Research

Research Library

 

The NightBalance Library offers a variety of clinical papers on the Sleep Position Trainer. We also provide an overview of the abstracts and the scientific background for download. Note that the NightBalance Library is available in English only.

 

Downloads
> Download the Abstracts of clinical studies
> Download a presentation on the Publications of NightBalance

> Download the Scientific Background & Evidence
>Link to the Springer Book on Positional Therapy in Obstructive Sleep Apnea

 

2016


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Positional therapy in patients with residual positional obstructive sleep apnea after upper airway surgery

 

Purpose/background: A considerable portion of patients has residual positional obstructive sleep apnea (POSA) after upper airway surgery. Those patients could benefit from additional treatment with positional therapy (PT). The objective of this prospective study was to assess the additional effect of PT in patients with residual POSA after upper airway surgery for sleep apnea.

 

Methods: A polysomnography (PSG) was used to diagnose a patient with residual POSA after surgery. After informed con- sent, patients were treated with PT for 3 months and underwent a follow-up PSG while using the sleep position trainer (SPT). Changes in apnea-hypopnea index (AHI) and sleep position parameters were analyzed. Compliance rates and mean disease alleviation (MDA) were determined.

 

Results: Thirty-three patients with a median postoperative AHI of 18.3/h sleep were included. With the SPT median AHI dropped to 12.5/h sleep and the Epworth Sleepiness Scale (ESS) improved from 10.0 to 7.0. After 3 months, 37.5 % patients were considered responders of whom 31.3 % had treatment success. The compliance rate with SPT was 89.0 %. MDA was 44.7 % for SPT alone. With the combination of both surgery and SPT, MDA was 65.6 %. Conclusions The results of this study indicate that additional PT in a complex OSA patient population with residual POSA after surgery can increase overall therapeutic effectiveness by improving the median MDA from 39.5 % (effect of surgery alone) to 65.6 % (effect of combining surgery and PT).

 

Article: L.B.L. Benoist,  M. Verhagen, B. Torensma, J.P. van Maanen, N. de Vries. Positional therapy in patients with residual positional obstructive sleep apnea after upper airway surgery. Sleep and Breathing 2016 DOI 10.1007/s11325-016-1397-x

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2015


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A promising concept of combination therapy for positional obstructive sleep apnea

 

Purpose The objective of this randomized controlled trial was to assess the additional effect of a chest-worn sleep position trainer (SPT) in patients with residual supine-dependent ob- structive sleep apnea (sdOSA) under mandibular advance- ment device (MAD) therapy.

 

Methods Baseline and follow-up polysomnography with MAD were performed. Twenty patients with sdOSA under MAD therapy underwent two consecutive randomized polysomnographies: one with SPT and one with combination of SPT + MAD. Data are presented as median (quartile 1, quartile 3).

 

Results The SPT reduced the time spent in supine sleeping position compared to baseline and MAD therapy. Both MAD and SPT were individually effective in reducing the overall apnea/hypopnea index (AHI) significantly when compared to baseline from 20.8 (15.1; 33.6)/h at baseline to 11.0 (6.7; 13.8)/h and to 11.1 (3.5; 17.7)/h with MAD or SPT, respec- tively. The combination of SPT + MAD further reduced the overall AHI to 5.7 (3.6; 7.4), which was significantly lower than with MAD alone (p<0.001) and SPT alone (p<0.008), respectively.

 

Conclusions The results of this study indicate that combina- tion of SPT + MAD leads to a higher therapeutic efficacy in patients with sdOSA under MAD therapy when compared to one of the treatment modalities alone.

 

Article: M. Dieltjens, A. V. Vroegop, A. E. Verbruggen, K Wouters, M. Willemen, W. A. De Backer, J. A. Verbraecken, P. H. Van de Heyning,  M. J. Braem, N. de Vries & O. M. Vanderveken. Sleep Breath (2015) 19:637–644

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Sleep Position Trainer vs Tennis Ball Technique in Positional OSA

 

 

icon_paperMedisch Spectrum Twente did research on the effects of the SPT vs TBT. The article Sleep Position Trainer vs Tennis Ball Technique in Positional OSA by M. Eijsvogel et al. compares the difference between the two techniques. Standard tennis ball techniques like the Positional Band (PB) can be as effective as CPAP in Positional OSA (POSA) but compliance is low. Can compliance of Positional Therapy in POSA be improved with a new device, the Sleep Position Trainer (SPT) and have the same effectiveness as PB?

 

55 new patients with POSA were randomized to SPT (29) or PB (26). Standard home-PSG was done at baseline and after 1 month therapy. Quibec Sleep Questionnaire (QSQ), ESS and VAS scores were taken. The SPT device was, in a non-vibrating mode, also build in the PB to measure daily compliance in both groups.

 

Comparing PSG: AHItot, AHIsup, &supTST was respecively 11.4, 30.7, 27.9% for SPT and 13.2, 37.3, 31.1% for PB. After 1 month the same parameters were respectively reduced to 39, 0.0, 0.0 for SPT and 5.8, 0.0, 0.0 for PB. After 1 month therapy also no differences in QSQ, ESS, PSG sleep parameters were observed, however perceived therapeutic effectiveness by means of VAS was 74.5 for SPT and 55.2 for PB. Compliance decreased in both groups with time. At 1 month compliance was 70% for SPT, 42% for PB. Compliance expressed as use >4 hours/night for >5 days/week was 76% for SPT, 42% for PB. Dropouts were 7% in SPT, 28% in PB.

 

SPT and PB effectively treat POSA when used. Only the SPT does have an acceptable compliance after 1 month.

 

Article: M. M. Eijsvogel, R.Ubbink, J. Dekker, E. Oppersma, F. H. de Jongh, J. van der Palen, M. G. Brusse-Keizer. Sleep Position Trainer versus Tennis Ball Technique in Positional Obstructive Sleep Apnea Syndrome. Journal of Clinical Sleep Medicine, Vol. 11, No. 2, 2015

 

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2014


icon_paperLong-term effectiveness and compliance of positional therapy with the Sleep Position Trainer in the treatment of positional obstructive sleep apnea syndrome

 

The article ‘Long-term effectiveness and compliance of positional therapy with the Sleep Position Trainer in the treatment of positional obstructive sleep apnea syndrome’ by J.P. van Maanen, MD and N. de Vries, MD, PhD has been published. The article gives shows the effectiveness, long-term compliance and effects on subjective sleep of the Sleep Position Trainer (SPT) in position-dependent obstructive sleep apnea (POSAS) patients.

 

The aim of this paper was to investigate the effect of the SPT over a period of six months. In this prospective, multicenter cohort study, adult patients with mild and moderate POSAS were included. Patients used the SPT for six months, and at baseline, after 1, 3, and 6 months questionnaires were filled in. The results show there was a decrease in the percentage time spend supine (21% at basline vs 3% at 6 months. The SPT compliance, defined as more than 4 hours of nightly use, was 64.4%. Regular use, defined as more than 4 hours of use over 5 nights per week , was 71.2%. Subjective compliance and regular use were 59.8% and 74.4%, respectively. Medias ESS (11 to 8), PSQI (8 to 6) and FOSQ (87 to 103) values significantly improved compared to baseline.

 

In conclusion we can say that positional thrapy using the SPT effectively diminished percentage of supine sleep and subjective sleepiness and improves sleep-related quality of life in patients with mild to moderate POSAS. SPT treatment is long-lasting in its effects. SPT has a high compliance and regular use rate. Subjective and objective compliance data correspond well.

 

Article: Van Maanen, J.P. & De Vries, N. 2014. Long-term effectiveness and compliance of positional therapy with the Sleep Position Trainer in the treatment of positional obstructive sleep apnea syndrome. Sleep Vol. 37, No. 7, 2014

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2013

 

 

The Sleep Position Trainer: a new treatment for Positional Obstructive Sleep Apnoea

 

icon_paperThe article ‘The Sleep Position Trainer: a new treatment for Positional Obstructive Sleep Apnoea’ by J.P. van Maanen et al. present a novel device for treating POSA patients. Patients older than 18 years with mild to moderate POSA slept with the Sleep Position Trainer (SPT), strapped to the chest, for a period of 29±2 nights. SPT measures the body position and vibrates when the patient lies in supine position.

Thirty-one patients completed the study. The median percentage of supine sleeping time decreased from 49.9% to 0.0%. The median AHI decreased from 16.4 to 5.2. Fifteen patients developed an overall AHI below five. Sleep efficiency did not change significantly. Epworth Sleepiness Scale decreased significantly. Functional Outcomes of Sleep Questionnaire increased significantly. Compliance was found to be 92.7%.

The Sleep Position Trainer applied for one month is a highly successful and well-tolerated treatment for POSA patients, which diminishes subjective sleepiness and improves sleep-related quality of life without negatively affecting sleep efficiency. Further research, especially on long-term effectiveness, is ongoing.

 

Article: Van Maanen, J.P., K.A. Meester, L.N. Dun, I. Koutsourlakis, B.I. Witte, D.M. Laman, A.A. Hilgevoord & N. de Vries. 2013. The Sleep Position Trainer: a new treatment for Positional Obstructive Sleep Apnoea. Sleep and Breathing 17(2):771-9/

 

 

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2012

 

The undervalued potential of positional therapy in position dependent snoring and obstructive sleep apnea

 

icon_paperIn 2012 the article ‘The undervalued potential of positional therapy in position dependent snoring and obstructive sleep apnea’ by Drs. M. Ravesloot has been published. The article gives a review on the current literature on the influence of positional therapy on positional OSAS.

 

The aim of this paper was to perform a thorough a review of the literature on positional sleep apnea and its therapy. A great deal could be gained in treating patients with POSA with positional therapy (PT). Sixteen studies were found in the literal review, which examined the effect of positional therapy on OSAS. The various techniques, results, and compliance rates are discussed. The long-term compliance for PT remains an issue, and although remarkable results have been shown using innovative treatment concepts for PT, there is room for both technical improvement of the devices and for further research.
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