David Repasky - CPAP Advocate & Specialist
Written and edited by David Repasky. David is a CPAP Patient Advocate and Equipment Specialist who brings a unique and vital perspective to the field of sleep apnea treatment. Since his own sleep apnea diagnosis in 2017, David has been on a personal journey that has transformed into a mission to help others navigate the challenges of CPAP therapy. His firsthand experience as a CPAP user, combined with his extensive knowledge of equipment and therapy practices, allows David to offer invaluable insights and support to those embarking on their own sleep apnea treatment paths.
Our content undergoes rigorous expert review, evidence-based research, and regular updates for accuracy.
Does your mild sleep apnea make it hard to get a good night's sleep? When it comes to treating sleep apnea, is CPAP therapy painful or uncomfortable; and are you looking for other options? If you answered "yes" to both of these questions, you might be a candidate for positional therapy using the Nightbalance Lunoa Positional Therapy Device.
It's important to recognize that choosing the Nightbalance over CPAP therapy needs to be a careful decision made between you and your doctor based on your sleep study, and remember it isn't for everyone.
In this article, we'll answer the following questions:
- What is Positional Obstructive Sleep Apnea?
- How Can Positional Therapy Resolve Mild Sleep Apnea?
- What is the Nightbalance Lunoa?
- Is the Nightbalance Lunoa a Good Alternative to CPAP?
What is Positional Obstructive Sleep Apnea?
Positional Obstructive Sleep Apnea is a mild form of sleep apnea that only occurs when you sleep in certain positions. Sleeping on your side is the ideal position because gravity works to your benefit, naturally pulling your airway open, and allowing oxygen to reach the lungs easily. Likewise, sleeping on your back is the worst position to sleep in, because gravity works against you in this position. On your back, the tongue falls backward, blocking your airway and causing your apnea to get worse.
Positional Obstructive Sleep Apnea is mild enough that in certain sleeping positions, you may not have apnea at all. With positional therapy, you can have relief to most of your symptoms.
What is Positional Therapy?
If sleeping on your side is truly the best sleeping position for preventing Obstructive Sleep Apnea, the goal of positional therapy is to keep the body in that position for the whole night. Traditionally, some people have been able to do this by using a side sleeper pillow, or a special belt that makes it uncomfortable to sleep on the back.
At home, I've personally made it a habit of sleeping with a side-sleeper pillow a part of my nightly routine. As a body pillow that goes along my back and in-between my legs, the side-sleeper pillow makes it more comfortable to sleep on my side and stay there the whole night.
I find it to be extremely helpful, and it's something that can help in a pinch as you first start the process of changing your sleep position.
How Can Positional Therapy Relieve Symptoms of Obstructive Sleep Apnea?
Positional therapy can be very effective at reducing symptoms of sleep apnea, explaining why many people are flocking towards positional therapy as a maskless way to treat sleep apnea. As a sleep apnea sufferer myself, I find that if I'm on my back, my AHI can be as high as 20, even with my CPAP. If I'm on my side, my AHI can be as low as 1.
I know my sleep apnea is too severe for positional therapy to be a standalone solution for me, but for someone with generally lower AHIs, that person may be able to rely solely on positional therapy to mitigate their symptoms.
What is the Nightbalance Lunoa?
Recently, Philips Respironics launched a prescription-only advanced positional therapy device, called the Nightbalance Lunoa. The Nightbalance is a first-generation device programmed to create a slight vibration should you roll over onto your back.
The vibration becomes a cue for you to go back to your side, and in the process, this will improve your nocturnal breathing. It uses no mask, wires, tubes, or pressurized air to do this, and there's nothing to wear on the head or face, only a small belt that goes around the chest.
The Nightbalance makes no noise, and won't disturb your partner. Even if your partner is the lightest sleeper, he or she won't be disturbed by the vibrations from the Nightbalance.
The Nightbalance uses automated technology to spend the first few days studying how you sleep. After two days of study, you'll get eight days of a gradual build-up to acclimate yourself to the device before therapy begins in full. Data and compliance results are sent to your care team, or regulatory agencies, every morning, when you place the device in the charging dock.
The Nightbalance is a prescription-only device, so your doctor will need to be on board before you try it, but it comes with a 30-day money-back guarantee. If you don't like it, you can return it for a full refund.
My Night With the Nightbalance Lunoa
CPAP.com was recently given a Nightbalance to test, and I was the first one at our company to give it a try. Overall, the device is simple and easy to use. Simply turn it on, slide it into the pouch, and zip it up.
The belt the device sits in is meant to go around the chest. It's a little small for that purpose, as it may only fit people with an average-sized chest. Luckily, the Nightbalance comes with an extension that made it possible to accommodate someone with a broader chest like I have. After securing the chest strap in place, I would typically begin to get ready for bed.
Nightbalance: Getting Ready for Bed
A few times I was surprised by the buzzing from the Nightbalance as I began to get comfortable. I then realized that despite the Nightbalance's advanced programming, the device has no way of telling if I'm asleep or awake.
This means that if you wear it before bed, you should stay in a position it likes or be prepared for the device to begin its escalating series of vibrations. Vibrations will start softly and then gradually get more and more intense until you reposition yourself on your side.
The best bet is to put it on after you're done watching TV or reading for the night, and you're ready to fall asleep. This will keep you from having to deal with vibrations from the Nightbalance as you go through your usual bedtime routine.
Nightbalance: How it Behaves During Sleep
For the most part, the Nightbalance did a good job of keeping me on my side. I would recommend anyone who purchases the Nightbalance also gets the Contour Legacy Leg Pillow. A pillow designed to sit between your legs, aligning the spine correctly and making it more comfortable to sleep on your side. It may also help to get the MedCline Reflux Relief System, an incline pillow, designed to comfortably elevate your position and keep you on your side.
The device is designed to prompt you gently during sleep to stay on your side, without waking you up. For the most part, it does that flawlessly. Aside from my tendency to lay on my back every night at 4 AM, I barely felt the device, and the vibrations were rarely severe enough that I would wake up.
The Nightbalance also did not disturb my partner either, and she's a very light sleeper. Overall, it's a revolutionary device able to treat sleep apnea in a very unique and unconventional way, one that works out well. It comes with a 30-day risk-free trial, so you won't need to worry about being stuck with the Nightbalance if you don't like it.
Is the Nightbalance a Good Alternative to CPAP?
The Nightbalance isn't for everyone. Some people have sleep apnea that's too severe to be treated by positional therapy. Positional therapy usually works for people that have mild sleep apnea. Moderate to severe cases will be unable to be treated by positional therapy alone and will require CPAP therapy.
When it comes to positional therapy, I'm a believer. I've seen first-hand how sleeping on my side can dramatically improve my AHI readings, making my sleep more productive. It really does work, but it's going to take time to train your body to sleep in a different position, and you may not get it right your first couple of tries. That's exactly why the Nightbalance was created. The Nightbalance helps train you to get into the habit of sleeping in a way that's healthier and less stressful so that you can get the restful, productive sleep you're looking for.
