Purpose: To evaluate the effect of a sleep position trainer (SPT) in patients with positional central sleep apnea (PCSA). Methods: A multicentre cohort study was conducted. Patients with symptomatic PCSA were included. Effectiveness, compliance and quality of life were assessed at 1- and 6-month follow-up. Results: Sixteen patients were included. Median AHI dropped from 23.4/h [12.9–31.2] to 11.5/h [7.2–24.5] (p = 0.044) after 1-month SPT therapy and in patients who continued treatment, median AHI further decreased after 6 months to 9.7/h [3.4–27.6] (p = 0.075). Median percentage of supine sleep decreased significantly from 37.6 [17.2–51.8] to 6.7 [0.7–22.8] (p < 0.001), after 1 month, and to 6.8 [0.7–22.1] (p = 0.001), after 6 months. Mean compliance over 1 and 6 months was 78.6 ± 35.3 and 66.0 ± 33.3%, respectively. Epworth Sleepiness Scale at baseline was 9.5 [3.3–11.8] and did not significantly decrease after 1 month (11.0 [3.0–13.0]) and 6 months (4.0 [3.0–10.5]) follow-up. Functional Outcomes of Sleep Questionnaire remained stable within the first month. However, after 6 months, there was a significant improvement compared to baseline values, 15.9 [11.9–18.4] vs. 17.8 [14.3–19.2]; p = 0.030. Conclusion: This is the first study on effects of positional therapy with a new-generation smart device in patients with PCSA after 1 and 6 months of follow-up. Results of this study show that the SPT is effective in reducing AHI and central AI, feasible in PCSA, and is associated with symptomatic improvement. While the working mechanism behind this effect remains speculative, the effect is positive and considerable.

Additional Metadata
Keywords Positional central sleep apnea, Positional therapy, Sleep apnea, Sleep position trainer, Sleep-disordered breathing
Persistent URL dx.doi.org/10.1007/s00405-019-05545-y, hdl.handle.net/1765/118140
Series VSNU Open Access deal
Journal European Archives of Oto-Rhino-Laryngology
Note corresponding author at Department of Otolaryngology and Head and Neck Surgery Amsterdam
Benoist, L.B.L, Vonk, P.E. (P. E.), de Vries, N.A, Janssen, H.C.J.P. (H. C.J.P.), & Verbraecken, J. (2019). New-generation positional therapy in patients with positional central sleep apnea. European Archives of Oto-Rhino-Laryngology. doi:10.1007/s00405-019-05545-y