Positional Therapy for Obstructive Sleep Apnea

OSA has been associated with higher morbidity and mortality rates, lower quality-of-life scores, and health problems such as atrial fibrillation, congestive heart failure, coronary artery disease, depression, diabetes mellitus, hypertension, and stroke.3 CPAP is the current first-line therapy; however, up to two-thirds of patients do not adhere to treatment.4 Positional therapies for OSA ideally prevent patients from lying in a supine position and promote side sleeping. Available positional therapy devices include lumbar or abdominal binders, backpacks, full-length pillows, tennis balls attached to the back of nightwear, and alarms with positional sensors.1 This Cochrane review of eight studies explored the effectiveness of positional therapy for OSA compared with CPAP (n = 72) and with an inactive control (n = 251).1 Three studies used vibration alarm devices, and five studies included physical positioning equipment such as pillows and semirigid backpacks. No significant differences were found between the groups in reported quality of life measured using the 36-item Short Form Health Survey or the Functional Outcomes of Sleep Questionnaire, sleep quality using the mean percentages of slow wave and rapid eye movements sleep, or self-reported adverse effects.