional therapy (PT) is one of several available treatment options for these patients. So far, PT has been hampered by compliance problems, mainly because of the usage of bulky masses placed in the back. In this article, we present a novel device for treating POSA patients.
Methods
Patients older than 18 years with mild to moderate POSA slept with the Sleep Position Trainer (SPT), strapped to the chest, for a period of 29 ± 2 nights. SPT measures the body position and vibrates when the patient lies in supine position.
Results
Thirty-six patients were included; 31 patients (mean age, 48.1 ± 11.0 years; mean body mass index, 27.0 ± 3.7 kg/m
2
) completed the study protocol. The median percentage of supine sleeping time decreased from 49.9 % [20.4–77.3 %] to 0.0 % [range, 0.0–48.7 %] (
p
 < 0.001). The median AHI decreased from 16.4 [6.6–29.9] to 5.2 [0.5–46.5] (
p
 < 0.001). Fifteen patients developed an overall AHI below five. Sleep efficiency did not change significantly. Epworth Sleepiness Scale decreased significantly. Functional Outcomes of Sleep Questionnaire increased significantly. Compliance was found to be 92.7 % [62.0–100.0 %].
Conclusions
The Sleep Position Trainer applied for 1 month is a highly successful and well-tolerated treatment for POSA patients, which diminishes subjective sleepiness and improves sleep-related quality of life without negatively affecting sleep efficiency. Further research, especially on long-term effectiveness, is ongoing.