Different therapeutic strategies have been investigated for the treatment of positional-OSA (POSA), but more evidence is needed about efficacy and compliance. The objective of this study was to describe the efficacy of vibrotactile neck-based treatment in POSA patients with different degrees of OSA-severity who were followed for 6-months.
This is a retrospective study including 162 POSA patients undergoing vibrotactile neck-based positional therapy. We compared polysomnographic data obtained at baseline and during positional therapy after one month. We performed a sub-group analysis based on OSA severity. Furthermore, we analyzed follow-up data in 84/162 (51.8%) patients with particular focus on discontinuation and complications related to the device.
We observed a significant difference between mean baseline OAHI (21.9±9.9events/h) and during positional therapy (12±9.2events/h; p<0.01). Moreover, 87/162(54.9%) patients showed a reduced baseline OAHI of at least 50% and 38/162(23.4%) achieved complete disease control (OAHI<5events/h). At sub-group analysis, at least 50% reduction from baseline OAHI was observed in 56.8% of mild patients, 55% of moderate, and 47.4% of severe, whereas complete control of disease was achieved in 50% of mild patients, 22.5% of moderate and 7.9% of severe. At 6-months follow-up, only 35/84 patients (41.6%) were regularly using the device, with a mean of 5.9±1.2 days per week.
Our results on the efficacy and long-term adherence to vibrotactile neck-based PT showed that positional therapy can be an efficient first-line treatment option for mild POSA and in selected cases of moderate disease. Long-term compliance is limited because of complications and low satisfaction in some patients.

© 2020 American Academy of Sleep Medicine.