Positional therapy as we all know can have a huge impact on the efficacy of treatments and in many cases positional treatment is the only therapy that a patient requires to be normalised.
This new device is worn around the neck in a similar way to how a collar would be worn. It is therefore very easy to use and is a device that is virtually non intrusive. When the night shift is activated it senses all of the possible positions that the patient can be in. When the patient finds themselves in a supine position the device will provide vibro-tactile feedback, gently at first however if the patient does not change position, over time the feedback builds to the point where the patient is unable to continue sleeping, leavening no other option but to change sleeping position. Whilst some patients initially may be awakened by this feedback ultimately they will register at the very early stages of the vibro-tactile feedback that this is not a good situation and change positions before they are disturbed from their sleep.
The vibro-tactile feedback is very effective at keeping patients in a non supine position and whilst it is doing this the NightShift collects important data which can then be downloaded and a report can be generated using the NightShift web portal. The following data is recorded:
- Actigraphy, this determines awake and asleep times.
- Positiional data including supine, left right prone and upright positions.
- Snoring Level in DB’s
The device can be initially setup to provide no vibro-tactile feedback so that over the first day or so a positional base line can be established. The device can then be setup to start providing the vibro-tactile feedback on subsequent days. Because the data is collected a accurate assessment can be made as to the efficacy of the positional therapy.
The detailed data can be easily viewed and assessed via the web portal generated report. You can see a example of this report by viewing the “Night Shift Web Reports.pdf”
The Night Shift continues to collect 12 months data which is then used to generate monthly reports which provide the following information:
- Hours Per Night Used
- Sleep Efficiency
- % of time off back
- Snoring level in DB’s
Often using algorithms NightShift also provides the following monthly information:
- Nights Used
- % of nights used
- % of Night Used > 5+ Hours
- Average hours when used
- Average sleep efficiency
- Average back attempts per night
- Number of nights off back
- Average sleep time of back
- Average snoring > 40 DB
- Average snoring > 50 DB
Attached you will find a initial study that was carried out in Holland on a prototype device. The results from the initial trail are quite impressive however it has been shown that the second generation device where two heptic motors are used to generate the vibro-tactile feedback keep patients in a non-supine position for at least 96% of the time.
This development is positional treatment provides important options when trying to optimise patient outcomes. This can be done in the following ways:
If a patient has positional OSA only the Night Shift can be used as the treatment.
When a patient using a MAS device is found to have much better results in a non supine position
A patient using Provent where it is found that Provent is more efficacious in a non supine position
Where a high CPAP pressure is required to treat OSA in the supine position. By using the Night Shift the required pressure could be reduced making CPAP more tolerable.