Role oft sleep position training in the treatment of the positional obstructive sleep apnoe sydrome

Introduction: A large subgroup of patients with obstructive sleep apnea (OSA) suffer of position-dependent OSA (POSA). Those patients tend to be young and non-obese. Compliance for CPAP therapy is often bad in this patient group. Alternative less-invasive therapy regimen would be desirable. The sleep position trainer exhibits a slight vibration whenever patients take a supine position prompting them to change their sleep position without arousal. Materials and Methods: Aim of the study is the evaluation of the therapeutic efficiency of the SPT in a double blind setting. In an attempt to decrease discomfort and improve compliance, two different sessions of sleep position training were compared: patients either participated in an slow graduated programm, or a quick intensive training to prevent supine position. Results: 13 patients (one female and 12 male) between 28 and 64 years with POSA were included. BMI ranged between 20 and 34 kg/m2. Mean AHI before start of sleep position training was 21,6/h (6-50/h). Mean rate of sleep in supine position was 48% (19-80%). After four weeks of using SPT mean AHI had improved to 13,9/h (3,6-29,7/h). Mean rate of sleep in supine position after training was 22,5% (4-79%). Three patients did not tolerate the device. In four patients no AHI reduction was observed despite of SPT. Five of 13 patients could be successfully treated. AHI reduction were greater than 50 % in this patient group. Conclusion: The SPT significantly reduces the ratio of supine sleeping position leading to lowered AHI values. It might therefore be an alternative in second line therapy of POSAS.