Skinner Margot A, Kingshott Ruth N, Filsell Sue, Taylor D Robin
Respiratory Research Unit, Dunedin School of Medicine, School of Physiotherapy, University of Otago, Dunedin, New Zealand.
Respirology. 2008 Sep;13(5):708-15. doi: 10.1111/j.1440-1843.2008.01328.x.
Avoidance of sleep in the supine position is recommended in the management of position-dependent OSA hypopnoea syndrome (OSAHS). Our aim was to evaluate the efficacy of a thoracic anti-supine band (TASB), designed to mimic the so-called 'tennis ball technique', compared with nasal CPAP (nCPAP).
Twenty adults with mild to moderately severe position-dependent OSAHS (mean AHI +/- SD) 22.7 +/- 12.0/H (range 6.0-51.2); AHI supine, 59.6 +/- 27.5/H, were included in a randomized cross-over trial. Portable sleep studies were undertaken at baseline and after 1 month on each treatment. A successful treatment outcome was defined as AHI <or= 10/H.
Mean AHI was 12.0 +/- 14.5/H with the TASB and 4.9 +/- 3.9/H with nCPAP (P = 0.02; 95% confidence interval for the difference: -13.1 to -1.0). With the TASB, treatment 'success' was achieved in 13/18 subjects, whereas 'success' was achieved in 16/18 subjects using nCPAP (P = 0.004). In the two subjects with baseline AHI < 10/H, AHI remained below 10 for both therapies. The TASB successfully reduced time spent in the supine position. Mean percentage supine sleep time was 6.3 +/- 5.9% with the TASB, and 35.4 +/- 34.1% with nCPAP (P < 0.001). No significant differences in sleep efficiency or subjective responses were observed between treatments.
Control of body position during sleep using an anti-supine device mimicking the so-called 'tennis ball technique' provides benefit in the management of position-dependent OSAHS in subjects who meet strict inclusion criteria. The overall improvement is, however, less than for nCPAP.
在体位性阻塞性睡眠呼吸暂停低通气综合征（OSAHS）的管理中，建议避免仰卧位睡眠。我们的目的是评估一种模仿所谓“网球技术”设计的胸部防仰卧带（TASB）与鼻持续气道正压通气（nCPAP）相比的疗效。
20名轻度至中度重度体位性OSAHS的成年人（平均呼吸暂停低通气指数[AHI]±标准差）22.7±12.0次/小时（范围6.0 - 51.2）；仰卧位AHI为59.6±27.5次/小时，被纳入一项随机交叉试验。在基线时以及每种治疗1个月后进行便携式睡眠研究。成功的治疗结果定义为AHI≤10次/小时。
使用TASB时平均AHI为12.0±14.5次/小时，使用nCPAP时为4.9±3.9次/小时（P = 0.02；差异的95%置信区间：-13.1至-1.0）。使用TASB时，13/18名受试者治疗“成功”，而使用nCPAP时16/18名受试者“成功”（P = 0.004）。在两名基线AHI < 10次/小时的受试者中，两种治疗的AHI均保持在10以下。TASB成功减少了仰卧位的时间。使用TASB时仰卧位睡眠时间的平均百分比为6.3±5.9%，使用nCPAP时为35.4±34.1%（P < 0.001）。治疗之间在睡眠效率或主观反应方面未观察到显著差异。
使用模仿所谓“网球技术”的防仰卧装置控制睡眠期间的身体姿势，对于符合严格纳入标准的体位性OSAHS患者的管理有益。然而，总体改善程度小于nCPAP。
