Sleep and Breathing

, Volume 21, Issue 3, pp 615–621 | Cite as

The effect on snoring of using a pillow to change the head position

  • Dorotheea CazanEmail author
  • Uwe Mehrmann
  • Angela Wenzel
  • Joachim T. Maurer
Sleep Breathing Physiology and Disorders • Original Article



Although not a disease, primary snoring often leads to social problems. In an earlier retrospective pilot study, we found hints that individuals were snoring less in a lateral versus a supine head position. The aim of this study is to elucidate on the effect of an anti-snoring pillow which changes the head position.


We designed an interventional, controlled, and randomized crossover study. It included 22 participants, between 18 and 78 years, who snored, had a BMI ≤ 30, and a sleep partner. Obstructive sleep apnea was ruled out by polysomnography (PSG) or by respiratory polygraphy (PG). Two potential participants dropped out. The first two phases were done at home (4 weeks in total), followed by two nights of polysomnography in our sleep laboratory. During all phases, questionnaires regarding snoring, sleep quality, and pillow tolerance were completed by the patients and, as relevant, by their partners.


The PSG parameters revealed a significant reduction in the snoring index (p = 0.03) when on the activated pillow without a deterioration in other respiratory parameters. This correlated well with the visual analog scale (VAS) that showed a significant decrease in snoring with the activated pillow according to the bed partners (p < 0.001). Subjective acceptance of the pillow during the study period was 100%.


This study shows that by using a pillow to change the head position, it is possible to reduce both subjective and objective snoring severity.

German Clinical Trial Number: DRKS 00008744 and ethics commission registry number registry number 2013-406 M-MA


Anti-snoring pillow Snoring Head position Snoring index Respiratory effort-related arousals (RERAs) 



I would particularly like to thank Mr. Alexander Radohs for his wonderful assistance and commitment in supporting the study, as well as his provision of excellent technical support.

Compliance with ethical standards


Sissel Novacare provided financial support to the Department of Otorhinolaryngology, Head and Neck Surgery of the Medical Faculty Mannheim at the Ruprecht-Karls University Heidelberg in the form of a study grant that covered the costs for the PSG nights in our lab. The two different pillows were also provided by the sponsor. The sponsor had no role in the design or conduct of this research. The authors received no benefit from the study grant.

Conflict of interest

Dorotheea Cazan and Angela Wenzel certify that they have no affiliations with or involvement in any organization or entity with any financial interest. Uwe Mehrmann was a temporary employee at Sissel/Novacare GmbH (company) acting as scientific consultant. Joachim T. Maurer once received an Honorarium for an invited lecture. All authors have no financial interest in the subject matter or the materials discussed in this manuscript.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and in accordance with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The study protocol was approved by the Medical Ethical Committee of the Medical Faculty Mannheim at the Ruprecht-Karls University Heidelberg (2013-406MA-MA).

Informed consent

Informed consent was obtained individually from all participants included in the study.


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Copyright information

© Springer-Verlag Berlin Heidelberg 2017

Authors and Affiliations

  1. 1.Department of Otorhinolaryngology, Head and Neck Surgery, Sleep Disorders CenterUniversity Hospital MannheimMannheimGermany
  2. 2.Nitetronic GmbH Schenefeld, Prior Consulting Scientist Sissel / Novacare GmbH Bad Dürkheim The Anti-snoring Distributing CompanyBad DürkheimGermany

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