Sleep and Vigilance

, Volume 2, Issue 2, pp 141–147 | Cite as

Supine Alarm Device can Restore REM Sleep in Patients with Obstructive Sleep Apnea

  • Janina JennesEmail author
  • Hamid Bayan
  • Anna Küskens
  • Annika Gieselmann
  • Reinhard Pietrowsky
Original Article


Study objectives

The obstructive sleep apnea syndrome (OSAS) is a type of sleep-related breathing disorder and a highly prevalent disease. Because of frequent arousals during the night, OSAS leads to a fragmentation of sleep and the loss of its restorative function. Being in the supine position during sleep makes the individual more susceptible to obstructive apneic events. This influence of sleeping position on OSAS is thought to be generally greater in rapid eye movement (REM) sleep than in non-rapid eye movement (NREM) sleep stages. The aim of the present study was to evaluate the effect of a supine alarm device that combines an auditory and vibrational signal to discourage patients with OSAS from lying in the supine position during sleep.


Thirteen participants with OSAS spent two nights in the sleep laboratory, one night with the device activated and the other night with it deactivated in randomized order. Full-night polysomnography, evening and morning blood pressure, and subjective sleep quality were assessed.


Under treatment with the activated supine alarm device, participants had significantly fewer respiratory events, a higher baseline blood oxygenation level, fewer oxygen desaturations, and a significant increase in REM sleep compared to the control condition. Subjective sleep quality significantly improved, whereas psychosomatic symptoms during sleep decreased.


Treatment with the supine alarm device appears to improve the amount of REM sleep and subjective sleep in patients with OSAS. Future research would benefit of evaluating patient acceptance and adherence to treatment in the home setting and long-term outcomes.


Obstructive sleep apnea Sleeping position Positional training Sleep-disordered breathing REM sleep 



The study was not funded.

Compliance with Ethical Standards

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 with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

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

Conflict of Interest

H. Bayan and A. Bayan patented the supine alarm device as described in the manuscript. J. Jennes, A. Küskens, A. Gieselmann, & R. Pietrowsky declare that they have no conflict of interest.


  1. 1.
    Flemons WW. Clinical practice. Obstructive sleep apnea. N Engl J Med. 2002. Scholar
  2. 2.
    Cartwright RD. Effect of sleep position on sleep apnea severity. Sleep. 1984. Scholar
  3. 3.
    Ravesloot MJL, van Maanen JP, Dun L, et al. The undervalued potential of position therapy in position-dependent snoring and obstructive sleep apnea—a review of the literature. Sleep Breath. 2013. Scholar
  4. 4.
    Konietzko N, Teschler H, Freitag L, editors. Schlafapnoe. Berlin: Springer; 2013.Google Scholar
  5. 5.
    Oksenberg A, Arons E, Greenberg-Dotan S, Nasser K, Radwan H. The significance of body posture on breathing abnormalities during sleep: data analysis of 2077 obstructive sleep apnea patients. Harefuah. 2009;148:304–9.PubMedGoogle Scholar
  6. 6.
    McSharry DG, Saboisky JP, DeYoung P, et al. Physiological mechanisms of upper airway hypotonia during REM sleep. Sleep. 2014. Scholar
  7. 7.
    Shea SA, Edwards JK, White DP. Effect of wake–sleep transitions and rapid eye movement sleep on pharyngeal muscle response to negative pressure in humans. J Physiol. 1999. Scholar
  8. 8.
    Findley LJ, Wilhoit SC, Suratt PM. Apnea duration and hypoxemia during REM sleep in patients with obstructive sleep apnea. Chest. 1985. Scholar
  9. 9.
    Peppard PE, Ward NR, Morrell MJ. The impact of obesity on oxygen desaturation during sleep-disordered breathing. Am J Respir Crit Care Med. 2009. Scholar
  10. 10.
    Mokhlesi B, Punjabi NM. “REM-related” obstructive sleep apnea: an epiphenomenon or a clinically important entity? Sleep. 2012. Scholar
  11. 11.
    Oksenberg A, Arons E, Nasser K, Vander T, Radwan H. REM-related obstructive sleep apnea: the effect of body position. J Clin Sleep Med. 2010;6(4):343–8.PubMedPubMedCentralGoogle Scholar
  12. 12.
    Lo Bue A, Salvaggio A, Insalaco G, Marrone O. Extreme REM rebound during continuous positive airway pressure titration for obstructive sleep apnea in a depressed patient. Case Rep Med. 2014. Scholar
  13. 13.
    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. Scholar
  14. 14.
    Bayan H, Bayan A (2014) Vorrichtung zur Erkennung einer ungesunden Situation einer liegenden Person, insbesondere Antischnarchvorrichtung. Google Patents.
  15. 15.
    Görtelmeyer R. Schlaffragebogen SF-A und SF-B. Weinheim: Internationale Skalen für Psychiatrie. Beltz; 1986.Google Scholar
  16. 16.
    Epstein LJ, Kristo D, Strollo PJ Jr, et al. Clinical guideline for the evaluation, management and long-term care of obstructive sleep apnea in adults. J Clin Sleep Med. 2009;5(3):263–76.PubMedGoogle Scholar
  17. 17.
    Jasper HH. Report of the committee on methods of clinical examination in electroencephalography: 1957. Electroencephalogr Clin Neurophysiol. 1958;10(2):370–5. Scholar
  18. 18.
    Rechtschaffen A, Kales A. A manual of standardized terminology, techniques and scoring system for sleep stages of human subjects. Los Angeles: Brain Information Service, University of California; 1968.Google Scholar
  19. 19.
    Iber C, Ancoli-Israel S, Chesson A, Quan SF for the American Academy of Sleep Medicine. The AASM manual for the scoring of sleep and associated events: rules, terminology and technical specifications. 1st ed. Westchester, Ill, American Academy of Sleep Medicine; 2007.Google Scholar
  20. 20.
    Cohen J. Statistical power analysis for the behavioral sciences. 2nd ed. New York: Academic Press; 1988.Google Scholar
  21. 21.
    Kass JE, Akers SM, Bartter TC, Pratter MR. Rapid-eye-movement–specific sleep-disordered breathing: a possible cause of excessive daytime sleepiness. Am J Respir Crit Care Med. 1996. Scholar
  22. 22.
    Almeneessier AS, Almousa Y, Hammad O, Olaish AH, AlAnbay ET, BAHammam AS. Long-term adherence to continuous positive airway pressure in patients with rapid eye movement-only obstructive sleep apnea: a prospective cohort study. J Thoracic Dis. 2017;5:5–10.Google Scholar

Copyright information

© Springer Nature Singapore Pte Ltd. 2018

Authors and Affiliations

  • Janina Jennes
    • 1
    Email author
  • Hamid Bayan
    • 1
  • Anna Küskens
    • 1
  • Annika Gieselmann
    • 1
  • Reinhard Pietrowsky
    • 1
  1. 1.Institute of Experimental PsychologyHeinrich-Heine-UniversityDüsseldorfGermany

Personalised recommendations