A Sleep Position Trainer for positional sleep apnea: a randomized, controlled trial

Abstract

We tested the effect of the Sleep Position Trainer, a vibrational device, for positional sleep apnea in an open, randomized controlled trial with 101 patients, where 52 patients were allocated to Sleep Position Trainer and 49 patients to a non-treatment control group for 2 months (Part 1). All patients were then followed as a cohort for a period of 6 months with use of the Sleep Position Trainer (Part 2). The participants were assessed with polygraphy at entry, and after 2 and 6 months. The mean apnea-hypopnea index supine was 35 per h (SD, 18) in the Sleep Position Trainer group and 38 per h (SD, 15) in the control group at entry. In a per protocol analysis, the mean total apnea-hypopnea index at entry and after 2 months in the Sleep Position Trainer group was 18 per h (SD, 10) and 10 per h (SD, 9; P < 0.001) versus 20 per h (SD, 9) and 18 per h (SD, 10; NS) in the control group. The mean supine sleep time decreased from 47% (SD, 22) to 17% (SD, 18; P < 0.001) in the Sleep Position Trainer group after 2 months. In the control group, the mean supine sleep time was 48% (SD, 20) at entry and 39% (SD, 21; NS) after 2 months. The positive effect of Sleep Position Trainer was maintained in all patients treated with Sleep Position Trainer after 6 months. Daytime sleepiness improved after 6 months. Compliance with the Sleep Position Trainer device during the first 2 months, defined as use of Sleep Position Trainer >4 h per night for all weekdays, was 75.5% (SD 21.2). The discontinuation rate was 28.8 and 49.4% after 2 and 6 months, respectively.

SleepPos App: An Automated Smartphone Application for Angle Based High Resolution Sleep Position Monitoring and Treatment

“…Nevertheless, these nine subjects provided relevant information to determine how the positional treatment worked on them. As there is evidence of the efficacy of vibrational devices in preventing certain sleep positions [ 46 , 47 , 48 ], the results obtained can be reliably interpretated as a proof-of-concept confirming the feasibility of the app to conduct positional therapy.…”

“…The summarized table information is the method currently used in most clinical departments to assess sleep position. Usually when positional treatment, such as the TBT technique [ 44 , 45 ] or other vibrational devices [ 46 , 47 , 48 ] are applied to a patient, the efficacy of this technique is validated upon the summarized information on how much time has been spent in a certain sleep position. However, recent studies have demonstrated how a higher resolution sleep position would be needed to better diagnose and monitor the positional occurrence of diseases, such as OSA [ 37 , 38 ], for which we believe that the combination of information provided by the ‘SleepPos’ app allows a better assessment of the sleep position.…”

“…There are multiple ways to achieve it, including the use of bands covering the thorax which contain objects inside them to prevent certain specific sleep positions, such as the tennis ball technique (TBT) for pOSA [ 44 , 45 ]. Other approaches attach devices to the body which vibrate when sleeping in a certain position [ 46 , 47 , 48 ] to force the patient to change it. These devices achieved the same results as the TBT, but with improved sleep quality, quality of life, and compliance [ 49 ], as the long-term adherence of the TBT is poor [ 50 ].…”

Enhanced Monitoring of Sleep Position in Sleep Apnea Patients: Smartphone Triaxial Accelerometry Compared with Video-Validated Position from Polysomnography

“…In the future, smartphones could have the potential to precisely monitor sleep position while, at the same time, providing diagnosis for OSA [ 38 , 41 , 52 ]. Furthermore, they could even incorporate the ability to verify or apply positional therapy for several days, similar to what other devices already do [ 60 , 61 ]. Monitoring a patient’s sleep position for multiple days would allow the effect of any treatment to be assessed, and modified if necessary, in a timely manner.…”

Basic research, chronobiology, ontogeny and clinical sleep medicine

“…Laub et al . () conducted a randomized controlled trial with 101 apnea patients where more than half of them were allocated to the Sleep Position Trainer and the remainder to a non‐treatment control group for 2 months. Patients were followed‐up and the main outcome was that the Sleep Position Trainer decreased supine sleep time significantly from 47 to 17% in the active treatment group, whereas in the control group the corresponding values were 48–39%.…”