Image: Postural Therapy Somnibel
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Positional Apneas: What are they?
Obstructive Sleep Apnea (OSA) is a respiratory disorder during sleep with a high prevalence in the population, where repeated episodes of upper airway obstruction cause breathing pauses during sleep and are often accompanied by intermittent hypoxia or oxygen desaturation and micro-arousals. Snoring, although not always, can sometimes be a precursor to Obstructive Sleep Apnea.
In a sleep study, when the apnea-hypopnea index in the supine position (i.e., lying on the back) is twice that in any other position, the diagnosis may be positional apnea.
In positional obstructive apnea, most of the symptoms, snoring, and breathing pauses occur while sleeping on the back. Sleeping on the back can block the airway and alter breathing. However, sleeping on the side can significantly reduce symptoms because the airway is more open and breathing is easier.
According to data provided by Sibelmed, a Spanish manufacturer of medical equipment and software for sleep disorders, it is estimated that there are between 5 and 7 million people with sleep apnea in Spain, of which 56% are positional.
In cases of positional sleep apnea and snoring, and as determined by a sleep specialist, Postural Therapy may be an alternative or complementary treatment to CPAP.
What is the Postural Treatment for Positional Apneas and Snoring?
Postural therapy is a clinically proven treatment endorsed by numerous clinical studies, which consider it an effective solution for positional obstructive sleep apnea and positional snoring, obtaining similar results to CPAP treatment.
Postural therapy can be:
Active: Vibrational positional devices.
Passive: Tennis balls technique, backpacks, and others.
Today, we will focus on the use of vibrational positional devices, which apply a gentle vibration when a person sleeps on their back to induce them to change position and reduce associated respiratory events. There are different types of positional devices that adjust to the head, torso, are secured with bands, adhesives, controlled through an application or not, and more.
Among the benefits that experts claim the use of this type of device can produce are a reduction in the index of apnea and snoring, an increase in blood saturation, improved blood pressure, improved sleep quality, reduced daytime sleepiness, and an improvement in the partner's rest and overall quality of life.
These devices are typically well-tolerated because they are easy to use, silent, hygienic, non-invasive, practically imperceptible, and the vibration stimuli they produce do not interrupt sleep.
Aside from the comfort and good tolerance, another advantage compared to using masks or other positional techniques like side-sleeping pillows, backpacks, tennis ball techniques, etc., is their discreet and compact size, making them easy to take when sleeping away from home.
Jordi Rigau, R&D Director de Sibelmed
"Somnibel has been clinically validated through a multicenter study of over 120 patients. In addition to the equipment's effectiveness in reducing the apnea-hypopnea index and time spent in supine position, the patient compliance rate with the therapy is higher than with CPAP, and patients value it for its comfort and ease of use. The development of Somnibel demonstrates once again that collaboration in R&D between hospitals and technology companies is the way forward to provide innovative solutions that improve patients' quality of life.""
When is Postural Therapy Indicated?
In the 2021 International Consensus Document on Obstructive Sleep Apnea (ICD), it is suggested that Postural Therapy be indicated in the following cases:
As a single treatment in patients with respiratory events exclusively in supine position with an AHI <15/h in other positions, always with confirmation of disease control.
As an adjuvant therapy that allows for a reduction in CPAP treatment pressure in patients with predominance of supine events.
In those patients with predominance of supine events who reject first-line therapies.
If you snore or suffer from apneas and believe they may be positional, consult with your sleep specialist doctor who can assess whether Postural Therapy is a suitable solution for your specific case.
REFERENCES
(1) Duran-Cantolla Arch Bronconeumol 2005
(2) Oksenberg Chest 1997 Richard Eur Arch Otorhinolaryngol 2006
(3) Documento Internacional de Consenso sobre Apnea Obstructiva del Sueño (ICD), Archivos de Bronconeumonía, 2021: https://www.archbronconeumol.org/en-documento-internacional-consenso-sobre-apnea-articulo-S0300289621001150
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