positional therapy

if your breathing is interrupted primarily when you are sleeping on your back, and normal when sleeping on your side or stomach, then your sleep doctor might recommend positional therapy for you. some devices used for positional therapy are worn around your waist or back and help keep you from turning over onto your back. they gently vibrate when they detect that you are starting to roll over onto your back.




some will increase the vibration intensity if you remain on your back. the vibration stops when the device detects you are on your side or stomach. they may also collect data that can be useful for your sleep doctor, such as information about your snoring and the frequency with which you change sleeping positions during sleep. your medical provider will help you find the sleep apnea treatment that works best for you.

to compare the efficacy of positional therapy versus cpap and positional therapy versus inactive control (sham intervention or no positional therapy intervention) in people with osa. in terms of secondary outcomes, one study each reported quality‐of‐life indices and quality‐of‐sleep indices with no significant difference between the two groups. the review found that cpap has a greater effect on improving ahi compared with positional therapy in positional osa, while positional therapy was better than inactive control for improving ess and ahi. no difference in quality of life or quality of sleep between the two groups was found. one study reported that there was no difference in quality of life and quality of sleep between positional therapy and inactive control. the prevalence of osa that appears on sleeping on the back and disappears on sleeping in any position other than on the back is 25% to 30% (joosten 2014). to compare the efficacy of positional therapy versus cpap and positional therapy versus inactive control (sham intervention or no positional therapy intervention) in people with osa. we were careful to check for multiple publications of the same data. for study characteristics and outcome data, we used a data collection form that we piloted on one study in the review. we did a sensitivity analysis for the robustness of the results excluding studies that did not use laboratory‐based polysomnography. two of the studies on posa required the participants to be symptomatic as well (permut 2010; jokic 1999). blinding was not possible in the studies because of the nature of the intervention and control.

most of the other studies had low or no attrition and we judged them to be at low risk of bias. cpap reduced ahi compared with positional therapy in both the studies. we included three additional studies following the post‐hoc amendment to the protocol of the review. svatikova 2011 assessed adherence in the second phase of their study where they assigned the original 18 participants to two groups: nine participants to continue use of sona® pillow and nine to use a pillow as they wished. we judged the studies included in this review to be at significant risk of bias and therefore the results cannot be considered conclusive. in all these people, effectively instituted positional therapy is likely to normalise the diagnostic indicators of obstructive sleep apnoea. an important question is whether the clinical outcomes vary with respect to different types of positional therapy devices. the estimates of ess, sleep quality and quality of life (sf 36 and fosq) in the comparison positional therapy versus cpap, and that of sleep quality and quality of life (sf 36 and fosq) in the comparison positional therapy and inactive control are imprecise. we did not include eijsvogel 2015 and dieltjens 2015, as the former compared two methods of positional therapy, while the latter compared positional therapy in addition to mandibular advancement device with mandibular advancement device alone. as the duration of the studies was short, and clinically relevant endpoints such as quality of life were not adequately evaluated in the studies, we cannot make a conclusive statement with respect to the interventions. amethods employed for randomisation and allocation concealment not explicitly stated in the study. it did not state the procedure of allocation concealment and had significant loss to follow‐up. however, we noticed motor reaction time to be significantly different in favour of positional therapy.

positional therapy is an effective method to treat patients with positional osa on the short-term. long-term compliance is low especially in patients with positional therapy is a behavioral strategy to treat sleep apnea. if your breathing is interrupted primarily when you are sleeping on your positional therapy is an intervention that helps to keep the person on their side during sleep. examples include something on the person’s, .

positional therapy is an intervention that helps to keep the person on their side during sleep. examples include something on the person’s back to stop them from rolling over (like a tennis ball), special pillows, or alarms that vibrate when the person rolls onto his or her back. how is the severity of osa estimated? four studies showed that positional therapy also decreased ahi scores compared with an inactive control (md = u22127.38 events per hour; 95% ci, u221210.10 to u22124.70). at eight weeks there was no difference in adherence to positional therapy vs. an inactive control (odds ratio = 0.80; 95% ci, 0.33 to 1.94; n = 101). 1 these positions include supine (on your back), lateral (on your left or right side), and prone (on your stomach). if the ahi or rdi is normal positional therapy involves wearing a special device around your waist that helps keep you sleeping on your side. it uses “vibro-tactile feedback” technology. one thing is clear, the most successful treatment for positional obstructive sleep apnea is the one that patients will adhere to. evidence strongly suggests, .

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