Sleep Position Research Articles

Randomized Clinical Study of Nano-Cerium Oxide and its Efficacy in Sciatic Nerve Regeneration: A Histopathological Evaluation

Background: Peripheral nerve damage is a frequent clinical condition. peripheral nerve injuries are variable, and these injuries are mostly caused by trauma. Blunt trauma has many types, including contusion, laceration, stretching, traction, penetrating and perforating injuries, abnormal sleeping positions, external pressure, internal compression, ischemia. Cerium oxide nanoparticles are used widely in the materials field. Besides their material applications. Objective: this study was examining how cerium oxide nanoparticles impact axonal regeneration of the sciatic nerve in rats. Materials and Methods: 24 adult animals used, weighing average (M±SD: 230 ± 20 g). The animals were separated into two group. The first group (control) was left without treatment, The second group (Nano cerium Oxide) was treated orally with 50 mg of Nano cerium oxide daily for 7 days. Right Sciatic nerve was completely transected in all animals. The result evaluated at 4th, 8th and 12th weeks post-operative. Results: The histopathological results, indicated that the high effective result in the second group, then the control group. The control group has a significant nerve damage and some regenerative signs over time. While there are indications of severe damage particularly at 4 and 8 weeks, then presence of almost normal nerve fibers at 12 weeks suggests partial recovery. Conclusion: Nano Cerium Oxide accelerated the regeneration of the peripheral nerves These findings suggest that this nanoparticle could can be seen as a novel therapy for promoting the regeneration of the nervous system.

Association Between Sleep Position, Obesity, and Obstructive Sleep Apnea Severity

Background: This study examines the relationship between obstructive sleep apnea severity, sleep position, and body weight, particularly focusing on the negative impact of sleeping in a supine position combined with being overweight in a population-based sample. Methods: The Apnea-Hypopnea Index (AHI) was utilized as a marker of OSA severity and sleep position from a standardized overnight polysomnography. Participants were categorized by body mass index (BMI) (kg/m2) into normal weight/underweight (<25) and overweight (≥25). Results and Conclusions: The results indicated a higher mean Apnea-Hypopnea Index for those sleeping in the supine position compared to other positions, with overweight individuals experiencing a proportionally greater impact from sleep position than their normal-weight counterparts.

Factors affecting lymphedema after neoadjuvant chemotherapy and axillary dissection in female breast cancer patients: a retrospective cohort study based on the Chinese population

PurposeBreast cancer-related lymphedema (BCRL) is a common complication among breast cancer survivors. Most BCRL studies have focused on patients receiving adjuvant chemotherapy, with relatively little attention paid to BCRL in patients undergoing neoadjuvant chemotherapy (NAC). This study aimed to investigate the risk factors associated with BCRL in Chinese women undergoing NAC and axillary lymph node dissection (ALND).MethodsAt our institution, this cohort study collected data from 336 women with breast cancer and documented axillary nodal metastasis at diagnosis, who received NAC and ALND surgery between 2015 and 2020. BCRL was assessed through both objective limb circumference measurements and subjective self-reported symptoms. Multivariate logistic regression was employed to identify risk factors for BCRL, considering clinical, demographic, and lifestyle-related characteristics.ResultsThe cumulative incidence of BCRL within 2.5 years was 43.75%. Factors independently associated with BCRL included radiotherapy (versus no radiotherapy; hazard ratio (HR) = 1.611; P = 0.020), NAC duration of 105 days or shorter (versus 105-143 days; HR = 0.471; P = 0.020), removal of more than 15 lymph nodes (versus 15 or fewer lymph nodes; HR = 1.593; P = 0.036), drainage duration of 20-29 days (versus 10-19 days; HR = 1.568; P = 0.028), and sleeping biased toward the affected arm (versus sleeping biased toward the healthy arm; HR = 2.033; P = 0.019).ConclusionThis study identified several risk factors for BCRL in breast cancer patients following NAC and ALND. Patients presenting with one or more of these factors should be monitored closely for early detection and intervention. Further research is warranted to explore the impact of drainage duration and sleep position on the development of BCRL.

Pediatric Obstructive Sleep Apnea: Clinical Manifestations and Consequences

Obstructive sleep apnea (OSA) significantly impacts the quality of life in children, affecting their physical and mental health. The pathophysiology involves a complex interaction between anatomical factors (such as enlarged tonsils, adenoids, and structural abnormalities) and obesity, along with neuromuscular compensations. Clinical manifestations include loud snoring, breathing pauses, restless sleep, unusual sleeping positions, and frequent awakenings. OSA can lead to enuresis, growth impairment, poor academic performance, and neurocognitive and behavioral difficulties. Long-term consequences are cardiovascular morbidity, metabolic dysfunction, and neurocognitive impairment. Many studies have explored these associations and the impact of adenotonsillectomy. This review provides an overview of clinical manifestations and consequences of OSA, aiming to enhance diagnosis and treatment strategies for pediatric OSA.

Characteristics of clinical descriptive variables and polysomnographic findings of catathrenia.

Catathrenia has been classified as a sleep-related breathing disorder variant in the third edition of the International Classification of Sleep Disorders, but its validity remains unverified. We analyzed the clinical descriptive variables and polysomnographic findings of catathrenia and discussed the similarities and differences to those of obstructive sleep apnea (OSA), non-REM parasomnias, and sleep bruxism (SB). A retrospective analysis was conducted on 47 patients diagnosed with nocturnal groaning through polysomnography. We examined sex, body mass index, age at symptom onset, weekly symptom frequency, and presence/absence of comorbidities, including OSA, periodic limb movement disorder, non-REM parasomnia, and SB. The groaning event (GE) index was calculated according to sleep position and sleep stage. The distribution of patients with catathrenia did not show sex difference (male/female = 20:27), body mass index was 20.6 ± 3.0 kg/m2, and age of onset was 18.2 ± 7.4 years. The GE index was higher in stages N1 and R than in stage N3 and in the supine position than in the lateral position. There were no cases complicated with non-REM parasomnia, but the complication of SB was observed in 30% of the participants, and SB events appeared immediately before or during the interictal period of the GE episodes in these cases. Given the clinical background, posture- and sleep stage-dependent appearance of GEs, and the relatively high complication rate of SB, catathrenia pathogenesis may be heterogeneous or comprise elements of different sleep disorders.

Sudden death of a two-month-old infant: A case report emphasizing safe sleep practices

A rare case of sudden cardiopulmonary arrest in a two-month-old infant during overnight breastfeeding is presented in this case report. The infant's respiratory distress prompted an emergency response, highlighting the complexities of managing critical situations in neonates. The report provides a comprehensive overview of the clinical presentation, resuscitation efforts, and laboratory findings. It emphasizes the importance of continuous education on safe sleep practices, breastfeeding techniques, and cultural factors that influence sleep safety. The aim is to raise awareness, foster understanding, and emphasize the necessity of a holistic approach to preventing adverse events in the vulnerable neonatal population. The case emphasizes the importance of establishing a safe sleeping environment by avoiding risk factors such as prone sleeping positions and soft bedding. It also highlights the need for culturally sensitive education. Additionally, the case addresses the challenges related to maternal alertness during night feeds and the controversial practice of bed-sharing. The report highlights the importance of healthcare providers in sharing information, conducting research, and involving communities to encourage a culture of sleep safety that protects the well-being of infants. Continuous education and awareness are crucial in this joint effort to safeguard the most vulnerable members of society.

Arousal burden is highest in supine sleeping position and during light sleep.

Arousal burden (AB) is defined as the cumulative duration of arousals during sleep divided by the total sleep time. However, in-depth analysis of AB related to sleep characteristics is lacking. Based on previous studies addressing the arousal index (ArI), we hypothesized that the AB would peak in the supine sleeping position and during non-rapid eye movement stage 1 (N1) and show high variability between scorers. Nine expert scorers analyzed polysomnography recordings of 50 participants, the majority with an increased risk for obstructive sleep apnea. AB was calculated in different sleeping positions and sleep stages. A generalized estimating equation was utilized to test the association between AB and sleeping positions, sleep stages, and scorers. The correlation between AB and ArI was tested with Spearman's rank-order correlation. AB significantly differed between sleeping positions (p<0.001). The median AB in the supine sleeping position was 47-62% higher than in the left and right position. The AB significantly differed between the sleep stages (p<0.001); the median AB was more than 200% higher during N1 than during other sleep stages. In addition, the AB differed significantly between scorers (p<0.001) and correlated strongly with ArI (r=0.935, p<0.001). AB depends on the sleeping position, sleep stage, and scorer as hypothesized. AB behaved similarly as the ArI, but the high variability in the ABs between scorers indicates a potential limitation caused by subjective manual scoring. Thus, the development of more accurate techniques for scoring arousals is required before AB can be reliably utilized.

A policy analysis of sleep-related legislation for Canadian licensed childcare facilities

BackgroundNational legislative guidelines for sleep and rest are lacking in the Canadian licensed childcare sector. No review of Canadian legislation for licensed childcare facilities has focused on sleep. This paper provides a review of the Canadian provincial and territorial legislative landscape, regarding sleep, rest, and naps in licensed childcare centers.MethodsChildcare statutes and regulations for each province and territory were identified and downloaded on a particular date. Statutes and regulations were reviewed focusing on sections articulating licensed childcare facility mandates governing sleep, rest, naps, and sleep equipment. An excel file was used to facilitate systematic data retrieval and comparisons across provinces and territories. Two authors developed and discussed themes that summarized data from the documents.ResultsNo statutes indicated recommendations for sleep, rest, or naps. Only one regulation defined rest (Alberta). Our analysis of regulations identified four themes representing sleep, rest, and naps: programming (general programming, daily programming); space (dedicated space, amount of space, age-specific space); equipment (developmental appropriateness, acceptable sleep equipment, age-specific equipment); and safety (staffing during sleep/rest, sleep position, sleep monitoring, sleep equipment safety, prohibited practices). In Canada, minimal regulatory consistency is evident in required sleep programming, space, acceptability of sleep equipment, and sleep safety considerations. Most jurisdictions’ regulations indicated necessity for developmentally appropriate rest or sleep areas and equipment, in particular for infants, but there was minimal consistency in defining infant age groups.ConclusionsAlthough we identified themes related to sleep across regulations, childcare regulations differ in their definitions of infants and specifications for children’s sleep and rest in licensed Canadian childcare facilities. Without adequate definitions in legislative components of appropriate sleep duration linked to children’s developmental stages, childcare facilities lack guidance to support healthy sleep for children in their care. Future research can examine translation of healthy sleep guidelines into government legislation and mandates for sleep, rest, and naps among young children in licensed childcare.

Classification of Sleeping Position Using Enhanced Stacking Ensemble Learning.

Sleep position recognition plays a crucial role in enhancing individual sleep quality and addressing sleep-related disorders. However, the conventional non-invasive technology for recognizing sleep positions tends to be limited in its widespread application due to high production and computing costs. To address this issue, an enhanced stacking model is proposed based on a specific air bag mattress. Firstly, the hyperparameters of the candidate base model are optimized using the Bayesian optimization algorithm. Subsequently, the entropy weight method is employed to select extreme gradient boosting (XGBoost), support vector machine (SVM), and deep neural decision tree (DNDT) as the first layer of the enhanced stacking model, with logistic regression serving as the meta-learner in the second layer. Comparative analysis with existing machine learning techniques demonstrates that the proposed enhanced stacking model achieves higher classification accuracy and applicability.

A Position Modification Device for the Prevention of Supine Sleep During Pregnancy: A Randomised Crossover Trial.

To assess the effectiveness and acceptability of a pillow-like position modification device to reduce supine sleep during late pregnancy, and to determine the impacts on the severity of sleep-disordered breathing (SDB) and foetal well-being. Randomised cross-over study. Individuals in the third trimester of pregnancy receiving antenatal care at a tertiary maternity hospital in Australia. Participants used their own pillow for a control week and an intervention pillow for a week overnight, in randomised order. Sleep position and total sleep time for each night of both weeks were objectively monitored, with a sleep study and foetal heart rate monitoring performed on the last night of each week. Primary outcome = percentage of sleep time in the supine position; secondary outcomes = apnoea-hypopnoea index, foetal heart rate decelerations and birthweight centile. Forty-one individuals were randomised with data collected on 35 participants over 469 nights. There was no difference in percentage of total sleep time in the supine position overnight between the control or intervention pillow week (13.0% [6.1, 25.5] vs. 16.0% [5.6, 27.2], p = 0.81 with a mean difference of 2.5% [95% CI] = -0.7, 5.6, p = 0.12), and no difference in the severity of SDB or foetal heart rate decelerations across weeks. However, increased supine sleep was significantly related to a higher apnoea-hypopnoea index (rs = 0.37, p = 0.003), lower birthweight (rs = -0.45, p = 0.007) and lower birthweight centile (rs = -0.45, p = 0.006). The proportion of supine sleep each night of the week varied widely both within and across participants, despite awareness of side-sleeping recommendations. We found no evidence to suggest that the adoption of a pillow designed to discourage supine sleep was effective in late pregnancy, with women spending an average of 1 h per night supine. Alternative devices should be investigated, incorporating lessons learnt from this study to inform trials of supine sleep minimisation in pregnancy. Clinical Trial: (Australia New Zealand Clinical Trials Registry): ACTRN12620000371998.

Postoperative Supine Sleeping Position Following Total Knee Arthroplasty Decreases Knee Flexion Contractures

Background Total knee arthroplasty (TKA) is an orthopaedic operation that improves quality of life and reduces pain in patients with disabling arthritis of the knee. One commonly recognized postoperative complication is flexion contracture of the knee. While early physical therapy and range of motion (ROM) exercises have helped improve ROM postoperatively, flexion contractures still remain a significant postoperative complication of TKA. This study evaluated postoperative sleeping position and its effect on terminal knee extension and ROM following primary TKA. We hypothesized that patients who slept in the supine position would achieve earlier knee extension and ROM when compared to those in the lateral recumbent position. Methods A total of 150 consecutive primary total knee arthroplasties (TKAs) were conducted by a single surgeon (JMC). Prospective data collection included assessments of preoperative range of motion (ROM), postoperative ROM, patient-reported outcome measures, and sleeping positions. Functional outcomes and patient-reported measures were compared between pre- and postoperative phases, as well as across different sleeping position groups. Results Postoperative follow up was a mean of 29.6 days. Mean postoperative terminal extension ROM at one month was 2.98 degrees in the supine group versus 6.03 degrees in the lateral group (P &lt; 0.001). Overall, there was significant improvement in patient reported outcome measures (WOMAC, Oxford, and pain) after surgery, but no difference existed between sleeping groups. For knee extension, a two-way ANOVA revealed that there was a statistically significant interaction between the effects of surgery and sleep position (p = 0.0053). Conclusions Our results demonstrate that sleeping position does affect initial postoperative knee terminal extension; however, there is no effect on patient reported outcomes. We found a statistically significant difference in extension when comparing patients in the supine versus lateral group. Patients who slept in the lateral position lacked 6.03 degrees of extension which is greater than the 5 degrees threshold needed for normal gait mechanics. Conversely, those in the supine group only lacked 2.98 degrees of extension, allowing for normal gait mechanics. This study identifies an easy, effective means of increasing patient knee range of motion following TKA.

Factors Related to the Sleep Duration of 3-Month-Old Infants.

Objective To identify the factors related to sleep duration in 3-month-old infants. Materials and Methods From 2021 to 2023, we conducted a cross-sectional study in the city of Araraquara, Brazil, involving 140 mothers and their respective 3-month-old infants. Maternal socioeconomic, demographic, obstetric, and nutritional characteristics, as well as nutritional and morbidity characteristics of the respective infants, were evaluated. Sleep duration was determined by the Brief Infant Sleep Questionnaire (BISQ). Multivariate linear regression analysis was used to assess the associations of maternal, newborn, and infant factors with sleep duration at three months. Results The nighttime sleep duration of the infants was of 9 hours. There were negative associations between nighttime sleep duration and prone sleep position ( p = 0.011), falling asleep between 8:30 pm and 11:00 pm ( p = 0.032), falling asleep after 11:00 pm ( p < 0.001), respiratory infection ( p = 0.011), dermatitis ( p = 0.002), and the presence of children under 9 years of age in the household ( p = 0.013). Discussion In the present study, factors such as infant morbidity, the presence of other children in the household, and sleeping habits were associated with a decrease in sleep duration in 3-month-old infants. Therefore, we emphasize the importance of early diagnosis of morbidity in the first months of life and of promoting healthy habits such as regulating the time to go to sleep, providing an adequate sleep environment, and other practices that help improve the quality and duration of sleep.

Sleep disruption and sleep position: Increased wake frequency in supine predicts lateral position preference.

Little is known about the physiological and biomechanical factors that determine individual preferences in lying posture during sleep. This study investigated relationships between position preference and position-specific arousals, awakenings, limb movements and limb movement arousals to explore the mechanisms by which biomechanical factors influence position preference. Forty-one mature-aged adults underwent 2 nights of at-home polysomnography ~2 weeks apart, on a standardised firm foam mattress, measuring nocturnal sleep architecture and position. The lateral supine ratio and restlessness indices specific to lateral and supine positions including limb movement index, limb movement arousal index, arousal index, wake index, respiratory arousal index and apnea-hypopnea index were calculated and analysed via linear mixed-effects regression. In the supine position, all restlessness indices were significantly increased compared with the lateral position, including a 379% increase in respiratory arousals (β = 7.0, p < 0.001), 108% increase in arousal index (β = 10.3, p < 0.001) and 107% increase in wake index (β = 2.5, p < 0.001). Wake index in the supine position increased significantly with more lateral sleep (β = 1.9, p = 0.0013), and significant correlation between lateral supine ratio polysomnography 1 and lateral supine ratio polysomnography 2 (β = 0.95, p < 0.001) indicated strong consistency in sleep preference. Overall, the findings suggest that some individuals have low tolerance to supine posture, represented by a comparatively high wake index in the supine position, and that these individuals compensate by sleeping a greater proportion in the lateral position.

Leveraging Attention-reinforced UWB Signals to Monitor Respiration during Sleep

The respiration state during overnight sleep is an important indicator of human health. However, existing contactless solutions for sleep respiration monitoring either perform in controlled environments and have low usability in practical scenarios or only provide coarse-grained respiration rates, being unable to accurately detect abnormal events in patients. In this article, we propose Respnea, a non-intrusive sleep respiration monitoring system using an ultra-wideband device. Particularly, we propose a profiling algorithm, which can locate the sleep positions in non-controlled environments and identify different subject states. Further, we construct a deep learning model that adopts a multi-head self-attention mechanism and learns the patterns implicit in the respiration signals to distinguish sleep respiration events at a granularity of seconds. To improve the generalization of the model, we propose a contrastive learning strategy to learn a robust representation of the respiration signals. We deploy our system in hospital and home scenarios and conduct experiments on data from healthy subjects and patients with sleep disorders. The experimental results show that Respnea achieves high temporal coverage and low errors (a median error of 0.27 bpm) in respiration rate estimation and reaches an accuracy of 94.44% on diagnosing the severity of sleep apnea-hypopnea syndrome.

Relationship between sleep position and otitis media in infants: The Japan environment and children's study

ObjectiveOtitis media is a disease that commonly occurs in infants. Various risk factors have been reported. Sleep position has been reported to be associated with various diseases. There is no report on the relationship between otitis media and sleep position. We examined the incidence of otitis media and sleep position in infants. MethodsWe used data from the Japan Environment Children's Study. We used multivariate logistic analysis to examine the relationship between sleep position and the incidence of otitis media in infants aged up to 6 months. In addition, we conducted a stratified analysis based on whether the child was able to turn over in bed at 6 months of age. ResultsThe study population comprised 85,731 participants. The incidence of otitis media by sleep position was significantly higher when the infant was in the prone position compared to any other position (adjusted odds ratio, 1.206; 95 %CI, 1.038–1.401). Stratified analysis of turning showed that otitis media was more common in the prone position in all groups. ConclusionIn the current study, infants aged 6 months or younger who slept in the prone position were more likely to have otitis media. Sleep position interview and guidance on changing sleep position may be useful for the prevention of otitis media.

Positional Regulation, Sucking Reflex and Incidence When Given Nutrition Through OGT in High-Risk Infants with Low Birth Weight Infants in the Nicu Room: A Case Study of Waled Hospital

High-risk babies are babies born at 32 – 36 weeks of gestation/prematurely, babies whose mothers suffer from Diabetes Mellitus, babies with a history of apnea, babies with seizures, sepsis, asphyxia, babies with bleeding disorders or breathing problems. Problems that often arise in cases of LBW babies include unstable body temperature, breathing problems, digestive and nutritional disorders, liver immaturity, anaemia, intraventricular bleeding, seizures, infections, hypoglycemia, hyperglycemia and hypocalcemia. This study aims to provide nursing care to babies at high risk in the Nicu Room at Waled Hospital, Cirebon Regency, on 27 December 2023. Examination of the sucking reflex is recommended as a screening that shows intact motor neuron function in neonates. The sucking reflex is well-developed in normal babies and is coordinated with breathing. Inhibition of the sucking reflex in the first hours of life will affect the ability to suck at the beginning of life and will directly hinder the nutritional intake received by the baby. Arranging sleeping positions for newborn babies is the role of the neonatal nurse in providing routine daily care. Positioning, especially for premature babies, is not easy. Positioning errors can result in changes in physiological status (increased respiratory rate, pulse frequency, and decreased oxygen saturation), disturbed comfort and quality of sleep, drinking intolerance, hip joint deformity, and bleeding in the brain. The issues affecting all three clients have not been resolved. However, interventions such as positioning, assessing sucking reflexes in high-risk babies, and providing nutrition through OGT are ongoing, with efforts to set the supine sleep position during enteral nutrition. While the problems faced by the high-risk infants in this study are not yet resolved, ongoing nursing interventions are crucial in managing their care. Continued attention to proper positioning, monitoring of sucking reflexes, and nutritional support through OGT is vital for improving the health outcomes of these vulnerable infants.

The influence of semi-fowler sleeping position education on sleep quality in congestive heart failure patients at Subang General Hospital

Background: Patients with congestive heart failure (CHF) frequently experience nocturnal dyspnea, leading to poor sleep quality, which can slow down recovery and prolong hospital stays. The semi-Fowler sleep position may alleviate breathing difficulties and improve sleep quality in CHF patients. Purpose: This study aimed to evaluate the impact of semi-Fowler sleep position education on the sleep quality of CHF patients. Methods: A quasi-experimental design with a pre-test and post-test control group was used, involving 26 CHF patients selected through accidental sampling from the inpatient ward of Subang General Hospital. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI), and the intervention involved educational booklets and demonstrations on the semi-Fowler sleep position. Results: Data analysis using the Mann-Whitney test showed a significant improvement in sleep quality post-intervention, with a p-value of 0.000, indicating a meaningful difference in sleep quality between the intervention and control groups. Conclusion: Educating CHF patients on the semi-Fowler sleep position significantly improved their sleep quality. These findings suggest that incorporating semi-Fowler position education into patient care may help reduce nocturnal discomfort and promote better recovery in CHF patients. This approach could be a practical intervention for improving patient outcomes and reducing hospital stays.

Transitioning sleeping position detection in late pregnancy using computer vision from controlled to real-world settings: an observational study

Sleeping on the back after 28 weeks of pregnancy has recently been associated with giving birth to a small-for-gestational-age infant and late stillbirth, but whether a causal relationship exists is currently unknown and difficult to study prospectively. This study was conducted to build a computer vision model that can automatically detect sleeping position in pregnancy under real-world conditions. Real-world overnight video recordings were collected from an ongoing, Canada-wide, prospective, four-night, home sleep apnea study and controlled-setting video recordings were used from a previous study. Images were extracted from the videos and body positions were annotated. Five-fold cross validation was used to train, validate, and test a model using state-of-the-art deep convolutional neural networks. The dataset contained 39 pregnant participants, 13 bed partners, 12,930 images, and 47,001 annotations. The model was trained to detect pillows, twelve sleeping positions, and a sitting position in both the pregnant person and their bed partner simultaneously. The model significantly outperformed a previous similar model for the three most commonly occurring natural sleeping positions in pregnant and non-pregnant adults, with an 82-to-89% average probability of correctly detecting them and a 15-to-19% chance of failing to detect them when any one of them is present.

A method for calculating vector forces at human-mattress interface during sleeping positions utilizing image registration

The vector forces at the human-mattress interface are not only crucial for understanding the distribution of vertical and shear forces exerted on the human body during sleep but also serves as a significant input for biomechanical models of sleeping positions, whose accuracy determines the credibility of predicting musculoskeletal system loads. In this study, we introduce a novel method for calculating the interface vector forces. By recording indentations after supine and lateral positions using a vacuum mattress and 3D scanner, we utilize image registration techniques to align body pressure distribution with the mattress deformation scanning images, thereby calculating the vector force values for each unit area (36.25 mm × 36.25 mm). This method was validated through five participants attendance from two perspectives, revealing that (1) the mean summation of the vertical force components is 98.67% ± 7.21% body weight, exhibiting good consistency, and mean ratio of horizontal component force to body weight is 2.18% ± 1.77%. (2) the predicted muscle activity using the vector forces as input to the sleep position model aligns with the measured muscle activity (%MVC), with correlation coefficient over 0.7. The proposed method contributes to the vector force distribution understanding and the analysis of musculoskeletal loads during sleep, providing valuable insights for mattress design and evaluation.

Comparison of sleep position monitoring between NaTu sensor and video-validated polysomnography in patients with obstructive sleep apnea.

This study aimed to evaluate the accuracy of a Bluetooth position monitor called NaTu sensor and its mobile phone application for detecting sleep position among patients with obstructive sleep apnea (OSA) during polysomnography (PSG). A cross-sectional study was conducted on adults with suspected of having OSA who underwent PSG. Sleep positions were recorded simultaneously using a video-validated PSG position sensor and the NaTu sensor. The area under the Receiver Operator Characteristic curve (ROC AUC), sensitivity, and specificity values were calculated to evaluate the validity of the NaTu sensor. Ninety participants (56.7% male) were included, with median age of 40.0years and body mass index of 29.4kg/m2. The mean AHI was 58.4 ± 31.2 events/hour, categorizing the severity of OSA as mild (5.6%), moderate (18.9%), and severe (75.5%). Sleep positions (supine, lateral right, lateral left) identified by the NaTu sensor closely agreed with the video-validated PSG. The kappa statistic demonstrated almost perfect agreement (k = 0.95, P < 0.001) for overall position recording. The ROC AUC for identifying supine, lateral right, and lateral left positions ranged from 0.974 to 0.981, with sensitivity ranging from 95.1% to 99.1% and specificity from 96.5% to 99.6%. Our wearable sensor monitoring significantly agrees with video-validated PSG in identifying sleep positions. This device is reliable and accurate for position monitoring and could be an alternative tool for monitoring positions in in-lab PSG, home sleep apnea testing, or tracking positional treatment at home. Thaiclinicaltrials.org with number TCTR20210701008.