Sleep position trainer versus tennis ball technique in positional obstructive sleep apnea syndrome

Abstract

Study objective: Positional therapy (PT) is an effective therapy in positional obstructive sleep apnea syndrome (POSAS) when used, but the compliance of PT is low. The objective of this study was to investigate whether a new kind of PT is effective and can improve compliance.

Methods: 29 patients were treated with the Sleep Position Trainer (SPT), 26 patients with the Tennis Ball Technique (TBT). At baseline and 1 month polysomnography, Epworth Sleepiness Scale (ESS) and the Quebec Sleep Questionnaire (QSQ) were taken. Daily compliance was objectively measured in both groups.

Results: Both therapies prevent supine sleep position to a median of 0% (min-max: SPT 0.0% to 67%, TBT 0.0% to 38.9%), resulting in a treatment success (AHI <5) in 68.0% of the SPT and 42.9% of the TBT patients. The ESS at baseline was <10 in both groups. Sleep quality parameters as wake after sleep onset (WASO; p = 0.001) and awakenings (p = 0.006) improved more in the SPT group. Total QSQ scores (0.4±0.2, p = 0.03) and the QSQ domains nocturnal symptoms (0.7±0.2, p = 0.01) and social interactions (0.8±0.3, p = 0.02) changed in favor of the SPT group. Effective compliance (≥4 h/night + ≥5 days/week) was 75.9% for the SPT and 42.3% for the TBT users (p = 0.01).

Conclusion: In mild POSAS with normal EES the new SPT device and the standard TBT are equally effective in reducing respiratory indices. However, compared to the TBT, sleep quality, quality of life, and compliance improved significantly more in the SPT group.

Keywords: Positional therapy; compliance; obstructive sleep apnea.

© 2014 American Academy of Sleep Medicine.

Figures

Figure 1. Flow chart of inclusion, exclusion and randomization of patients.

POSAS, positional obstructive sleep apnea syndrome; PSG, polysomnography; TBT, tennis ball technique; SPT, sleep position trainer.

Figure 2. AHI supine.

AHI supine at baseline (white boxes) and at 1-month with TBT or SPT (shaded boxes). Medians at 1-month are zero: for the TBT the median is at the bottom of the interquartile range box (25%–75%); the SPT interquartile range box (25%–75%) and median are identical. AHI, apnea-hypopnea index; TBT, tennis ball technique; SPT, sleep position trainer.

Figure 3. Position device: compliance (≥ 4 h/night).

TBT, tennis ball technique; SPT, sleep position trainer.

Figure 4. Position device: supine position.

TBT, tennis ball technique; SPT, sleep position trainer.

Figure 5. Position device: vibration activity and reactions.

SPT, sleep position trainer.