Abstract
Introduction: Positional sleep apnoea is defined as having a supine AHI≥2x AHI non-supine with ≥10% supine sleep. Positional obstructive sleep apnoea (POSA) is the most common type, while positional central sleep apnoea (PCSA) can be found at a much lower extent. A sleep position trainer (SPT) is a device used in POSA to avoid the supine sleeping position. Aims: to evaluate the efficacy of 1 M therapy with SPT in PCSA.
Material and methods: The SPT (NightBalance, Delft, NL) is worn in a strap around the chest and activates a vibration when sleeping supine. Inclusion criteria: age>18 y; supine sleeping position in 10-90% of TST; total supine AHI ≥2x total AHI non-supine with the central supine Apnoea Index (AI)≥2x central non-supine AI; CAI≥25% total AHI; AHI non-supine ≤ 15 (based on PSG). PSG was performed during follow-up.
Results: N=16 (all male, 52±12 y, BMI 27±3 kg/m2 ). 4 patients had hypertension or arrhythmia.
| T=0 Median [IQR] | T=1Median [IQR] | p-value | |
| % supine (TST) | 37.6 [17.2-51.8] | 6.7 [0.7-22.8] | 0.01 |
| Total AHI | 23.4 [12.9-31.2] | 11.5 [7.2-24.5] | 0.04 |
| Total central AI | 9.4 [6.4-11.8] | 2.5 [1.0-5.4] | 0.01 |
| Supine AHI | 59.8 [42.2-76.5] | 70.2 [24.2-112.0] | 0.18 |
| Non-supine AHI | 7.3 [2.1-11.8] | 7.6 [4.1-15.2] | 0.16 |
| Supine central AI | 21.0 [12.9-36.9] | 9.6 [0.5-22.0] | 0.08 |
| Non-supine central AI | 7.3 [2.1-11.8] | 1.2 [0.1-3.8] | 0.01 |
| ESS | 8±5 | 9±6 | 0.35 |
IQR= Interquartile range
The time slept supine dropped significantly after 1-M positional therapy, and was accompanied by a significant reduction in total AHI and total central AI. However, ESS was unchanged.
Conclusion: positional therapy with the SPT in PCSA is efficacious and can be considered as a new treatment modality. Long-term follow-up and compliance monitoring is ongoing.
- Copyright ©the authors 2016
