title: Poor long-term patient compliance with the tennis ball technique for treating positional obstructive sleep apnea.
abstract: OBJECTIVE
  Little is known regarding long-term patient compliance with the tennis ball technique (TBT), one of the original simple methods of positional therapy (i.e., avoiding the supine posture during sleep) for posture-dependent obstructive sleep apnea patients. The purpose of this study was to investigate long-term patient compliance with TBT.
  
  
  METHODS
  A follow-up questionnaire was mailed to all patients prescribed TBT at the Adelaide Institute for Sleep Health between July 2004 and March 2008 (n = 108).
  
  
  RESULTS
  Sixty-seven patients replied to the questionnaire. Baseline demographic/clinical characteristics were not significantly different from non-respondents. Among the respondents, follow-up time was (mean +/- SD) 2.5 +/- 1.0 years. Four (6.0%) reported they were still using TBT (group A); 9 (13.4%) were no longer using TBT, claiming to have learned to avoid the supine position during sleep (group B); and 54 (80.6%) were neither using TBT nor avoiding the supine posture (group C). The main reason for ceasing TBT use in group C was that TBT was too uncomfortable (34/54 patients).
  
  
  CONCLUSIONS
  Long-term patient compliance with TBT appears to be very poor, with less than 10% of patients reporting continued use (group A) approximately 30 months after prescription. With most TBT non-compliers reporting it to be too uncomfortable, alternative forms of positional therapy appear to be needed.
authors: Adelaide Institute for Sleep Health, Repatriation General Hospital, Daw Park, Adelaide, Australia. james.bignold@health.sa.gov.au
authors: James J
authors: JJ
authors: Bignold
authors: Georgina
authors: G
authors: Deans-Costi
authors: Mitchell R
authors: MR
authors: Goldsworthy
authors: Claire A
authors: CA
authors: Robertson
authors: Douglas
authors: D
authors: McEvoy
authors: Peter G
authors: PG
authors: Catcheside
authors: Jeremy D
authors: JD
authors: Mercer
mesh_terms: D004864:Equipment and Supplies / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance / Q000706:statistics & numerical data*; D011187:Posture; D020181:Sleep Apnea, Obstructive / Q000628:therapy*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome