Top

European Archives of Oto-Rhino-Laryngology

Published in:

Open Access 01-08-2018 | Miscellaneous

Subjective effects of the sleep position trainer on snoring outcomes in position-dependent non-apneic snorers

Authors: L. B. L. Benoist, A. M. E. H. Beelen, B. Torensma, N. de Vries

Published in: European Archives of Oto-Rhino-Laryngology | Issue 8/2018

Abstract

Purpose

To evaluate the effect of a new-generation positional device, the sleep position trainer (SPT), in non-apneic position-dependent snorers.

Methods

Non-apneic position-dependent snorers with an apnea–hypopnea index (AHI) < 5 events/h were included between February 2015 and September 2016. After inclusion, study subjects used the SPT at home for 6 weeks. The Snore Outcome Survey (SOS) was filled out by the subjects at baseline and after 6 weeks, and at the same time, the Spouse/Bed Partner Survey (SBPS) was filled out by their bed partners.

Results

A total of 36 participants were included and 30 completed the study. SOS score improved significantly after 6 weeks from 35.0 ± 13.5 to 55.3 ± 18.6, p < 0.001. SBPS score also improved significantly after 6 weeks from 24.7 ± 16.0 versus 54.5 ± 25.2, p < 0.001. The severity of snoring assessed with a numeric visual analogue scale (VAS) by the bed partner decreased significantly from a median of 8.0 with an interquartile range (IQR) of [7.0–8.5] to 7.0 [3.8–8.0] after 6 weeks (p = 0.004).

Conclusions

Results of this study indicate that positional therapy with the SPT improved several snoring-related outcome measures in non-apneic position-dependent snorers. The results of this non-controlled study demonstrate that this SPT could be considered as an alternative therapeutic option to improve sleep-related health status of snorers and their bed partners.

Armstrong MW, Wallace CL, Marais J (1999) The effect of surgery upon the quality of life in snoring patients and their partners: a between-subjects case-controlled trial. Clin Otolaryngol Allied Sci 24(6):510–522CrossRefPubMed

Wilson K, Stoohs RA, Mulrooney TF, Johnson LJ, Guilleminault C, Huang Z (1999) The snoring spectrum: acoustic assessment of snoring sound intensity in 1139 individuals undergoing polysomnography. Chest 115(3):762–770CrossRefPubMed

Pevernagie D, Aarts RM, De MM (2010) The acoustics of snoring. Sleep Med Rev 14(2):131–144CrossRefPubMed

Koutsourelakis I, Perraki E, Zakynthinos G, Minaritzoglou A, Vagiakis E, Zakynthinos S (2012) Clinical and polysomnographic determinants of snoring. J Sleep Res 21(6):693–699. https://doi.org/10.1111/j.1365-2869.2012.01018.x CrossRefPubMed

Young T, Palta M, Dempsey J, Skatrud J, Weber S, Badr S (1993) The occurrence of sleep-disordered breathing among middle-aged adults. N Engl J Med 328(17):1230–1235CrossRefPubMed

Bhattacharyya N (2015) Sleep and health implications of snoring: a populational analysis. Laryngoscope 125(10):2413–2416. https://doi.org/10.1002/lary.25346 CrossRefPubMed

Deary V, Ellis JG, Wilson JA, Coulter C, Barclay NL (2014) Simple snoring: not quite so simple after all? Sleep Med Rev 18(6):453–462. https://doi.org/10.1016/j.smrv.2014.04.006 CrossRefPubMed

Torzsa P, Keszei A, Kalabay L, Vamos EP, Zoller R, Mucsi I, Novak M, Kopp MS (2011) Socio-demographic characteristics, health behaviour, co-morbidity and accidents in snorers: a population survey. Sleep Breath 15(4):809–818. https://doi.org/10.1007/s11325-010-0442-4 CrossRefPubMed

Ohayon MM, Guilleminault C, Priest RG, Zulley J, Smirne S (2000) Is sleep-disordered breathing an independent risk factor for hypertension in the general population (13,057 subjects)? J Psychosom Res 48(6):593–601CrossRefPubMed

10.

Stradling JR (1995) Epidemiology of snoring and its consequences. Monaldi Arch Chest Dis 50(2):123–128PubMed

11.

Gottlieb DJ, Yao Q, Redline S, Ali T, Mahowald MW (2000) Does snoring predict sleepiness independently of apnea and hypopnea frequency? Am J Respir Crit Care Med 162(4 Pt 1):1512–1517. https://doi.org/10.1164/ajrccm.162.4.9911073 CrossRefPubMed

12.

Jia EZ, Yang ZJ, Chen SW, Qi GY, You CF, Ma JF, Zhang JX, Wang ZZ, Qian WC, Wang HY, Ma WZ (2005) Level of proinsulin in association with cardiovascular risk factors and sleep snoring. World J Gastroenterol 11(32):5047–5052CrossRefPubMedPubMedCentral

13.

Dunai A, Keszei AP, Kopp MS, Shapiro CM, Mucsi I, Novak M (2008) Cardiovascular disease and health-care utilization in snorers: a population survey. Sleep 31(3):411–416CrossRefPubMedPubMedCentral

14.

Cartwright R (2008) Sleeping together: a pilot study of the effects of shared sleeping on adherence to CPAP treatment in obstructive sleep apnea. J Clin Sleep Med 4(2):123–127PubMedPubMedCentral

15.

Ben-Israel N, Tarasiuk A, Zigel Y (2012) Obstructive apnea hypopnea index estimation by analysis of nocturnal snoring signals in adults. Sleep 35(9):1299–1305C. https://doi.org/10.5665/sleep.2092 CrossRef

16.

Ulfberg J, Carter N, Talback M, Edling C (2000) Adverse health effects among women living with heavy snorers. Health Care Women Int 21(2):81–90. https://doi.org/10.1080/073993300245311 CrossRefPubMed

17.

Beninati W, Harris CD, Herold DL, Shepard JW Jr (1999) The effect of snoring and obstructive sleep apnea on the sleep quality of bed partners. Mayo Clin Proc 74(10):955–958CrossRefPubMed

18.

Nakano H, Ikeda T, Hayashi M, Ohshima E, Onizuka A (2003) Effects of body position on snoring in apneic and nonapneic snorers. Sleep 26(2):169–172CrossRefPubMed

19.

Choi JH, Park YW, Hong JH, Kim SJ, Park DS, Miyazaki S, Lee SH, Shin C, Lee JB (2009) Efficacy study of a vest-type device for positional therapy in position dependent snorers. Sleep Biol Rhythms 7:181–187CrossRef

20.

Benoist LB, Morong S, van Maanen JP, Hilgevoord AA, de Vries N (2014) Evaluation of position dependency in non-apneic snorers. Eur Arch Otorhinolaryngol 271(1):189–194. https://doi.org/10.1007/s00405-013-2570-5 CrossRefPubMed

21.

Mador MJ, Kufel TJ, Magalang UJ, Rajesh SK, Watwe V, Grant BJ (2005) Prevalence of positional sleep apnea in patients undergoing polysomnography. Chest 128(4):2130–2137CrossRefPubMed

22.

Permut I, az-Abad M, Chatila W, Crocetti J, Gaughan JP, D’Alonzo GE, Krachman SL (2010) Comparison of positional therapy to CPAP in patients with positional obstructive sleep apnea. J Clin Sleep Med 6(3):238–243PubMedPubMedCentral

23.

Ravesloot MJ, van Maanen JP, Dun LN, de Vries N (2013) The undervalued potential of positional therapy in position-dependent snoring and obstructive sleep apnea-a review of the literature. Sleep Breath 17(1):39–49. https://doi.org/10.1007/s11325-012-0683-5 CrossRefPubMed

24.

Oksenberg A, Arons E, Greenberg-Dotan S, Nasser K, Radwan H (2009) The significance of body posture on breathing abnormalities during sleep: data analysis of 2077 obstructive sleep apnea patients. Harefuah 148(5):304–309 (351, 350)PubMed

25.

Richard W, Kox D, den Herder C, Laman M, van Tinteren H, de Vries N (2006) The role of sleep position in obstructive sleep apnea syndrome. Eur Arch Otorhinolaryngol 263(10):946–950CrossRefPubMed

26.

van Maanen JP, Meester KA, Dun LN, Koutsourelakis I, Witte BI, Laman DM, Hilgevoord AA, dV N (2013) The sleep position trainer: a new treatment for positional obstructive sleep apnoea. Sleep Breath 17(2):771–779. https://doi.org/10.1007/s11325-012-0764-5 CrossRefPubMed

27.

van Maanen JP, 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 37(7):1209–1215. https://doi.org/10.5665/sleep.3840 CrossRefPubMedPubMedCentral

28.

Benoist L, de Ruiter M, de Lange J, de Vries N (2017) A randomized, controlled trial of positional therapy versus oral appliance therapy for position-dependent sleep apnea. Sleep Med 34:109–117. https://doi.org/10.1016/j.sleep.2017.01.024 CrossRefPubMed

29.

de Ruiter MHT, Benoist LBL, de Vries N, de Lange J (2018) Durability of treatment effects of the sleep position trainer versus oral appliance therapy in positional OSA: 12-month follow-up of a randomized controlled trial. Sleep Breath 22(2):441–450. https://doi.org/10.1007/s11325-017-1568-4 CrossRefPubMed

30.

Gliklich RE, Wang PC (2002) Validation of the snore outcomes survey for patients with sleep-disordered breathing. Arch Otolaryngol Head Neck Surg 128(7):819–824CrossRefPubMed

31.

Lee LA, Yu JF, Lo YL, Chen NH, Fang TJ, Huang CG, Cheng WN, Li HY (2014) Comparative effects of snoring sound between two minimally invasive surgeries in the treatment of snoring: a randomized controlled trial. PLoS One 9(5):e97186. https://doi.org/10.1371/journal.pone.0097186 CrossRefPubMedPubMedCentral

32.

Chen WC, Lee LA, Chen NH, Fang TJ, Huang CG, Cheng WN, Li HY (2015) Treatment of snoring with positional therapy in patients with positional obstructive sleep apnea syndrome. Sci Rep 5:18188. https://doi.org/10.1038/srep18188 CrossRefPubMedPubMedCentral

33.

Zuberi NA, Rekab K, Nguyen HV (2004) Sleep apnea avoidance pillow effects on obstructive sleep apnea syndrome and snoring. Sleep Breath 8(4):201–207CrossRefPubMed

34.

Wenzel S, Smith E, Leiacker R, Fischer Y (2007) Efficacy and longterm compliance of the vest preventing the supine position in patients with obstructive sleep apnea. Laryngorhinootologie 86(8):579–583CrossRefPubMed

35.

Braver HM, Block AJ (1994) Effect of nasal spray, positional therapy, and the combination thereof in the asymptomatic snorer. Sleep 17(6):516–521CrossRefPubMed

36.

Loord H, Hultcrantz E (2007) Positioner–a method for preventing sleep apnea. Acta Otolaryngol 127(8):861–868CrossRefPubMed

37.

Bignold JJ, ans-Costi G, Goldsworthy MR, Robertson CA, McEvoy D, Catcheside PG, Mercer JD (2009) Poor long-term patient compliance with the tennis ball technique for treating positional obstructive sleep apnea. J Clin Sleep Med 5(5):428–430PubMedPubMedCentral

38.

Cazan D, Mehrmann U, Wenzel A, Maurer JT (2017) The effect on snoring of using a pillow to change the head position. Sleep Breath 21(3):615–621. https://doi.org/10.1007/s11325-017-1461-1 CrossRefPubMed

39.

Stuck BA, Dreher A, Heiser C, Herzog M, Kuhnel T, Maurer JT, Pistner H, Sitter H, Steffen A, Verse T (2015) Diagnosis and treatment of snoring in adults-S2k Guideline of the German Society of Otorhinolaryngology, Head and Neck Surgery. Sleep Breath 19(1):135–148. https://doi.org/10.1007/s11325-014-0979-8 CrossRefPubMed

40.

Sutherland K, Vanderveken OM, Tsuda H, Marklund M, Gagnadoux F, Kushida CA, Cistulli PA (2014) Oral appliance treatment for obstructive sleep apnea: an update. J Clin Sleep Med 10(2):215–227. https://doi.org/10.5664/jcsm.3460 PubMedPubMedCentralCrossRef

41.

Series F, Marc I (1994) Changes in snoring characteristics after 30 days of nasal continuous positive airway pressure in patients with non-apnoeic snoring: a controlled trial. Thorax 49(6):562–566CrossRefPubMedPubMedCentral

42.

Dieltjens M, Vroegop AV, Verbruggen AE, Wouters K, Willemen M, De Backer WA, Verbraecken JA, Van de Heyning PH, Braem MJ, de VN, Vanderveken OM (2014) A promising concept of combination therapy for positional obstructive sleep apnea. Sleep Breath 19(2):637–644. https://doi.org/10.1007/s11325-014-1068-8 CrossRefPubMedPubMedCentral

Title: Subjective effects of the sleep position trainer on snoring outcomes in position-dependent non-apneic snorers
Authors: L. B. L. Benoist
A. M. E. H. Beelen
B. Torensma
N. de Vries
Publication date: 01-08-2018
Publisher: Springer Berlin Heidelberg
Published in: European Archives of Oto-Rhino-Laryngology / Issue 8/2018
Print ISSN: 0937-4477
Electronic ISSN: 1434-4726
DOI: https://doi.org/10.1007/s00405-018-5036-y

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Subjective effects of the sleep position trainer on snoring outcomes in position-dependent non-apneic snorers

Abstract

Purpose

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 8/2018

Analysis of dysphagia in advanced-stage head-and-neck cancer patients: impact on quality of life and development of a preventive swallowing treatment

Otogenic lateral sinus thrombosis in children: proposal of an experience-based treatment flowchart

To do or not to do: salvage management for hypopharyngeal cancer after chemoradiation therapy

Histogram analysis of apparent diffusion coefficient maps for differentiating malignant from benign parotid gland tumors

The diagnostic value of TROP-2, SLP-2 and CD56 expression in papillary thyroid carcinoma

Preservation of the facial and lower cranial nerves in glomus jugulare tumor surgery: modifying our surgical technique for improved outcomes