Loord Helena, Hultcrantz Elisabeth
Department of ENT, University Hospital, Linköping, Sweden.
Acta Otolaryngol. 2007 Aug;127(8):861-8. doi: 10.1080/00016480601089390.
A 'Positioner' preventing sleeping on the back can effectively reduce obstructive sleep apnea (OSA), but not always snoring for patients with long-term OSA. By preference, the device should be used for younger snorers without OSA as a training tool to avoid sleeping on the back. Instructions and support by a nurse are necessary for compliance.
Snoring is a progressive condition with a prevalence of 25-30% among the adult male population. Long-term snoring seems to be the basis for apneas caused by vibration damage to the pharyngeal tissue. Patients with OSA often have more apneas in the supine position than in the lateral position. Preventing sleeping on the back is a way to treat OSA. The aim of this study was to evaluate the efficacy and comfort of a recently developed Positioner.
A total of 23 patients diagnosed with positional sleep apnea (AHI>15 in supine position and AHI<5 in lateral position), were included. The Positioner--a soft vest, attached to a board placed under the pillow, makes it impossible for the patient to sleep on his back. It was fitted and tried out individually. Patients answered sleep questionnaires and kept sleep diaries before beginning use. After 3 months, a new sleep study was done while using the Positioner and new questionnaires were filled out.
Eighteen patients (5 women and 13 men) completed the study. The rest could not tolerate being strapped into the Positioner. Of those participating, 61% demonstrated a decrease of AHI to<10 using the Positioner. The Epworth Sleepiness Scale (ESS) decreased from a mean of 12.3 to 10.2. Half of the patients snored more frequently with the Positioner. The evaluation of comfort showed that minor adjustments are desirable.
一种防止仰卧睡眠的“定位器”可有效降低阻塞性睡眠呼吸暂停（OSA），但对于长期患有OSA的患者，并不总能减轻打鼾症状。最好将该设备用于无OSA的年轻打鼾者，作为避免仰卧睡眠的训练工具。护士的指导和支持对于确保患者依从性是必要的。
打鼾是一种渐进性疾病，在成年男性人群中的患病率为25%至30%。长期打鼾似乎是咽部组织振动损伤导致呼吸暂停的基础。OSA患者仰卧位时的呼吸暂停通常比侧卧位时更多。防止仰卧睡眠是治疗OSA的一种方法。本研究的目的是评估一种新开发的定位器的疗效和舒适度。
共纳入23例被诊断为体位性睡眠呼吸暂停的患者（仰卧位时呼吸暂停低通气指数[AHI]>15，侧卧位时AHI<5）。该定位器是一件柔软的背心，连接在置于枕头下方的一块板上，使患者无法仰卧睡眠。它是为每个患者单独安装和试用的。患者在开始使用前回答睡眠问卷并记录睡眠日记。3个月后，在使用定位器的同时进行了一项新的睡眠研究，并填写了新的问卷。
18例患者（5名女性和13名男性）完成了研究。其余患者无法忍受被绑在定位器上。在参与研究的患者中，61%使用定位器后AHI降至<10。Epworth嗜睡量表（ESS）从平均12.3降至10.2。一半的患者使用定位器后打鼾更频繁。舒适度评估表明需要进行一些小调整。
