Accurate position monitoring and improved supine-dependent obstructive sleep apnea with a new position recording and supine avoidance device

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dc.contributor.authorBignold, J.
dc.contributor.authorMercer, J.
dc.contributor.authorAntic, N.
dc.contributor.authorMcEvoy, R.
dc.contributor.authorCatcheside, P.
dc.date.issued2011
dc.description.abstractStudy Objectives: Approximately 30% of obstructive sleep apnea (OSA) patients have supine-predominant OSA, and simply avoiding supine sleep should normalise respiratory disturbance event rates. However, traditional supine-avoidance therapies are inherently uncomfortable, and treatment adherence is poor and difficult to monitor objectively. This study evaluated the efficacy of a novel, potentially more acceptable position monitor and supine-avoidance device for managing supine-predominant OSA and snoring. Design and Setting: In-laboratory evaluation of position recording accuracy versus video recordings (validation study), and randomized controlled crossover trial of active versus inactive supine-avoidance therapy in the home setting (efficacy study). Patients: 17 patients undergoing in-laboratory sleep studies (validation) and 15 patients with supine-predominant OSA (efficacy). Interventions: Efficacy study: 1 week of inactive and 1 week of active treatment in randomized order, separated by 1 week. Measurements and Results: Agreement between 30-sec epoch-based posture classifications from device versus video records was high (median κ 0.95, interquartile range: 0.88-1.00), and there was good supine time agreement (bias 0.3%, 95%CI: −4.0% to 4.6%). In the efficacy study, apnea-hypopnea index (AHI) and snoring frequency were measured in-home using a nasal pressure and microphone based system during inactive and active treatment weeks. The position monitoring and supine alarm device markedly inhibited supine time (mean ± SEM 19.3% ± 4.3% to 0.4% ± 0.3%, p < 0.001) and reduced AHI (25.0 ± 1.7 to 13.7 ± 1.1 events/h, p = 0.030) but not snoring frequency. Conclusions: This new position monitoring and supine alarm device records sleep position accurately and improves OSA but not snoring in patients with supine-predominant OSA.
dc.description.statementofresponsibilityJames J. Bignold, Jeremy D. Mercer, Nick A. Antic, R. Doug McEvoy, Peter G. Catcheside
dc.identifier.citationThe Journal of Clinical Sleep Medicine, 2011; 7(4):376-383
dc.identifier.doi10.5664/JCSM.1194
dc.identifier.issn1550-9389
dc.identifier.issn1550-9397
dc.identifier.orcidMcEvoy, R. [0000-0002-5759-0094]
dc.identifier.orcidCatcheside, P. [0000-0002-9372-6788]
dc.identifier.urihttp://hdl.handle.net/2440/68184
dc.language.isoen
dc.publisherThe American Academy of Sleep Medicine
dc.rightsCopyright status unknown
dc.source.urihttp://www.aasmnet.org/jcsm/ViewAbstract.aspx?pid=28226
dc.subjectHumans
dc.subjectSleep Apnea, Obstructive
dc.subjectSnoring
dc.subjectMonitoring, Physiologic
dc.subjectPolysomnography
dc.subjectTreatment Outcome
dc.subjectConfidence Intervals
dc.subjectRisk Factors
dc.subjectCross-Over Studies
dc.subjectAge Factors
dc.subjectSupine Position
dc.subjectReference Values
dc.subjectVideo Recording
dc.subjectAdult
dc.subjectMiddle Aged
dc.subjectSouth Australia
dc.subjectFemale
dc.subjectMale
dc.subjectPatient Positioning
dc.subjectClinical Alarms
dc.titleAccurate position monitoring and improved supine-dependent obstructive sleep apnea with a new position recording and supine avoidance device
dc.typeJournal article
pubs.publication-statusPublished

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