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The Buzz About Positional Therapy for Sleep Apnea

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It happened again—a night’s sleep was wrecked by the gasping for air, snoring and snorting caused by obstructive sleep apnea (OSA). The symptoms strike whenever you roll over onto your back, and even though you know a CPAP machine would fix the problem, you just can’t get yourself to use one. You might even have a machine gathering dust in a corner of your bedroom.

No worries. If lying on your back really is what sets off your OSA, there is, in fact, a new way to avoid symptoms and get some shut-eye.

DON’T LET SLEEP APNEA GET YOU FLAT ON YOUR BACK

Half of people with OSA generally have symptoms only when they are sleeping on their backs. This is called positional OSA. Until recently, CPAP was the main and doctor-preferred treatment for positional OSA even though simply not sleeping on your back prevents symptoms, too. Studies have shown that, although not quite as effective as CPAP, positional therapy—which offers a variety of techniques to keep a sleeper off his or her back—is adequate to control OSA symptoms in people who won’t or can’t use a CPAP machine.

Until now, positional therapy has been pretty basic, involving use of low-tech objects such as tennis balls, body pillows or foam belts that discourage or prevent a person from rolling onto his back during sleep. Now, a new approach, called vibro-tactile positional therapy, uses vibration to prevent a person from sleeping on his back. And the device, called Night Shift,  does not restrict movement like the older options do.

NO LOST SLEEP

Night Shift is a relatively thin neck collar with a sensor that vibrates when you roll onto your back. The intensity of the vibration increases until you change your sleep position.

Surprisingly, this vibrating gadget will not disrupt sleep and keep you up as much as your OSA will, says Lawrence J. Epstein, MD, an expert in sleep medicine and positional therapy from Harvard Medical School and past president of the American Academy of Sleep Medicine. Although you might be briefly roused to roll over, you usually won’t completely awaken, he said. You simply will shift position and fall right back into deeper sleep.

The device also electronically monitors how often you roll onto your back, how long you stay in that position before shifting and how much you snore or have breathing problems during sleep, explained Dr. Epstein. “This information can be downloaded onto a computer and sent to your doctor to determine how effective the device is for you,” he said.

According to a small published study sponsored by Advanced Brain Monitoring, Inc. (the makers of Night Shift) and conducted by the inventors of the device, Night Shift reduced sleep apnea by more than half in 83% of the study participants who used the device nightly for four weeks. This had a greatly improved effect on snoring, daytime depression and sleepiness and, most importantly, getting enough oxygen during sleep. At some point though, a larger, independent study will need to confirm Night Shift’s effectiveness and also compare it to CPAP. But the bottom line is that using any technique that will help prevent OSA is better than nothing. OSA is a risk factor for cardiovascular problems, such as irregular heartbeat, high blood pressure and heart attack, and eye problems, such as glaucoma—so it is vital to do what you can to prevent it.

HOW TO GET THE DEVICE

Night Shift is available by prescription only, so if you want to try it, speak with your doctor. Dr. Epstein advised that it may be worth your while to see a board-certified sleep specialist rather than your primary care physician to get a prescription for the device. Unlike a primary care doctor, a sleep specialist (a physician with training and board certification in sleep medicine) can ensure that positional therapy is right for you. Such a doctor will also best use the product’s technology to closely monitor your response to treatment.

Although Night Shift is not yet widely covered by insurance, at $349, it’s about one-third of the price of a CPAP machine.

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Source: Source: Lawrence J. Epstein, MD, program director of the Sleep Medicine Fellowship Program and associate physician, division of sleep and circadian disorders, departments of medicine and neurology at Brigham and Women’s Hospital, and instructor in medicine at Harvard Medical School, all in Boston. Dr. Epstein also is past president of the American Academy of Sleep Medicine. Date: February 17, 2015 Publication: Bottom Line Health
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