Elevated Posture for the Management of Obstructive Sleep Apnea
Study by M. A. Skinner, R. N. Kingshott, D. R. Jones, S. D. R. Homan and D. R. Taylor
Randomized Crossover Trial · Sleep and Breathing (Vol. 8, Issue 4, pp. 193-200) · DOI: 10.1007/s11325-004-0193-1
Key Takeaway
Sleeping Raised Helped Some People, but CPAP Worked Far Better
What was tested: 14 adults with mild to moderate obstructive sleep apnea, where breathing stops and starts during sleep, tried two treatments in random order. One was a pillow that raises the head and shoulders. The other was CPAP, a machine that blows air through a mask to keep the airway open (Skinner et al., 2004).
What the numbers showed: On the elevation pillow, the average apnea-hypopnea index (breathing pauses and shallow breaths per hour) fell from 27 to 21. On CPAP it was 5. 4 people reached the study's success mark on the pillow, compared with 12 on CPAP.
What this means for you: Sleeping raised helped some people but not most, and the authors could not predict who would benefit. They see it as a second-choice treatment. The study used a special pillow, not an adjustable bed base.
Key Numbers
How the Study Was Done
This was a randomized crossover study, which means each person tried both treatments in a random order. The 14 adults had an apnea-hypopnea index between 10 and 60 events per hour. The researchers compared a shoulder and head elevation pillow with CPAP (Skinner et al., 2004).
Success meant 10 or fewer events per hour. Partial success meant more than 10 but fewer than 16. We read the published abstract. The full paper is behind a paywall, so details such as the pillow's angle and how long each treatment was used are not given here.
What the Study Compared
CPAP Machine
Average of 5 events per hour. 12 of 14 people reached the success mark.
Head and Shoulder Elevation Pillow
Average fell from 27 to 21 events per hour. 4 of 14 reached the success mark and 3 more partly did.
What the Study Found
On the elevation pillow, 4 people met the success mark, 3 had partial success and 7 did not improve enough. On CPAP, 12 met the success mark, 1 had partial success and 1 did not. The difference between the two treatments was significant (p = 0.008) (Skinner et al., 2004).
The authors conclude that sleeping raised helps some people with sleep apnea and can be a second-line treatment. No starting measure, including whether a person's apnea was worse when lying on their back, predicted who would benefit.
An earlier version of this page gave the wrong authors, issue, pages and DOI, and a patient count, tilt angle and results that do not match the published abstract. Those figures and the adjustable base product picks have been removed.
How to Apply This Study When Choosing a Mattress
What it tells you: Sleeping with your head and shoulders raised may cut breathing pauses for some people with mild to moderate sleep apnea, but CPAP worked far better in this study.
If you think you have sleep apnea, talk to a doctor about a sleep test. This study did not test mattresses or adjustable bed bases.
Study Scope and Limitations
14 adults, one type of elevation pillow compared with CPAP, and no way found to predict who would benefit. We read only the abstract, so funding and some methods are not stated here. The study did not test adjustable bed bases or mattresses.
Primary Citation
Skinner, M. A., Kingshott, R. N., Jones, D. R., Homan, S. D. R., & Taylor, D. R. (2004). Elevated posture for the management of obstructive sleep apnea. Sleep and Breathing, 8(4), 193-200. https://doi.org/