Positional Therapy: Sleep Apnea & the Tennis Ball Technique

A new study from Australia examined long-term compliance with the tennis ball technique in people with obstructive sleep apnea. The results were published in the Journal of Clinical Sleep Medicine.

What is the tennis ball technique? It is a simple method of positional therapy that helps you avoid sleeping on your back. It was first introduced in the early 1980s.

A tennis ball is fastened to the back with a belt or strap. This makes sleeping on your back uncomfortable.

Soft tissue in the throat is less likely to collapse and block the airway when you sleep on your side. As a result positional therapy may help reduce the breathing pauses that occur when you have OSA.

The study involved 67 people with OSA, mostly men. They were overweight and had an average age of 60 years.

They had an overall apnea-hypopnea index of 29.6 breathing pauses per hour of sleep; an AHI of 15 to 30 is considered “moderate” sleep apnea. Their average AHI soared to 53 when sleeping on their back; it dropped to 14.1 when side sleeping.

They were instructed to use the tennis ball technique. Then they were followed up after an average of 2.5 years.

Results show that only four people reported that they were still using the technique. Nine people claimed that they had learned to avoid sleeping on their back.

The primary complaint was that the technique was too uncomfortable. Another common complaint was that the tennis ball moved around. Some people said the technique was ineffective. Others reported that it caused backache.

A similar study in 2006 followed up 50 people after six months. Nineteen people were still using the technique; 12 said that they had learned to avoid back sleeping.

Other variations of the technique have been used. These include a backpack with a foam ball inside, a vest that contains a piece of hard foam, a thoracic anti-supine band, a triangular pillow, and a posture alarm.

The AASM reports that positional therapy can be an effective treatment option. But some people with OSA will continue to have breathing pauses while side sleeping. Talk to your sleep specialist to see if positional therapy is a good option for you.

Get help for sleep apnea at an AASM-accredited sleep center near you.

Image by Tiffany