title: Usage of positional therapy in adults with obstructive sleep apnea.
abstract: OBJECTIVE
  Many positional therapy (PT) strategies are available for treating positional obstructive sleep apnea (OSA). PT is primarily supplied to selected patients as a secondary treatment option when other therapies have failed. To our knowledge this is the largest study to date to assess effectiveness and long-term compliance of PT (both commercial waistband and self-made constructions, mimicking the tennis ball technique) as primary treatment in patients with different positional OSA severities.
  
  
  METHODS
  PT was used by 53 patients, of which 40 patients underwent a follow-up polygraphic evaluation under treatment after a median time interval of 12 weeks. Patients were routinely contacted regarding their clinical status and treatment compliance.
  
  
  RESULTS
  PT was successful in 27 out of 40 patients (68%). Overall AHI reduced significantly from a median (interquartile range [IQR]) AHI of 14.5 (10.7-19.6) to 5.9 (3.1-8.5), p < 0.001. The commercial waistband and self-made constructions were equally effective (median (IQR) reduction in overall AHI (Δ9.6 (5.5-11.9) and Δ6.8 (3.2-11.3) respectively), p = 0.22). Short-term compliance was good as most patients used PT more than 7 hours/night (mean 7.2 ± SD 1.4) and more than 6 days/ week (mean 6.5 ± SD 1.3). However, after mean 13±5 months, 26 patients (65%) reported they no longer used PT, especially patients with moderate positional OSA (89%).
  
  
  CONCLUSIONS
  On the short-term, PT using the tennis ball technique, is an easy method to treat most patients with positional OSA, showing significant reductions in AHI. Unfortunately, long-term compliance is low and close follow-up of patients on PT with regard to their compliance is necessary.
authors.affiliation: University of Groningen, University Medical Center Groningen, Department of Pulmonary Medicine and Tuberculosis, Groningen, the Netherlands: University of Groningen, University Medical Center Groningen, GRIAC Research Institute, Groningen, the Netherlands.
authors.forename: Grietje E
authors.initials: GE
authors.lastname: de Vries
authors.affiliation: University of Groningen, University Medical Center Groningen, Department of Oral and Maxillofacial Surgery, Groningen, the Netherlands.
authors.forename: Aarnoud
authors.initials: A
authors.lastname: Hoekema
authors.affiliation: University of Groningen, University Medical Center Groningen, Department of Oral and Maxillofacial Surgery, Groningen, the Netherlands.
authors.forename: Michiel H J
authors.initials: MH
authors.lastname: Doff
authors.affiliation: University of Groningen, University Medical Center Groningen, Department of Pulmonary Medicine and Tuberculosis, Groningen, the Netherlands: University of Groningen, University Medical Center Groningen, GRIAC Research Institute, Groningen, the Netherlands.
authors.forename: Huib A M
authors.initials: HA
authors.lastname: Kerstjens
authors.affiliation: University of Groningen, University Medical Center Groningen, Department of Pulmonary Medicine and Tuberculosis, Groningen, the Netherlands: University of Groningen, University Medical Center Groningen, Center for Home Mechanical Ventilation, Groningen, the Netherlands.
authors.forename: Petra M
authors.initials: PM
authors.lastname: Meijer
authors.affiliation: University of Groningen, University Medical Center Groningen, Department of Clinical Neurophysiology, Groningen, the Netherlands.
authors.forename: Johannes H
authors.initials: JH
authors.lastname: van der Hoeven
authors.affiliation: University of Groningen, University Medical Center Groningen, Department of Pulmonary Medicine and Tuberculosis, Groningen, the Netherlands: University of Groningen, University Medical Center Groningen, GRIAC Research Institute, Groningen, the Netherlands: University of Groningen, University Medical Center Groningen, Center for Home Mechanical Ventilation, Groningen, the Netherlands.
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Wijkstra
mesh_terms: D004867:Equipment Design; D005260:Female; D006801:Humans; D008297:Male; D010349:Patient Compliance; D017286:Polysomnography; D011187:Posture; D012189:Retrospective Studies; D020181:Sleep Apnea, Obstructive / Q000628:therapy*
keywords: breathing disorder; compliance; effectiveness; obstructive sleep apnea; positional therapy; sleep-related