TURN OVER! You’re Snoring… Independent review of novel positional therapy device

TURN OVER! You’re Snoring… Independent review of novel positional therapy device

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If you or your partner snore, then the words:

TURN OVER! – You’re Snoring… 

May be all too familiar!

Of course, the premise here is that the snorer (me!) will stop snoring in a different position (off their back most probably) and the offended, sleep disrupted partner, can then try to go back to sleep… 

Most people have heard of ways to help ‘train’ the snorer to get off their back (known as ‘Positional therapy’) including perhaps a tight fitting T-shirt with a tennis ball sewn into the back of it.

The idea being to make it uncomfortable to sleep this way (known as ‘supine’).

Adrian Zacher MBA

Adrian Zacher MBA

Author, Snoring and Sleep Apnoea Care Navigator

I teach UK dentists to help their patients stop snoring; sleep and breathe at the same time. Many of my customers find their work so rewarding they devote their practice to it. I’m a sleep-industry insider with a quarter of a century of sleep medicine experience.

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Good to know:

Snorer.com is independent. We don’t sell anti-snoring devices, chin straps or whatever! And we don’t benefit from affiliate deals.

Turn over - you're snoring!

Getting more serious

These approaches then develop slightly to include foam tubing or pillows strapped to the offending snorer’s back.

All these methods can help, but any change in sleep position throughout the night and over the course of time isn’t documented, and perhaps its not a lifelong solution:

So who knows what’s happening?

Certainly, the snorer’s partner may appreciate some noise reduction, but when they themselves are asleep – what’s going on?

Enter the new high-tech solutions and some more jargon (or when you know this device ‘buzz’ words) to explain:

  • Vibrotactile feedback: Essentially this means that when the device detects that the snorer is on their back it vibrates, just enough to encourage the snorer to turn over. You may know this, perhaps on your mobile/cellphone, as ‘Haptic feedback’.
  • Supine dependency: This is when the snorer either only snores when sleeping on their back, or that sleep apnoea is worsened when sleeping this way.

There are currently two competitors in this space and I was lucky enough to have the chance to try the NightShift device.

Point to note here: 

I don’t get paid for my thoughts and ramblings or get some other kickback.

Before I continue, its important to note that the NightShift device is a prescription medical device and that snoring may be a symptom of obstructive sleep apnoea (OSA).

If you are concerned about OSA you should consult your Doctor.

Now we have that out of the way, lets take a look at this thing:

Here’s a shot, I grabbed from the company leaflet:

NightShift device
Here it is on my hand (to give you some idea of scale).
NightShift on my hand for scale

My personal experience of positional therapy

I was impressed with the packaging and pleased to see how small the device was.

Hmmm….

The strap around the neck looks like it will throttle me – BUT – actually it contains two magnets to separate and release, right under my Adams apple. So if my wife gets annoyed with me… it separates.

The straps are actually quite comfortable, it just feels a bit strange the first few nights.

Note: The strap has loops (the manufacturer calls them retention bands) to slip the excess through. I mistakenly thought that mine had these loops missing, but they were at the end of the straps, over the magnets…

See the picture below (yes, its a bit small and hard to make out [its the ‘lump’ at the end] but it will become clearer in context below):

Neckstrap of NightShift device
You have to slide the loops along the strap, to limit the amount it can move.
See picture below:
slide the loops along

After getting the straps right, I turned it on…

Mistake!

Charge it first by plugging it into your computer with the micro USB lead that it comes with.

The next thing to do (which again I didn’t do the first night) is to head over to the manufacturer’s website (with the Nightshift device plugged in to your computer) and correct the time and date: www.nightshifttherapy.com

You need to have a current version of Java running on your PC for this to work. Get Java

So, did it work for me? Did I turn over?

Yes.

Put it this way, I use it every night.

I also use an oral appliance ‘mouthpiece’ and together the Nightshift controls my snoring and I feel better rested in the morning.

However, the first few nights of using it, I actually felt worse on waking as the device was making me turn over to sleep on my side. (At least it wasn’t my wife screaming at me “Turn over! You’re snoring….”)

This is to be expected I guess.

Now after a few weeks of using it, it must be changing my behaviour.

When I had it charged it lasted in excess of 3 nights. Its neat how when you turn it on, it vibrates to indicate how many nights of use it can provide.

I also like the delay in starting the vibrations for 15 minutes, so you can get to sleep before it starts working.

Did I turn over?

Have a look at the graph below and I will attempt to explain what they mean. 

This ‘3 day graph’ shows that my attempts to sleep ‘supine’ (on my back) have decreased considerably. I have deliberately spaced the nights chosen to give some idea of change.

The most recent data is the first graph. This shows improvement!

Look at the red line. This is when I was sleeping on my back and just following the line you can see I turned over like a good boy.

Now look at the second and third graphs and you will see I am sleeping less on my back, than I originally was.

It works!

There is the capability to record and display up to 12 months data, which I anticipate when I have been using it for some time, will prove valuable as there will be more data to work with.

Its interesting to see that it records how much I was snoring too… (click the image below to make it a bit bigger)

3 day detailed report

Who can help you stop snoring?

Get signposted (free) to the right professional

How to use the NightShift positional therapy device

Here’s a user instruction video placed on YouTube by the manufacturer.

I make no representations as to how useful or valid it is.

Night Shift – Using the Device

Conclusion

I think this is a fascinating area with real potential to manage sleep-related breathing disorders.

According to the manufacturer’s research 83% of participants had a 50% reduction in AHI (apnoea hypopnea index), 90% had > 35% reduction in AHI. The mean reduction across all participants was 69% and the median reduction was 79%.1

Combining an oral appliance with positional therapy appears to manage snoring and for those with supine dependent, mild to moderate obstructive sleep apnoea – reduce the incidence of apnoeaic episodes.

Its not clear to me, but I would imagine that it would also reduce the length of the apnoeaic episode too.

The take-away message seems to be:

‘Turn over and you will sleep better yourself 

Finally, a question occurred to me when thinking about this post and discussing my experience with the supplier:

  • Is the device really ‘training’ me to turn over?
  • What would happen if I stopped using it after a period of training?
  • Would I ‘forget’ and resume supine sleep?

The inventor Dan Levendowski was kind enough to let me know that yes it was training me – but continual use is advisable.

It just remains for me to add my thanks to Advanced Brain Monitoring and GDS Medtech for letting me try this product and review it.

Night Shift is CE marked and gained FDA clearance on the 3rd June 2014.

Here are some more independent reviews and how-to’s about snoring and sleep apnoea products, cures and aids:

Reference

The NightShift research paper, “Capability of a neck worn device to measure sleep/wake, airway position, and differentiate benign snoring from obstructive sleep apnea“, published in the Springer Journal in Feb 2015 http://link.springer.com/article/10.1007%2Fs10877-014-9569-3 new-window

Related:

NightShift crowdfunding page: https://www.indiegogo.com/project/preview/29da0980 new-window (now closed – Nov 2018)

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Created by Adrian Zacher Last updated 19th June 2019

Do Anti Snore Pillows work? (Sleep-Expert Review 2019)

Do Anti Snore Pillows work? (Sleep-Expert Review 2019)

Snorer.com
Rated 5/5 based on 16 customer reviews

Anti snore pillows: Do they work?

Anti snore pillows seem ideal: an easy and comfy way to return peace and quiet to your bedroom…

But:

Do they really stop you snoring? 

If you’re thinking of buying an anti snore pillow, then read this independent (no advertisements or affiliate links!) sleep-industry expert review.

I examine:

  • How anti snore pillows claim to work
  • What the clinical evidence tells us 
  • What the experts say
Adrian Zacher MBA

Adrian Zacher MBA

Author, Snoring and Sleep Apnoea Care Navigator

I teach UK dentists to help their patients stop snoring; sleep and breathe at the same time. Many of my customers find their work so rewarding they devote their practice to it. I’m a sleep-industry insider with a quarter of a century of sleep medicine experience.

Google Scholar

Tired of the sleepiness and the snoring?

Then read our free, definitive step-by-step how to stop snoring Guide.

This comprehensive Guide walks you through self-help, signposting, screening, professional assessment and diagnosis, the three categories of prescription treatment, follow-up and rounds off with a substantial FAQ.

CAUTION: Snoring may be a symptom of Obstructive Sleep Apnoea / Apnea (OSA)

Without first being screened for obstructive sleep apnoea (OSA) your purchase of an anti-snore pillow could be delaying your diagnosis and effective treatment (should your snoring be a symptom of OSA.)

A treatment that will prolong your healthy life!

Get signposted to the most appropriate professional (it’s free!)

The professional will screen you for OSA and decide if you’re ‘just’ a snorer or if your snoring needs investigating.

Your GP may be able to help you. Or if you live the UK, you can also find sleep-trained dentists who can screen you and recognise Obstructive Sleep Apnoea/Apnea (OSA) symptoms. These dentists can also provide you with a custom-made anti-snoring device.

Anti snore pillows (How they claim to work)

Various anti snore pillows are available, yet they share design similarities:

They’re either ‘door-wedge’ shaped or double-curved with the hollow being where you place your head.

In this independent review, I look past the marketing ‘hype’ and examine the science (if there is any) behind their claims:

sleep on your side Encouraging you to sleep on your side
better breathing by supporting your head and neck Encouraging better breathing by supporting your head and neck
better body alignment Encouraging better body alignment (whatever that is)

 

So we have 3 claims to review:

Anti Snore Pillows (What I'm not including in this review)

There’s another type of anti snore pillow that I’m not including in this review.

They’re the expensive (circa 300 USD) ‘high tech nudge’ pillows that don’t treat your snoring – they merely disturb your sleep in some way when a snore is detected. They wake you up enough to regain muscle tone in your throat.

Some manufacturers claim that after a while you will get used to this pillow movement and regain tone in your throat without waking up.

The jury is out on this.

No. 1. Anti Snore Pillows make you sleep on your side

Why? Why is sleeping on your side an aim? And how does that help stop snoring?

Think First Aid.

Are you familiar with the ‘Recovery Position’? Perhaps you should be!

This is when the unconscious individual is moved by a first-aider off their back into a semi-prone position known as the ‘Recovery Position’ to help them breathe.

We’ll come back to how this relates to snoring and anti snore pillows, later in this post (it’s called positional therapy).

Check out the video below about the Recovery Position by the St John’s Ambulance. It’s all about ensuring you can breathe when unconscious.

Here’s an authentic and less than favourable review of an anti snore pillow in the Huffington Post

The Recovery Position (YouTube video) by the St John’s Ambulance.

No.2. Anti Snore Pillows support your neck

According to the NHS ↗, the most common cause of neck pain is when your neck has become locked in an awkward position while sleeping.

But what’s neck pain got to do with snoring?

Allow me to explain:

If your pillow inadequately supports your neck while you sleep, and your head is on your shoulder. Then the airway in your twisted neck may become restricted.

And you guessed it:

You snore.

Anti snore pillow neck ache
So, there is merit in supporting your neck while you sleep:
  • From both a neck pain perspective
  • And if your current pillow could be improved upon, it seems reasonable it could improve your breathing while you sleep

But unless your pillow is truly terrible and you routinely wake-up with neck pain from a strange sleeping position;

I would not expect it to stop you snoring.

But what do the experts say?

What do the experts say about anti snore pillows?

Clinical experts research products or theories to establish if it does or doesn’t work. You can think of it as proof or as close as possible to ‘fact’.

There is good evidence that positional therapy i.e. training the individual NOT to sleep on their back (No. 1 in this review) can help stop snoring1.

What do the experts say about anti snore pillows?

No. 3. Anti Snore Pillows stop snoring by encouraging 'Better Body Alignment'

Encouraging better ‘body alignment’ (as in sleeping with your head and body straight and your neck not bent) would on the face of it seem reasonable.

Perhaps if you were to sleep with your neck at an acute angle (as I mentioned in my review of claim No. 2) then yes the airway in your throat would be restricted and it could make you snore.

However, marketing a pillow with a supposed anti snore feature being improved ‘body alignment’, is I think reaching a little.

Anti snore pillows are they the most effective positional therapy device?

The Real Question

So if positional therapy has some validity as a way to stop snoring, the real question is:

Are anti snore pillows the most effective positional therapy device?

And to answer that I will:

  • Look a little closer at positional therapy
  • Provide a rough cost/benefit analysis
  • Review what the experts advise

Unless your pillow is truly terrible, I would not expect a new one to stop you snoring.

Adrian Zacher MBA

Snoring & Sleep Apnoea Care Navigator

Positional therapy for snoring and sleep apnoea

Turn over you're snoring!

Positional therapy for snoring is ‘as old as the hills‘. Think tennis ball in the breast pocket of a t-shirt worn back to front.

Position dependent snoring1 is the technical name for when snoring either stops or lessens in different (not on your back) sleep positions.

Fortunately things have moved on some from tennis balls and anti snore pillows.

I’m not going to review the various high tech ways to or my experience of them here.

Suffice to say positional therapy may be useful IN ADDITION to:

  • A prescription, custom-made anti-snoring device
  • Positive Airway Pressure therapy

To get either of these you’ll need to know what you’re trying to ‘fix’. As in not self-diagnose yourself.

Keep reading:

Sleeping prone or on your front with an anti snore pillow

My personal experience of an anti snore pillow

When I rolled over and tried to sleep prone (on my front) my wife reported that the part of the pillow designed to support my neck when I slept on my side, pushed against my throat.

It appeared to be collapsing my airway!

She said I was making some very strange noises…

However, I continue to use an orthopaedic neck support pillow (remarkably similar shape!) and wouldn’t used anything else. I’ve learnt not to sleep quite so flat on my face!

Are they worth the money?

Anti Snore Pillows (Cost/Benefit Analysis)

Are anti snore pillows worth the money?

From a financial perspective its hard to beat the tennis ball in the pocket of the t-shirt.

With anti snore pillows on the market from 5 GBP they may be worth a punt.

However, you need to be aware of these limitations:

  • The tennis ball or anti snore pillow might not be enough to stop the snorer sleeping on their back (they just ignore it)
  • You have no evidence of effect throughout the night (other than the lack of a partner’s elbow in the ribs!)

Anti Snore Pillow: Costs

Anti snore pillow prices online and in the shops range from as little as 5 GBP to 25 GBP.

As a first-line and relatively harmless way to stop snoring they probably make financial sense.

However (and it’s a big HOWEVER) if they don’t stop the snoring problem then you need to seek the advice of a professional.

Pretty much everything is going to cost more than a tennis ball or a stop snoring pillow, but if you’re serious about no longer snoring, then consult a professional. There are considerable drawbacks to self-diagnosis.

  • If you have mild to moderate obstructive sleep apnoea (OSA) and you’re using an oral appliance then some data to show you turned over and your sleep has improved might be worthwhile.
  • If you’re on an auto-titrating PAP then getting off your back may reduce pressure and make PAP more tolerable.

Are you trying to ‘cure the snore?‘ (Before you know what’s wrong?)

Trying to ‘cure the snore’ before you know why you snore – is like driving a car before you’ve passed your test.

Wrong

You might think you can drive – but you could be on the wrong side of the road!

Treatment (the ‘cure’ for the snore) follows diagnosis i.e. find out if your snoring is more than just anti-social before trying to ‘cure’ it – for this you need signposting.

What about anti-snoring devices?

If anti snore pillows aren’t helping then you might wonder what else is available. Enter anti snoring devices.

Anti-snoring devices are commonly oral appliances you wear in your mouth at night.

They work by holding your lower jaw in a more forward position. This keeps your tongue away from the back of your throat so you don’t snore.

What’s the best anti-snoring device?

Example of an anti-snoring device

Example of an anti-snoring device. Image courtesy of SomnoMed and used with permission.

What about surgery?

A long way from an anti snore pillow…

Surgery for snoring is divided into whether hard and soft tissue is involved.

Soft tissue surgery is intended to improve the effect of an anti-snoring device or PAP therapy (more about what PAP is in a moment).

Whereas hard tissue surgery (that changes the way you look) is intended to eliminate the need for any other treatment.

Learn more:

Radio-frequency ablation for snoring

Image representing a soft tissue operation: radio-frequency palatal surgery.

Image representing a hard tissue operation: bi-maxillary osteotomy (both jaws operated on).

What about CPAP?

There are pillows especially designed for PAP users. Keep reading:

CPAP stands for Continuous Positive Airway Pressure therapy. Today, it is referred to as just PAP.

PAP works by providing low pressure air (through a mask worn over your nose and sometimes both your nose and mouth) to the airway in your throat. This pneumatically holds open your airway.

While an arduous therapy, it is highly effective if snoring is actually a symptom of obstructive sleep apnoea (OSA).

Learn more:

Example of a full face PAP mask

Do’s

Don’ts

  • Don’t self-diagnose yourself as ‘just’ snoring
  • Don’t buy over-the-counter stop snoring gadgets
  • Don’t ignore drowsiness or sleepiness during your normal awake time (consult your GP)
  • Signposting to the right professional

    When self-help and pillows aren’t helping it’s time to get serious.

    Signposting is when you’re directed to the most appropriate expert to help you stop snoring.

    The expert professional (your GP, additionally if you’re in the UK a sleep-trained dentist2) will screen you for sleep apnoea and decide if you need further investigation i.e. a sleep study.

    If you don’t need a sleep study a custom-made anti-snoring device (available from the sleep-trained dentist) is the first way to stop snoring and treat mild to moderate OSA3.

    Oh and signposting is free.

    Signposting to the right professional to stop snoring

    Summary

    My final verdict is that anti snore pillows are a relatively low-cost way to try to stop snoring. But don’t get your hopes up.

    You need to be comfortable to sleep well, so find a pillow that helps you sleep comfortably on your side and supports your neck. Consider orthopaedic pillows in addition to the big headline grabbing brands.

    When snoring is a problem consult a professional. If you’re in the UK you can get signposted to the right type.

    Otherwise consult your primary care physician. They have your medical history and want you to be well (they’re not trying to sell you something!)

    A final note about high tech anti snore ‘nudge pillows’:

    I’d like to see the impact this type of anti snore pillow has on the individual’s sleep quality.

    They appear to me to be fragmenting sleep and preventing deep restorative sleep from occurring. I consider the onus upon the pillow manufacturers to substantiate their marketing claim.

    And I come back to the fact that this is a ‘treatment’ before knowing why you snore: there has been no prior assessment or screening for sleep apnoea.

    Reviews

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    If you are looking for impartial advice about snoring from an expert in the field, the highly respected Adrian Zacher should be your go to. We applaud Adrian’s work, to raise awareness about the health implications of snoring, and the importance of prescription, custom-made devices for long-term success.

    Lucie Ash Director Somnowell Snorer.com September 7, 2018

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    Here are some more high quality, independent sleep-expert reviews of anti-snoring devices, snoring and sleep apnoea / apnea products, cures and aids!

    Glossary

    Anti-Snoring Device – generally considered a product worn in your mouth to stop you snoring.

    Custom-made – a bespoke device made specifically for you by a registered dental technician, working to prescription, using CE marked materials. In Europe working to the Medical Devices Directive  administered in the UK by the Medicines and Healthcare Products Regulatory Authority (MHRA)

    OSA Obstructive Sleep Apnoea – (also spelt apnea) When an individual is unable to sleep and breathe at the same time. Visually, a repetitive pattern of breathing interruptions (apnoeas) occurring while the individual sleeps, due to a physical obstruction in the airway.

    OTC – Over-the-Counter product sold over the pharmacy counter or on-line without prescription, medical or dental assessment and without a review of medical/dental history.

    Signposting – Is the medical term for directing people to the most appropriate professional to help them based upon their answers to some high-level questions.

    Sleep-trained Dentist – A dentist that has undergone special interest training in sleep. As such they are able to obtain professional indemnity insurance.

    References

    1. Benoist LB, Morong S, van Maanen JP, et al. Evaluation of position dependency in non-apneic snorers. Eur Arch Otohinolaryngol. 2013;271(1):189–94. https://link.springer.com/article/10.1007/s00405-013-2570-5  new window
    2. Stradling, J. and Dookun, R. 2009, Snoring and the role of the GDP: British Society of Dental Sleep Medicine (BSDSM) pre-treatment screening protocol, British Dental Journal, 206, 307 – 312. Available here: http://www.nature.com/bdj/journal/v206/n6/abs/sj.bdj.2009.214.html new window [accessed 12 April 2017]
    3. The American Academy of Sleep Medicine (AASM) has approved oral appliance therapy (OAT) as a first line treatment for patients diagnosed with mild to moderate OSA. https://www.sleepapnea.org/treat/sleep-apnea-treatment-options/ new window

    Created by Adrian Zacher | Page last updated 3rd June 2019

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