Positional therapy uses side-sleeping to reduce sleep apnea events. Positional therapy sleep apnea works for patients with positional OSA — significantly worse on back than sides.
Who benefits
Positional OSA:
- AHI on back at least 2x AHI on sides
- Mild-moderate OSA typical
- About 50-60% of OSA has positional component
- Pure positional OSA (no apnea on sides) — best candidates
Methods
Tennis ball technique:
- Sew tennis ball into back of pajamas
- Discomfort prevents back sleeping
- Cheap, sometimes effective
Positional devices:
- Wedges or backpacks preventing back sleeping
- Vibrating devices alerting when on back
- Specialized pillows
FDA-cleared devices:
- Night Shift
- Philips Position Trainer
- Vibrate when patient on back
Effectiveness
- Reduces AHI in positional OSA
- Some patients achieve normal AHI
- Less effective for severe OSA
- Compliance often better than CPAP
- May complement other treatments
Combining with other therapies
- Adjunct to oral appliance
- Adjunct to weight loss
- Reduces CPAP pressure requirements
- Stand-alone for some mild positional OSA
Frequently Asked Questions
Will positional therapy alone cure my sleep apnea?
For pure positional mild-moderate OSA, sometimes. Severe usually needs more.
Does the tennis ball technique actually work?
Some yes. Compliance varies. FDA-cleared devices more sophisticated.
What’s a positional sleep apnea device?
Vibrates or alerts when you turn on your back, prompting position change.
How do I know if I have positional OSA?
Sleep study with positional analysis.
Can I use positional therapy with CPAP?
Yes. May reduce required pressure.
The bottom line on positional therapy
Effective option for positional OSA. Multiple methods from low-tech to FDA-cleared devices. Discuss with sleep specialist.