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. 2020 Oct 15;16(10):1711-1719.
doi: 10.5664/jcsm.8664.

Efficacy and long-term follow-up of positional therapy by vibrotactile neck-based device in the management of positional OSA

Eugenio De Corso  1   2 , Rodolfo F Mastrapasqua  2 , Antonella Fiorita  1   2 , Stefano Settimi  2 , Dario Antonio Mele  2 , Pasqualina Maria Picciotti  1   2 , Antonella Loperfido  2 , Sabino Marrone  2 , Grazia Rizzotto  2   3 , Gaetano Paludetti  1   2 , Emanuele Scarano  1   2
Affiliations

Efficacy and long-term follow-up of positional therapy by vibrotactile neck-based device in the management of positional OSA

Eugenio De Corso et al. J Clin Sleep Med. .

Abstract

Study objectives: Different therapeutic strategies have been investigated for the treatment of positional obstructive sleep apnea, but more evidence is needed about efficacy and compliance. The objective of this study was to describe the efficacy of vibrotactile neck-based treatment in patients with positional obstructive sleep apnea with different degrees of obstructive sleep apnea severity who were followed for 6 months.

Methods: This is a retrospective study including 162 patients with positional obstructive sleep apnea undergoing vibrotactile neck-based positional therapy. We compared polysomnographic data obtained at baseline and during positional therapy after 1 month. We performed a subgroup analysis based on obstructive sleep apnea severity. Furthermore, we analyzed follow-up data in 84/162 (51.8%) patients with particular focus on discontinuation and complications related to the device.

Results: We observed a significant difference between mean baseline obstructive apnea-hypopnea index (OAHI; 21.9 ± 9.9 events/h) and during positional therapy (12 ± 9.2 events/h; P < .01). Moreover, 87/162 (54.9%) patients showed a reduced baseline OAHI of at least 50% and 38/162 (23.4%) achieved complete disease control (OAHI < 5 events/h). At subgroup analysis, at least 50% reduction from baseline OAHI was observed in 56.8% of patients with mild, 55% with moderate, and 47.4% with severe OAHI, whereas complete control of disease was achieved in 50% of patients with mild, 22.5% with moderate, and 7.9% with severe OAHI. At a 6-month follow-up, only 35/84 patients (41.6%) were regularly using the device, with a mean of 5.9 ± 1.2 days per week.

Conclusions: Our results on the efficacy and long-term adherence to vibrotactile neck-based positional therapy showed that positional therapy can be an efficient first-line treatment option for mild positional obstructive sleep apnea and in selected cases of moderate disease. Long-term compliance is limited because of complications and low satisfaction in some patients.

Keywords: Nightshift; OSA; POSA; obstructive sleep apnea; positional OSA; positional therapy; vibrotactile neck-based device.

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Figures

Figure 1
Figure 1. The Nightshift device.
The Nightshift (Advanced Brain Monitoring, Carlsbad, CA) device is composed of a case attached to the back of the neck with an adjustable, latex-free, silicone rubber strap secured by a magnetic clasp.
Figure 2
Figure 2. Difference between OAHI index from baseline polysomnography to positional therapy for the entire population.
The dark line shows the median value, the box indicates I and IV quartile, and indicators show confidence intervals. Measurement unit is events/h. AHI = apnea-hypopnea index, OAHI = obstructive sleep apnea-hypopnea index.
Figure 3
Figure 3. Difference between OAHI index from baseline polysomnography to positional therapy in patients affected by mild POSA.
The dark line shows the median value, the box indicates I and IV quartile, and indicators show confidence intervals. Measurement unit is events/h. AHI = apnea-hypopnea index, OAHI = obstructive sleep apnea-hypopnea index, POSA = positional obstructive sleep apnea.
Figure 4
Figure 4. Scatter plot.
Measurement unit is events/h. Dependence of OAHI during therapy from baseline for all patients is demonstrated with an R of .468 (P < .01). Baseline OAHI was the only significant predictor of therapy OAHI. AHI = apnea-hypopnea index, OAHI = obstructive sleep apnea-hypopnea index.
Figure 5
Figure 5. Kaplan-Meier function for long-term use of the device.
See this image and copyright information in PMC

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