title: The effect on snoring of using a pillow to change the head position.
abstract: OBJECTIVE
  Although not a disease, primary snoring often leads to social problems. In an earlier retrospective pilot study, we found hints that individuals were snoring less in a lateral versus a supine head position. The aim of this study is to elucidate on the effect of an anti-snoring pillow which changes the head position.
  
  
  METHODS
  We designed an interventional, controlled, and randomized crossover study. It included 22 participants, between 18 and 78 years, who snored, had a BMI ≤ 30, and a sleep partner. Obstructive sleep apnea was ruled out by polysomnography (PSG) or by respiratory polygraphy (PG). Two potential participants dropped out. The first two phases were done at home (4 weeks in total), followed by two nights of polysomnography in our sleep laboratory. During all phases, questionnaires regarding snoring, sleep quality, and pillow tolerance were completed by the patients and, as relevant, by their partners.
  
  
  RESULTS
  The PSG parameters revealed a significant reduction in the snoring index (p = 0.03) when on the activated pillow without a deterioration in other respiratory parameters. This correlated well with the visual analog scale (VAS) that showed a significant decrease in snoring with the activated pillow according to the bed partners (p < 0.001). Subjective acceptance of the pillow during the study period was 100%.
  
  
  CONCLUSIONS
  This study shows that by using a pillow to change the head position, it is possible to reduce both subjective and objective snoring severity.
  DRKS 00008744 AND ETHICS COMMISSION REGISTRY NUMBER REGISTRY NUMBER 2013-406 M-MA.
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery, Sleep Disorders Center, University Hospital Mannheim, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany. Dorotheea.Cazan@umm.de.
authors.forename: Dorotheea
authors.identifier: http://orcid.org/0000-0002-7295-6576
authors.initials: D
authors.lastname: Cazan
authors.affiliation: Nitetronic GmbH Schenefeld, Prior Consulting Scientist Sissel / Novacare GmbH Bad Dürkheim The Anti-snoring Distributing Company, Bad Dürkheim, Germany.
authors.forename: Uwe
authors.initials: U
authors.lastname: Mehrmann
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery, Sleep Disorders Center, University Hospital Mannheim, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany.
authors.forename: Angela
authors.initials: A
authors.lastname: Wenzel
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery, Sleep Disorders Center, University Hospital Mannheim, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany.
authors.forename: Joachim T
authors.initials: JT
authors.lastname: Maurer
mesh_terms: D000328:Adult; D001512:Bedding and Linens; D018592:Cross-Over Studies; D005260:Female; D006257:Head; D006801:Humans; D008297:Male; D011187:Posture; D012913:Snoring / Q000503:physiopathology* / Q000517:prevention & control* / Q000628:therapy
keywords: Anti-snoring pillow; Head position; Respiratory effort-related arousals (RERAs); Snoring; Snoring index