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Laryngoscope. 2006 Nov;116(11):1995-2000.

Positional therapy for obstructive sleep apnea patients: A 6-month follow-up study.

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  • 1Sleep Disorders Unit, Loewenstein Hospital, Rehabilitation Center, Raanana, Israel.



Approximately half of obstructive sleep apnea (OSA) patients are positional (i.e., the majority of their breathing abnormalities during sleep appear in the supine posture). Little information exists as to whether avoiding the supine posture during sleep (positional therapy) is a valuable form of therapy for these patients.


To assess the use of positional therapy (by the tennis ball technique [TBT]) during a 6 month period in 78 consecutive positional OSA patients.


Demographic, polysomnographic, and self-reported questionnaire data on the use of the TBT were analyzed.


Of the 50 patients who returned the questionnaire, 19 (38%) (group A) said they were still using the TBT, and 12 (24%) (group B) said they used it initially and stopped using it within a few months but were still avoiding the supine position during sleep. Nineteen patients (38%) (group C) stopped using the TBT within a few months but did not learn how to avoid the sleep supine posture. Patients still using the TBT showed a significant improvement in their self-reported sleep quality (P < .005) and daytime alertness (P < .046) and a decrease in snoring loudness (P < .001). Patients of groups A and B were older than patients who did not comply with this therapy (P < .001). The main reason for patients stopping the use of the TBT in group C was that using it was uncomfortable.


Positional therapy appears to be a valuable form of therapy mainly for some older aged positional OSA patients.

[PubMed - indexed for MEDLINE]
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