[Treatment] POSAS (Position dependant OSAS)

[A KLERK]

Here and there I see some threads related to tennis balls as a remedy against sleeping on the back. Indeed the tongue falling back can slowly cut off the airflow, thus causing an obstructive apnea. A (much) higher pressure could solve this, but gives rise to other problems, like leakage.

Since about two years a very nice solution is available: the SPT (Sleep Position Trainer) by NightBalance. Just Google that! It is extensively tested and just last week gained reimbursement in the Netherlands. I'm not connected to this company in any manner, just very proud that our Dutch ApneuVereniging was involved in this milestone.

No tennis balls on your back, but just a tiny piece of electronics in a pocket on your chest!

[Sleeprider]

We have a lot of members that come here and show a pattern of dense obstructive apnea followed by periods of no events, then another cluster. That pattern has come to be recognized as related to positional apnea. It is interesting to note that some people actually have higher AHI on their side than supine, based on posted sleep studies. As a result, a device to prevent back-sleeping may or may not be effective. In recent years, forum members have often been recommended to try a soft cervical collar when that pattern is present, and the results have been nothing short of phenomenal. No studies, but I would put the success rate of a soft cervical collar at about 80% in resolving positional obstructive apnea with lower pressure, and it works in both supine and side-sleepers who tend to tuck their chin or end up in other positions that obstruct the airway.

I looked up the SPT and it has some studies backing up its efficacy, but I could not find what the cost of the item is. I'm sure it would be a good solution for someone with increased apnea in the supine position, and may be an alternative to the inexpensive cervical collar, or even cheaper tennis balls.

A. Klerk, the moderators looked at the original post, and the link you had seems to fall under the "manufacturer's clause" like Resmed and Respironics. The site doesn't apparently provide any link to actual sales, and is okay to post.

[A KLERK]

No hassle, Walla Walla! Thank you, SleepRider for the thoughts. It's rather cheap, but on the contrary, we in Holland don't know about the collar   
I'll bring that into our ApneuVereniging!
Have a nice X-Mas!

[hwka]

The cost is never mentioned - which immediately raised a flag with me.
So I went a-searching.
I finally found a report where a patient was referred to the product by a specialist so it would seem to have credibility.
The cost was 400 Euros to buy and 30 Euros a month to rent.
Now I have no doubt that a supine position increases apnea events particularly obstructive events.
Forget the science and consider gravity alone and you can see the sense in that.
But 400 Euros is an awful lot of tennis balls - and arguably no more effective.

[Jan Flikweert]

Hi all,

An old post, but it costs EUR 850,--.

https://vitalaire-winkel.nl/product/slaa...htbalance/

The health insurance in the Netherlands covers only one device, I suppose CPAP or f.e. Nightbalance.

Rental is possible for EUR 50,-- p/month.

My 2 questions in this case are:
1. Does this device keep you awake? The goal of much apnea patients I suppose is to get a better sleep.
2. Does it train your behaviour?

Kind regards,

Jan Flikweert

[Sleeprider]

Jan, we advocate positional therapy for many members, in the form of a soft cervical collar, aids to avoid back-sleeping, and changes to bedding and pillows. The Philips Nightbalance seems to have some studies showing positional therapy is an important addition or substitute to CPAP in avoiding obstruction. As you know, I have raised positional apnea as a possibly significant factor in your own therapy thread. I don't think one needs to spend a lot of money for an electronic device.

The Nightbalance works by analyzing sleep for the first two nights and doing nothing. It then gradually introduces gentle vibrations from night 3 through night 10 which are intended to acclimate the patient to the NightBalance device. Full therapy begins on night 10. This is a behavior modification device that uses vibrations, which are disruptive, to create an avoidance behavior, sleeping on your back. In my opinion, it would be ideally paired with CPAP therapy as most individuals do not fully resolve positional apnea with positional modifications alone. We have see hundreds of cases on the forum where amazing improvements can be implemented using the simple, inexpensive positional therapy aids we suggest.

[BoxcarPete]

I was able to train myself to side sleep with no tools other than stubbornness. I tried one of those pillows for pregnant ladies to help them be more comfortable side sleeping, didn't work well for me. No sweat, my wife who was pregnant at the time gladly took it off my hands.