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New Positional Obstructive Sleep Apnea Therapy

By Jerrold Kram, MD, FCCP

A recently published study found that over 70% of those diagnosed obstructive sleep apnea and having an apnea-hypopnea index less than 60 are at least twice as severe when sleeping on their back as compared to other (non-supine) position.

This condition is referred to as “positional obstructive sleep apnea” (POSA). The most commonly recommended approach for treating POSA is to sew tennis balls into a night shirt. Several manufacturers (REMatee and Zzoma) developed commercial adaptations of the tennis-ball approach using cushions held in place by a waist belt or shoulder harness to restrict back-sleeping.

I recently read very promising study results using a novel position therapy device called the Night Shift. Worn on the back of the neck, Night Shift begins to vibrate when users start to sleep on their back and slowly increases in intensity until a position change occurs. For patients with POSA, 90% responded to Night Shift therapy and had a median apnea-hypopnea severity reduction of 79%!   Study participants had significantly less sleep fragmentation and hypoxemia, and they slept more deeply. A majority of participants experienced reduced daytime sleepiness, depression symptoms, and snoring.

Night Shift is also an intelligent, interactive monitor that allows users to track its affect on snoring and sleep quality. For truck drivers and others in safety-sensitive occupations, Night Shift reports can be generated using the internet-based report portal to prove, like CPAP, that therapy is being used.

By avoiding back-sleeping, CPAP pressures will be reduced for those using auto-titrating units. Oral appliance and ProventTM therapy outcomes also improve when patients avoid back-sleeping.   Night Shift may also start being used to monitor changes in awakenings and snoring for women concerned about increased pre-natal risks associated with pregnancy-related snoring and sleep apnea.

You may be interested to know that Night Shift is being launched by the manufacturer, Advanced Brain Monitoring, in the United States on April 23rd with the “Night Shift Therapy” campaign on This approach is interesting because participants are actually enrolled in a study. The benefit of enrollment is that Night Shift can be purchased at a substantial “study” discount. The first 250 who sign up to participate will obtain an additional 15% discount.

If you’re interested in learning more about Night Shift or to watch their campaign video, please go to


Jerrold Alan Kram, MD, FCCP, D-ABSM Medical DirectorDr Kram is one of the country’s most experienced sleep specialists. He began his work in the field in 1980, opened the California Center for Sleep Disorders (CCSD) in 1983 and received his Board Certification in Sleep Medicine in 1989. He graduated with honors from the New York University School of Medicine and completed his pulmonary fellowship at University of California, San Francisco.Dr. Kram brings an inclusive philosophy to the practice of Sleep Medicine and his running of CCSD. He is actively engaged in programs to spread sleep expertise throughout the local medical community and is a featured speaker in professional and community lectures nationwide. Most recently he has been named to the board of directors at the National Sleep Foundation.

Comments (2)

  1. I have had sleep apnea my whole life. If I fall asleep on my back, it is all bad. I wake myself several times. In order for me to sleep good, I have to sleep on my side. I still have some problems then. If I had the funds, I would defiantly try to fix this.

  2. that the very nice article to connect the online web users wonder fun post for the online so talk about sleep to join the online thanks for the share this information.

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