A new-generation device for patients with positional obstructive sleep apnea

Over the last two decades there has been a dramatic increase in obstructive sleep apnea (OSA) prevalence, which has serious health implications. Therefore management of this chronic condition is mandatory to improve symptoms and prevent long-term health risks. The majority of patients with mild to moderate OSA have more apneic events in the supine sleeping position, as compared to non-supine positions. The most common definition that has been used for positional OSA (POSA) is defined as an apnea hypopnea index (AHI) that is at least twice as high in the supine position as compared to non-supine positions. In this thesis we evaluated the prevalence of position dependency in non-apneic snorers and we also looked at the potential of positional therapy with the sleep position trainer (SPT) in POSA patients.
Prevalence of position dependency in non-apneic snorers is more than 65% and this group can potentially be treated with the SPT. We demonstrated that the SPT is effective in reducing the severity of snoring and improving the impact to patients’ quality of life. In a randomized controlled trial we evaluated respiratory indices between oral appliance therapy (OAT) and SPT after 3 and 12 months. We showed that both therapies are equally effective in reducing the AHI in mild to moderate POSA and that the efficacy was maintained over 12 months of therapy. Adherence to both treatment modalities was high, and similar in the two groups. Lastly, we showed that the SPT also has the potential of being combined with other therapies.