Skip to main content
SpringerLink
Log in

Long-Term (6 Months) Effectiveness, Compliance, and Subjective Sleep Outcomes of Treatment with the Sleep Position Trainer in a Large Cohort of Position-Dependent OSA Patients

  • Chapter
  • First Online:
Positional Therapy in Obstructive Sleep Apnea

  • 1475 Accesses

Abstract

This chapter evaluates the long-term effects of using the Sleep Position Trainer (SPT) in position-dependent OSA (POSA) patients over a period of 6 months, in terms of effectiveness, compliance, and subjective sleep parameters. In a large cohort of 106 adult POSA patients, the percentage of supine sleep time decreased rapidly during the training phase of SPT use (day 3–9) to near total avoidance of supine sleep time. This decrease was maintained during the following months of treatment. SPT compliance, defined as more than 4 h of usage per night as an average over seven nights per week, was 64.4 %. Epworth Sleepiness Scale (11–8), Pittsburgh Sleep Quality Index (8–6), and Functional Outcomes of Sleep Questionnaire (87–103) values showed a significant improvement compared to baseline.

Positional therapy using the SPT effectively diminishes percentage of supine sleep and subjective sleepiness and improves sleep-related quality of life in patients with mild-to-moderate POSA. SPT treatment is long-lasting in its effects and has a high compliance.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 159.00
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Abbreviations

AHI:

Apnea–Hypopnea Index

BMI:

Body Mass Index

ESS:

Epworth Sleepiness Scale

FOSQ:

Functional Outcomes of Sleep Questionnaire

OSA:

Obstructive sleep apnea syndrome

POSA:

Positional obstructive sleep apnea syndrome

PSQI:

Pittsburgh Sleep Quality Index

PT:

Positional therapy

SPT:

Sleep Position Trainer (with permission from the Associated Professional Sleep Societies, LLC, Darien, IL, USA)

References

  1. Randerath WJ, Verbraecken J, Andreas S, et al. Non-CPAP therapies in obstructive sleep apnoea. Eur Respir J. 2011;37:1000–28.

    Article  CAS  PubMed  Google Scholar 

  2. Permut I, Diaz-Abad M, Chatila W, et al. Comparison of positional therapy to CPAP in patients with positional obstructive sleep apnea. J Clin Sleep Med. 2010;6:238–43.

    PubMed Central  PubMed  Google Scholar 

  3. van Maanen JP, Meester KA, Dun LN, et al. The sleep position trainer: a new treatment for positional obstructive sleep apnoea. Sleep Breath. 2013;17:771–9.

    Article  PubMed  Google Scholar 

  4. Berger M, Oksenberg A, Silverberg DS, Arons E, Radwan H, Iaina A. Avoiding the supine position during sleep lowers 24 h blood pressure in obstructive sleep apnea (OSA) patients. J Hum Hypertens. 1997;11:657–64.

    Article  CAS  PubMed  Google Scholar 

  5. Bignold JJ, Mercer JD, Antic NA, McEvoy RD, Catcheside PG. Accurate position monitoring and improved supine-dependent obstructive sleep apnea with a new position recording and supine avoidance device. J Clin Sleep Med. 2011;7:376–83.

    PubMed Central  PubMed  Google Scholar 

  6. Cartwright RD, Lloyd S, Lilie J, Kravitz H. Sleep position training as treatment for sleep apnea syndrome: a preliminary study. Sleep. 1985;8:87–94.

    CAS  PubMed  Google Scholar 

  7. Maurer JT, Stuck BA, Hein G, Verse T, Hormann K. Schlafapnoetherapie mit einer neuartigen rückenlage-verhinderungs-weste. Dtsch Med Wochenschr. 2003;128:71–5.

    Article  CAS  PubMed  Google Scholar 

  8. van Maanen JP, Richard W, van Kesteren ER, et al. Evaluation of a new simple treatment for positional sleep apnoea patients. J Sleep Res. 2012;21:322–9.

    Article  PubMed  Google Scholar 

  9. Zuberi NA, Rekab K, Nguyen HV. Sleep apnea avoidance pillow effects on obstructive sleep apnea syndrome and snoring. Sleep Breath. 2004;8:201–7.

    Article  PubMed  Google Scholar 

  10. Bignold JJ, Deans-Costi G, Goldsworthy MR, et al. Poor long-term patient compliance with the tennis ball technique for treating positional obstructive sleep apnea. J Clin Sleep Med. 2009;5:428–30.

    PubMed Central  PubMed  Google Scholar 

  11. Clark GT. Mandibular advancement devices and sleep disordered breathing. Sleep Med Rev. 1998;2:163–74.

    Article  CAS  PubMed  Google Scholar 

  12. Weaver TE, Grunstein RR. Adherence to continuous positive airway pressure therapy: the challenge to effective treatment. Proc Am Thorac Soc. 2008;5:173–8.

    Article  PubMed Central  PubMed  Google Scholar 

  13. Johns MW. A new method for measuring daytime sleepiness: the Epworth sleepiness scale. Sleep. 1991;14:540–5.

    CAS  PubMed  Google Scholar 

  14. Buysse DJ, Reynolds 3rd CF, Monk TH, Berman SR, Kupfer DJ. The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res. 1989;28:193–213.

    Article  CAS  PubMed  Google Scholar 

  15. Weaver TE, Laizner AM, Evans LK, et al. An instrument to measure functional status outcomes for disorders of excessive sleepiness. Sleep. 1997;20:835–43.

    CAS  PubMed  Google Scholar 

  16. Cartwright RD, Diaz F, Lloyd S. The effects of sleep posture and sleep stage on apnea frequency. Sleep. 1991;14:351–3.

    CAS  PubMed  Google Scholar 

  17. Kribbs NB, Pack AI, Kline LR, et al. Objective measurement of patterns of nasal CPAP use by patients with obstructive sleep apnea. Am Rev Respir Dis. 1993;147:887–95.

    Article  CAS  PubMed  Google Scholar 

  18. Kushida CA, Nichols DA, Holmes TH, et al. Effects of continuous positive airway pressure on neurocognitive function in obstructive sleep apnea patients: the Apnea Positive Pressure Long-term Efficacy Study (APPLES). Sleep. 2012;35:1593–602.

    PubMed Central  PubMed  Google Scholar 

  19. Vanderveken OM, Dieltjens M, Wouters K, De Backer WA, Van de Heyning PH, Braem MJ. Objective measurement of compliance during oral appliance therapy for sleep-disordered breathing. Thorax. 2013;68:91–6.

    Article  PubMed Central  PubMed  Google Scholar 

  20. Dieltjens M, Braem MJ, Vroegop AV, et al. Objectively measured vs. self-reported compliance during oral appliance therapy for sleep-disordered breathing. Chest. 2013. doi:10.1378/chest.13-0613.

    PubMed  Google Scholar 

  21. Nakazawa Y, Sakamoto T, Yasutake R, et al. Treatment of sleep apnea with prosthetic mandibular advancement (PMA). Sleep. 1992;15:499–504.

    CAS  PubMed  Google Scholar 

  22. Walker-Engstrom ML, Wilhelmsson B, Tegelberg A, Dimenas E, Ringqvist I. Quality of life assessment of treatment with dental appliance or UPPP in patients with mild to moderate obstructive sleep apnoea. A prospective randomized 1-year follow-up study. J Sleep Res. 2000;9:303–8.

    Article  CAS  PubMed  Google Scholar 

  23. Walker-Engstrom ML, Ringqvist I, Vestling O, Wilhelmsson B, Tegelberg A. A prospective randomized study comparing two different degrees of mandibular advancement with a dental appliance in treatment of severe obstructive sleep apnea. Sleep Breath. 2003;7:119–30.

    Article  PubMed  Google Scholar 

  24. Marklund M, Stenlund H, Franklin KA. Mandibular advancement devices in 630 men and women with obstructive sleep apnea and snoring: tolerability and predictors of treatment success. Chest. 2004;125:1270–8.

    Article  PubMed  Google Scholar 

  25. Wenzel S, Smith E, Leiacker R, Fischer Y. Effektivität und Langzeit-Compliance der Therapie mit Rückenlage-Verhinderungsweste bei obstruktiver Schlafapnoe. Laryngorhinootologie. 2007;86:579–83.

    Article  CAS  PubMed  Google Scholar 

  26. Heinzer RC, Pellaton C, Rey V, et al. Positional therapy for obstructive sleep apnea: an objective measurement of patients’ usage and efficacy at home. Sleep Med. 2012;13:425–8.

    Article  PubMed  Google Scholar 

  27. Leseux L, Rossin N, Sedkaoui K, et al. Education of patients with sleep apnea syndrome: feasibility of a phone coaching procedure. Phone-coaching and SAS. Rev Mal Respir. 2012;29:40–6.

    Article  CAS  PubMed  Google Scholar 

  28. Willemin MC, Fry S, Peres S, Wallaert B, Mallart A. Effects of an educational program in non-adherent apneic patients treated with continuous positive airway pressure. Rev Pneumol Clin. 2013;69:70–5.

    Article  PubMed  Google Scholar 

  29. Fuchs FS, Pittarelli A, Hahn EG, Ficker JH. Adherence to continuous positive airway pressure therapy for obstructive sleep apnea: impact of patient education after a longer treatment period. Respiration. 2010;80:32–7.

    Article  PubMed  Google Scholar 

  30. Ballard RD, Gay PC, Strollo PJ. Interventions to improve compliance in sleep apnea patients previously non-compliant with continuous positive airway pressure. J Clin Sleep Med. 2007;3:706–12.

    PubMed Central  PubMed  Google Scholar 

  31. van Maanen JP, de Vries N. Long-term effectiveness and compliance of positional therapy with the sleep position trainer in the treatment of positional obstructive sleep apnea syndrome. Sleep 2014;37:1209–15.

    Google Scholar 

Download references

Acknowledgments

The authors wish to acknowledge the advice and criticism of Herman Braat, consultant data analytics, and the following persons and the departments they work in for actively being involved in patient enrollment:

R van Uffelen, MD

Albert Schweitzer Ziekenhuis

RJAM van der Hulst, MD, PhD, and JTh Schmidt MD, PhD

Amstelland Ziekenhuis

WJA Wijnands, MD, PhD

Deventer Ziekenhuis

J Dolsma, MD

Diaconessenhuis

F Brijker, MD, PhD

Diakonessenhuis

MAC Klaaver, MD

Havenziekenhuis

AF Kuipers, MD

Isala Klinieken

H Janssen, MD

Kempenhaeghe

LS Hoep, MD

Laurentius Ziekenhuis

JQPJ Claessen, MD, PhD

Martini Ziekenhuis

R Hilgerink, MSc

Medisch Spectrum Twente

PJE Vos, MD, PhD

Rijnstate Ziekenhuis

EFG Kapteijns, MD

Rode Kruis Ziekenhuis

D Kox, MD

Sint Antonius Ziekenhuis

WEJJ Hanselaar, MD

Sint Franciscus Gasthuis

JGM Ribbert, MD

Zuwe Hofpoort Ziekenhuis

Author information

Authors and Affiliations

  1. Department of Otolaryngology, Sint Lucas Andreas Ziekenhuis, Jan Tooropstraat 164, 1061 AE, Amsterdam, The Netherlands

    J. Peter van Maanen M.D.

  2. NightBalance B.V., Delft, The Netherlands

    Arjan van der Star M.Sc.

  3. Department of Otolaryngology, Sint Lucas Andreas Ziekenhuis, Amsterdam, The Netherlands

    Nico de Vries M.D., Ph.D.

  4. Department of Otolaryngology, University Hospital Antwerp, Antwerp, Belgium

    Nico de Vries M.D., Ph.D.

Authors
  1. J. Peter van Maanen M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Arjan van der Star M.Sc.
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Nico de Vries M.D., Ph.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to J. Peter van Maanen M.D. .

Editor information

Editors and Affiliations

  1. Department of Otolaryngology, Sint Lucas Andreas Ziekenhuis, Amsterdam, The Netherlands

    Nico de Vries

  2. Department of Otorhinolaryngology, Sint Lucas Andreas Ziekenhuis, Amsterdam, The Netherlands

    Madeline Ravesloot

  3. Department of Otolaryngology, Sint Lucas Andreas Ziekenhuis, Amsterdam, The Netherlands

    J. Peter van Maanen

Rights and permissions

Reprints and permissions

Copyright information

© 2015 Springer International Publishing Switzerland

About this chapter

Cite this chapter

van Maanen, J.P., van der Star, A., de Vries, N. (2015). Long-Term (6 Months) Effectiveness, Compliance, and Subjective Sleep Outcomes of Treatment with the Sleep Position Trainer in a Large Cohort of Position-Dependent OSA Patients. In: de Vries, N., Ravesloot, M., van Maanen, J. (eds) Positional Therapy in Obstructive Sleep Apnea. Springer, Cham. https://doi.org/10.1007/978-3-319-09626-1_24

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-09626-1_24

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-09625-4

  • Online ISBN: 978-3-319-09626-1

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation