0790 Positional Obstructive Sleep Apnoea: When and Why the Neck-Based Vibrotactile Device Fails

Abstract Introduction The efficacy of positional therapy with a neck vibrotactile device for positional obstructive sleep apnoea (POSA) has been demonstrated, but its inefficacy in changing body position has not been equally explored. The primary aim of this study was to evaluate the failure rate of the neck vibrotactile positional therapy in POSA. Secondary aims were: to investigate the reliability of a single night sleep study for labelling a supine sleeper, any differences on supine time between the laboratory and the home environment, the impact of the device on snoring and the compliance. Methods A retrospective observational study reviewed patients with a diagnosis of POSA according to Cartwright and who had received monitoring and/or treatment with a Night ShiftTM (NS) Sleep Positioner neck device for 4 nights in Monitor or Therapy mode or both. The diagnosis of POSA was made on respiratory polygraphy or polysomnography and a minimum supine sleep time of 15% was required. A supine sleeper was defined if supine sleep time at home was > 5% at least in 2 nights of neck vibrotactile device in Monitor mode. Failure was defined as continuous vibration time 5 minutes and a supine time > 5% in at least 2 nights. Results Ninety two adult patients were enrolled. The failure rate, restricted to 74 patients who had received the neck vibrotactile device in Therapy mode for 2 nights, was 14.8%, with a compliance rate of 96%. Non-supine sleepers at home were 13/74 (17.5%). A significant reduction of supine sleep time at home was observed in comparison with the diagnostic sleep study (23.9% vs 51%, p < 0.001). Snoring rate was significantly reduced while using the vibrotactile device in Therapy mode versus Monitor mode. Conclusion Considering the failure rate of the device in changing body position, and the rate of patients that at home spontaneously do not sleep in supine position, around 32% of positional therapy prescribed might be inappropriate. An adequate trial with the neck vibrotactile device, in diagnostic and therapeutic modality, might disclose these cases. Main reasons for inefficacy are: sedatives, chronic sleep deprivation, motor limitations and cognitive impairment. Support (if any)