Short term effects of neck-based treatment and monitoring device for positional obstructive sleep apnea

Introduction: positional components characterize a subgroup of patients suffering from obstructive sleep apnea syndrome (OSAS). Devices designed to limit supine position have been recently developed,but definitive evidence of their efficacy is lacking. In particular, no data exist related to a neck-worn vibrating device (Night shift™)intended to induce positional change in patients with positional OSA. We evaluated the efficacy of a neck-worn device by measuring snoring,sleep/wake time,time supine,and the frequency and duration of feedback to monitor compliance. Materials and Methods: 15 patients(13 males;mean age 65.9;SD 7.2;BMI 31.1-SD 2.0),with a mean apnea-hypopnea index (AHI) of 19.1 (SD 9.2) and high prevalence of positional apneas/hypopneas were prospectively studied.The efficacy of a 3 days trial of in-home supine-avoidance therapy by Night shift™ was assessed by self reported questionnaire and polysomnography. Results: in all participants the neck device produced a significant reduction in overall AHI,(mean delta-AHI of 19.1 and 3.5, respectively-p<0.001).The overall and supine AHI,Respiratory Disturbance Index,Oxygen Desaturation Index,percent time SpO2<90% also decreased significantly.However,patients did not experience a significant improvement in the perceived quality of sleep.Only 4/15 patients reported that their sleep was subjectively improved. Conclusions: based on a short term trial, the neck position therapy device Night shift™ is effective in restricting supine sleep, improving AHI, and related polisomnographic indexes. However it seems unable to provide a relevant improvement in patient's sleep quality. Larger population sample and longer follow up are needed.