Snoring & Apnea Treatment with Positional Therapy
This article will describe conservative and budget-friendly ways to prevent back sleeping using positional devices. Positional devices are a well-researched treatment option for individuals who snore or have apnea when sleeping on their backs.
Understanding Positional Therapy
Positional therapy revolves around the concept that altering sleeping positions can significantly impact the severity of snoring and sleep apnea. It is not uncommon for individuals to experience snoring and apnea episodes predominantly while sleeping on their backs, also known as the supine position.
Gravity pulls the lower jaw, tongue, and uvula down when a person sleeps on their back, blocking the upper airway. Although this can occur when sleeping in the lateral or side position, the results can often be more pronounced when sleeping in the supine position.
Positional therapy aims to reduce airway obstruction and improve breathing patterns during sleep by encouraging alternative sleeping positions. This may, in turn, reduce or eliminate snoring and apnea.
Do you snore only when you sleep on your back?
Positional therapy may offer a conservative and inexpensive treatment option for some patients diagnosed with primary snoring (snoring with absence of apnea and verified through testing). Positional therapy in these cases would be helpful if the snoring occurs when the individual sleeps on their back, as opposed to snoring events occurring in various non-supine (non-back ) positions.
Does your apnea occur mostly when sleeping on your back?
For individuals with apnea that occurs solely and most of the time in the supine position, positional therapy may be the primary treatment modality in lieu of CPAP (continuous positive airway pressure) devices or professional dental sleep appliances such as mandibular advancement splints.
Is your sleep apnea oral appliance partially effective?
Positional devices may also help as an adjunct treatment for patients who use an oral appliance to treat obstructive sleep apnea. Oral appliance patients who would benefit most from adding a positional device to their sleep routines are those in whom partial success response occurs. In these cases, the oral appliance has reduced the apnea, but the individual still has residual apnea events when sleeping on their back. A positional device can help resolve residual apnea events and improve treatment success.
Recommended positional devices
Below is a list of positional devices that promote non-supine (non-back) sleeping and may help you improve symptom relief and treatment success of primary snoring or apnea, as verified through sleep testing.
Some of these devices have been recommended to my patients for years, while other products have been recommended by fellow sleep disorder dentists of the American Academy of Dental Sleep Medicine.
These devices, when utilized effectively, have the potential to alleviate apnea symptoms and restore restful sleep.
SlumberBUMP
The SlumberBUMP features a strategically placed inflatable bump that encourages side sleeping. The SlumberBUMP is lightweight and easy to travel with. The SlumberBUMP comes with a 1-year limited warranty and the option to purchase a 2-year warranty and travel bag. The SlumberBUMP costs approximately $80. Check out the video demo here: SlumberBUMP Video Demo
Sleep Noodle
The Sleep Noodle resembles the Slumber Bump but uses a cylindrical foam insert. This device offers customizable support to encourage lateral sleeping positions. There are two types. The UP version offers a vertical or horizontal alignment of the insert. The respective costs of the 2 types of Sleep Noodles are $50 and $80. For a demo, see the Sleep Noodle website. These positional devices are also available on Amazon.
ZZOMA
The ZZOMA uses a lightweight belt with an inflatable bladder and a traveling pouch for easy travel. It is worn snugly across the chest and has a series of projections that discourage back sleeping, thereby reducing the severity of snoring and apnea and fostering uninterrupted sleep.
The ZZOMA is available by prescription only. The initial cost for the ZZOMA positional device is approximately $280, and it is returnable within 30 days. The ZZOMA website has a great FAQ (questions and answers) page that discusses cost reimbursement by health savings plans. Your sleep medical provider can simply fax in an RX, or the company offers Telemedicine consults through I-Sleep Physicians for $35 if you do not have a sleep medical provider.
The T-Shirt by Rematee
The T-shirt by Rematee is a nightshirt with a pocket that holds up to 3 inflatables, making it easy for travel and easy to wash. The T-SHIRT is non-refundable but can be exchanged within 1-2 weeks for a different size or product style. The approximate cost of The T-SHIRT by Rematee is $110. For a video demo, watch this Remetee video.
Stop Snoring T-Shirt
This t-shirt is likely one of the simplest positional devices available and helpful if you don’t sew. The Stop Snoring T-shirt incorporates a strategically placed pocket to accommodate a hand towel, tennis ball, or rolled-up socks. Positioned against the back, the inserted item serves as a gentle reminder to maintain lateral sleeping positions, promoting optimal airflow. A tennis ball or towel is not included. The approximate cost for the Stop Snoring T-Shirt is $25 and is available through Amazon. The description says there is a 30-day period in which you can return the product for a refund.
NightShift Positional Therapy
This wearable device works very differently than the above positional devices. The NightShift employs an electronic wearable monitor that delivers subtle vibrations when detecting supine sleep. These vibrations prompt users to instinctively change positions, mitigating apnea episodes and optimizing sleep quality. The strap can be placed around your chest or neck.
The NightShift has compliance report capability (portal and app) and costs about $500. As with the SlumberBUMP, the NightShift requires a medical prescription. It comes with a 30-day warranty and can be returned if found ineffective. It also has a 24-month limited warranty and may be eligible for insurance reimbursement. For much more info on the NightShift see their website.
Give it Some Time
Getting accustomed to wearing a sleep positional device may take 2 weeks or more. The more uncomfortable it is, the more likely you favor your back during sleep. For some individuals, after you have “self-trained” yourself not to sleep on your back, you may need to use it occasionally as a refresher in sleep position ” learning.” Others may need to continue using it regularly as a sleep aid.
Depending on the shape and size of the positional device, you may have to lift off the bed substantially to roll over to the other side, which may cause an added challenge to work through.
Finding the Perfect Fit
While the array of positional therapy devices offers hope for snoring and apnea sufferers, finding the ideal solution may require a trial-and-error approach. Individuals are encouraged to explore different options, guided by healthcare professionals, to discover the device that best suits their needs. However, the cornerstone of success is consistent usage and compliance, ensuring maximum efficacy in alleviating apnea symptoms and promoting restorative sleep.
Positional Sleep Devices: Summary
Positional therapy offers a hopeful and relatively inexpensive treatment option for snoring and apnea treatment, offering personalized solutions to combat this pervasive condition. Please remember that any chronic, regularly occurring snoring should always be evaluated by a medical healthcare provider before self-treatment. Snoring is often a symptom of apnea, a serious condition if left untreated.
As we continue to unlock the potential of innovative devices and evidence-based approaches, the journey towards restful sleep and improved quality of life for snoring and apnea sufferers remains within reach.
Resources
These studies provide insights into the effectiveness and utility of positional therapy as a treatment option for sleep apnea, helping clinicians and patients make informed decisions about their treatment plans.
- Srijithesh, P. R., Aghoram, R., Goel, A., & Dhanya, J. (n.d.). Positional therapy for obstructive sleep apnoea. Cochrane Database of Systematic Reviews, 5, CD010990. PMID: 31041813. PMCID: PMC6491901. DOI: 10.1002/14651858.CD010990.pub2. (2019) Retrieved from https://pubmed.ncbi.nlm.nih.gov/31041813/
- van Maanen, J. P., & de Vries, N.. Long-term effectiveness and compliance of positional therapy with the Sleep Position Trainer in treating positional obstructive sleep apnea syndrome. Sleep, 37(7), 1209–1215. (2014) https://doi.org/10.5665/sleep.3840
- Lee, K. I., & Choi, J. H. (2023). Positional therapy for obstructive sleep apnea: Therapeutic modalities and clinical effects. Sleep Medicine Research, 14(3), 129-134. Published online: September 30, 2023. DOI: https://doi.org/10.17241/smr.2023.01837.
- Eijsvogel, M. M., Wiegersma, S., Rijnhart, J. J. M., Delnoij, E., Ravesloot, M. J. L., de Vries, N., & Stegenga, B. (2019). Positional Therapy for Obstructive Sleep Apnea: A systematic review and meta-analysis. Journal of Clinical Sleep Medicine, 15(1), 115–124. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6491901/
- Ravesloot, M. J. L., White, D., Heinzer, R., Oksenberg, A., & Pépin, J.‐L. (2017). Efficacy of the New Generation of Devices for Positional Therapy for Patients With Positional Obstructive Sleep Apnea: A Systematic Review of the Literature and Meta-analysis. Journal of Clinical Sleep Medicine, 13(6), 813–824. DOI: https://doi.org/10.5664/jcsm.6622
Dr. Lydia Sosenko, author of MySleepDevice.com, is a general dentist and Diplomate of the American Academy of Dental Sleep Medicine. Dr. Sosenko has worked closely with the dental and medical communities providing oral appliance therapy for snoring and apnea patients since 1996. She remains passionate in helping build awareness of the dangers of snoring and apnea and the importance of treatments, including oral appliance therapy. MySleepDevice.com has been created for educational purposes only and is not intended to replace the advice, treatment or diagnosis by your healthcare providers.
This article is general in nature and for educational purposes only. Please consult with your sleep health provider before starting any treatment option for snoring and apnea.