# A Comparison of Snoring Changes With a Supine‐Avoidance Alarm Device Compared to Constant Positive Airway Pressure Treatment in Patients With Supine‐Predominant OSA

## TL;DR

This study compares two treatments for snoring in patients with sleep apnea, finding that a supine-avoidance device works better for some people than others.

## Contribution

The study evaluates the effectiveness of supine-avoidance therapy versus CPAP in reducing snoring in supine-predominant OSA patients.

## Key findings

- Supine-avoidance therapy nearly eliminated supine sleep but did not consistently reduce snoring frequency in all patients.
- CPAP significantly reduced snoring frequency compared to supine-avoidance therapy in the whole group.
- In supine-predominant snorers, supine-avoidance therapy reduced snoring frequency, though CPAP was more effective.

## Abstract

This study aimed to quantify how much snoring occurs in patients with supine‐predominant OSA and the comparative effectiveness of supine‐avoidance therapy versus CPAP to reduce objective measures of snoring. Participants had a 1‐week in‐home sleep posture assessment and a in‐home PSG study before being randomised to either CPAP or supine‐avoidance therapy for 6–8 weeks, then switched treatments for another 6–8 weeks. Snoring and treatment outcomes were examined in a subgroup of patients with supine dependent snoring. Baseline measurements showed snoring frequency was 48.9 [95% CI 16.7 to 188.7], 26.3 [95% CI 17.0 to 106.3], 57.5 [95% CI 16.8 to 190.7] snores/h for the whole group, supine snorer and non‐supine snorers respectively. Supine sleep as a percentage of total sleep was almost completely abolished with supine‐avoidance treatment (Baseline = 30.7% [95% 15.4 to 46.4], supine‐avoidance = 0.2% [95% 0.0 to 15.7]). In the whole group, CPAP significantly reduced overall snoring frequency although residual snoring remained. However, no treatment effect was observed with supine‐avoidance therapy in reducing snoring frequency (frequency of snores ≥ 50 dBA; baseline = 48.9 [95% 16.7 to 188.7], supine‐avoidance = 36.8 [95% 6.3 to 233.7], CPAP = 4.2 [95% 2.1 to 29.5] snores/h). In the sub‐group of supine‐predominant snorers, supine‐avoidance therapy was associated with reduced snoring frequency (Baseline = 26.3 [95% 17.0 to 106.3], supine‐avoidance = 14.3 [95% 3.0 to 18.1], CPAP = 4.6 [95% 2.6 to 8.9] snores/h). Supine‐avoidance therapy may not necessarily lead to a systematic reduction of snoring frequency in patients with supine‐predominant OSA but appears effective in a subgroup of patients.