1. Study characteristics.
| Study, design | Participants | Device |
Age Mean, years (SD) |
AHI (events/h) Mean (SD) |
Supine AHI (events/h) Mean (SD) |
OSA type and definition of POSAa |
BMI Mean (SD) |
Men n (%) | Duration of intervention period (washout) |
|
Bignold 2011 Cross‐over |
16 | Vibrating alarm |
58.2 (13.9) | 24.1 (10.5) | 51.3 (23.3) | POSA Overall AHI ≥ 15; ≥ twice supine position; non‐supine AHI < 15 |
28.8 (2.5) | 13 (81.3%) | 1 week (1 week) |
|
Jackson 2015 Parallel |
86 | Tennis ball sleep position modification device | 48 (11.2)/ 51.2 (11.4) | 20.1(8.8)/ 21.8 (10) |
43.2(25.5)/ 39.7 (19.3)* |
POSA AHI > 10; supine AHI twice non‐supine AHI |
30.0 (5.3)/30.9 (7.7) | 37 (78.7%)/30 (76.9%) | 4 weeks |
|
Laub 2017 Parallel |
101 | Vibrating alarm | 50.3(12.9)/ 51.2 (13.3) |
16.9 (8.5)/19.9 (9.7) |
34.8 (17.5)/37.7 (15.5)b | POSA AHI supine ≥ twice AHI non‐supine; AHI supine ≥ 10; AHI non‐supine < 10 Daytime tiredness and/or disturbed sleep and/or snoring |
27.1/27.9 | 39 (75%)/38 (78%) | 6 months |
|
Van Maanen 2012 Cross‐over |
30 | Vibrating alarm |
48 (9.5) | 27.7 (SEM 2.4) |
59.7 (SEM 3.6) |
POSA AHI > 5; AHI supine twice or > in non‐ supine position |
27.7 (3.6) | 26 (86%) | 2 nights (1‐2 weeks apart) |
|
Permut 2010 Cross‐over |
38 | Zzoma® positional sleeper |
49 (12) | 13 (5) | 31 (19) | POSA AHI ≥ 5 with symptom of excessive daytime sleepiness or AHI ≥ 15 with 50% decrease in non‐supine position |
31 (5) | 25 (65.7%) | 2 nights (none) |
|
Jokic 1999 Cross‐over |
14 | Backpack with soft ball | 51 (9) | 17 (8) | 63.8 (SEM 41.3) |
POSA Supine AHI ≥ 2 times AHI in lateral position, and AHI in lateral position < 15; subjective daytime sleepiness |
30 (4) | 12 (85.7%) | 2 weeks (none) |
|
Skinner 2008 Cross‐over |
20 | Thoracic anti‐supine band | 55.9 (9.8) | 22.7 (12) | 59.6 (27.5) | POSA AHI > 5; supine AHI ≥ 2 times AHI in other positions; maximum AHI in all other non supine position ≤ 10 |
30.7 (5.1) | Not reported | 1 month (1 week washout) |
|
Svatikova 2011 Cross‐over |
18 | Sona® anti‐snoring pillow to prevent supine sleep | Median: 58 (IQR 54, 68) |
Median: 39 (IQR 21,54) | Median 49 (IQR 35,60) | AHI ≥ 5; not restricted to POSA |
Median 29 (IQR 28, 33) |
11 (61.1%) | 2 consecutive night (none) |
| AHI: apnoea hypopnoea index; BMI: body mass index; IQR: interquartile range; OSA: obstructive sleep apnoea; POSA: positional obstructive sleep apnoea; SD: standard deviation; SEM: standard error of mean | |||||||||
aCartwright criteria: POSA is defined as OSA with 50% or more reduction in AHI when the person is lying on his or her side rather than on the back. bCases and controls in parallel‐group study.