Have you got sleep apnea or snoring? Looking for an alternative treatment? Think about positional therapy.

For many people, obstructive sleep apnea is worse when sleeping on their back. So, using a device to prevent sleeping on their back can be a helpful treatment for sleep apnea. In this interview Dr David Cunnington talks with Daniel Levendowski from Advanced Brain Monitoring about the Night Shift device, a positional sleep apnea treatment.

In Australia, the Night Shift device can be purchased from HomeMed

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David Cunnington: I’m here with Dan Levendowski from Advanced Brain Monitoring and Dan, you’ve got the Night Shift device. I really like that device. Can you tell us a bit about what it is?

Daniel Levendowski: So the Night Shift is designed to help patients stay off their back when they sleep and what our research has shown that about 75 percent of patients who have sleep apnea are much more severe, twice as severe, as least twice as severe when they sleep on their back, so that if they can sleep off their back, they will actually get a better night’s sleep and in some cases, it could be the only treatment that they would need for sleep apnea.

David Cunnington: We’ve been using tennis balls and pillows and things for a number of years. My problem with that is really there’s no data beyond six weeks and we think the effect wears off. But what have you found with your device?

Daniel Levendowski: So I think there are two issues in thinking about that. One is compliance. Will patients continue to use it long term? The problem with the tennis balls, it was designed around pain. It made it so uncomfortable to – when you’re on your back, that it was supposed to induce you to stay off your back. What we use is a vibrator similar to a cell phone. We call it vibrotactile feedback. So it’s very much like your cell phone when you get a phone call coming in. It does the same thing. It begins to vibrate at a very low level on your back and then slowly increases in intensity until you finally get off your back.

What we do is we don’t begin the feedback until 15 minutes. So it gives the patients an opportunity to fall asleep and then it slowly moves them in most cases where they don’t even recall that it was giving them the feedback to get off their back.

So you asked the question earlier about whether or not it works long term and what not. We have some research that we looked at patients wearing the device for up to a year and what we found is on average, patients attempt to sleep on their back between five to seven times per night and this is over the vast majority that are in that range.

Occasionally, they recall the device waking them up in the middle of the night and when that happens, it might be one or two times a night and what we found is it generally occurs when they complete a sleep cycle, when they’re already changing positions after the end of the sleep cycle and they’re already partially awake.

So then they move on to their back. The device vibrates and they say, “Aha! It woke me up.” But as you know, how the sleep cycles work, it’s a natural completion of a period where they’re already slightly aroused.

David Cunnington: One of the things I like about the device is I can actually get data out of it. It helps me as the responsible physician to have an idea. Is it working? Is it doing what I need it to do? So how do people actually do that side of it?

Daniel Levendowski: So the device can be plugged in as long as you have – you need a USB on your computer and we have a free user of our report generator where the patients or the clinician can go. All of the information is stored on the device and when they plug it in, then they can go and simply print out the report and the report will tell them how many times during the night they attempted to go on their back and we give a very nice detail of showing when that occurred and how quickly they responded.

So we give them the average number of time – of vibrations that it took for them to get off their back as well as the range. It gives them information. The device uses what we call actigraphy or it looks at movement and from that, not only can we look at the position but we can also look at sleep-wake. So it’s almost twice as accurate as Fitbit and some of these other wearable wrist devices because we’re wearing the device around the neck.

David Cunnington: Show us how it works.

Daniel Levendowski: So it goes around the neck like this. Then it has a magnetic clasp. So when we were designing it, we wanted to make sure that people weren’t fearful of putting something around their neck during sleep that could possibly be a safety hazard. So we created the magnetic clasp that holds it securely in place and then the material we’ve had – people mentioned they weren’t sure if this was going to be comfortable. But the silicone is very similar to what is used for swimming goggles and what not.

So against the skin, it has a very nice tactile feel. But it also grips a little bit. So the device doesn’t move around much so that it stays in the back of the neck and doesn’t give you false feedback of telling you to get off your back because the device maybe shifted to the side. So that simply doesn’t happen.

David Cunnington: Great. Thanks very much Dan for that information and thank you for inventing the device. I really find it helpful and use it with a lot of my patients.

Daniel Levendowski: Thank you David.

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