ABSTRACT
Background:
Although mild
head of
bed elevation (HBE) is a proven
method to reduce
obstructive sleep apnea, there is no study to apply mild HBE in daily
life using an adjustable
bed.
Objective:
We aimed to explore the applicability of mild HBE using an adjustable
bed in daily
life by investigating adverse events and discomforts induced by mild HBE. This
pilot randomized trial additionally investigated the objective effects of mild HBE on
sleep using
polysomnography (PSG).
Methods:
Pilot randomized controlled trial. With a two-tailed alpha of 0.05 and a
power of 0.95, the minimum number of participants for each group;
control group slept on flat
bed and study group slept on
bed with mild HBE on follow-up PSG; was calculated to be 12. Considering a 20% follow-up loss, we enrolled a total of 32 participants (16 participants for each group).
Setting:
Dongguk
University, Ilsan
hospital.
Participants:
A total of 37 individuals complained of subjective
sleep disturbance in the
Republic of Korea, 32 of whom met the inclusion criteria between September 2021 to July 2022. 23 participants completed the study and participants were randomly assigned into two groups. Intervention A mild HBE of 7.5 degrees using an adjustable
bed was implemented. PSG results and
questionnaires were evaluated.
Results:
There was no difference in the proportion of adverse events between groups after post-intervention which was adjusting mild HBE on study group. Changes in
sleep satisfaction from baseline to post-intervention showed no significant difference between groups either. However, changes in respiratory distress index (RDI) (F = 6.088, 95% CI, 17.0% to 26.4%; P = .023) and
apnea-hypopnea index (AHI) (F = 5.542, 95% CI, 13.6% to 23.5%; P = .029) were significantly different.
Conclusions:
Mild HBE is an implementable
method for changing
sleep posture without definitely causing discomfort or worsening
sleep satisfaction. Since an easily applicable way to implement mild HBE using an adjustable
bed in daily
life reduces RDI and AHI in both subjects complaining of
sleep disturbance and
obstructive sleep apnea, it can be an alternative
treatment for
obstructive sleep apnea.