![]() Patients with predominant obstructive sleep apneas and AHI ≥ 5 events/h were diagnosed with the OSAS. Apneas were classified as obstructive, central, or mixed according to the presence or absence of respiratory efforts. The inclusion criteria were as follows: patients referred for potential sleep disordered breathing following a polysomnography study, an apnea-hypopnea index (AHI) of ≥5 events/h with LP, age between 20 and 80 years, BMI 50% reduction in airflow, (2) 3%, or (3) a moderate reduction in airflow with associated arousal by electroencephalography. Participants were recruited from the province of Thessaly region (Greece). This was a single-center, randomized prospective study. The aim of our study was to investigate the effect of different pillows on PSG parameters in patients with OSAS. ![]() Toward this end, the effect of pillow usage should be evaluated in order to determine how it shapes polysomnography (PSG)-captured parameters and its implication in sleep disordered breathing phenotypes. In this context, two major research questions regarding the implementation of specific pillows as a possible OSAS treatment arise: who will benefit and how? As a heterogeneous disease, OSAS' treatment goals extend from severity to phenomenology ( 4, 14). Considering that pillow design can be guided ( 12, 13) to alleviate specific symptoms, an evaluation of pillow type impact on sleep health may be directly relevant to their efficacious implementation. ![]() Previous research has suggested that the use of custom fitted pillows may represent an efficacious and cost-effective treatment option in mild to moderate OSAS ( 10), filling a niche where continuous positive airway pressure (CPAP) would not be indicated ( 11). Previous studies on pillow usage are limited in number and focus on the role of cervical positional therapy, collectively reporting an improvement on snoring ( 6– 9). Considering Obstructive Sleep Apnea Syndrome's (OSAS's) heterogeneity ( 4) and the implication of other overlapping symptoms, such as snoring ( 5), it is necessary to assess the biological context of potential interventions. Conversely, incorrect pillow placement, such as that occurs during travel, may be detrimental to sleep health ( 3). In patients with mild sleep-disordered breathing, optimal pillow usage may reduce snoring and improves sleep quality efficiency and, by extent, depth ( 2). Pillows affect sleep quality by maintaining the natural curvature of the spine, thus ensuring optimal sleep posture ( 1). Secondly, they indicate that a focus on the treatment of the snoring OSAS subtype warrants further dedicated investigation. These findings indicate that pillow type and usage, often uncontrolled in OSAS studies (contribution to the field), may impact several PSG parameters and are related to a snoring subtype of the syndrome. In Group B (with MFP), a statistically significant decrease of 47.0 ± 15.9% was observed in snoring events ( p 0.05) compared to LP. Statistically significant differences between pillow types were detected in desaturation index and heart rate. Thirty-two consecutive patients with OSAS were randomly allocated into two groups with randomized pillow usage. The aim of this study was to investigate the effect of different pillows on polysomnography (PSG)-derived parameters in patients with Obstructive Sleep Apnea Syndrome (OSAS). Specific pillow use is a seldom studied or controlled factor in the setting of sleep disordered breathing. 5Department of Respiratory Medicine, Faculty of Medicine, University of Thessaly, Larissa, Greece.4Department of Neurology, Faculty of Medicine, University of Cyprus, Lefkosia, Cyprus.3Institute of Sport, Faculty of Education Health and Wellbeing, University of Wolverhampton, Walsall, United Kingdom.2School of Physical Education and Sports Sciences, University of Thessaly, Trikala, Greece.1Laboratory of Cardio-Pulmonary Testing and Pulmonary Rehabilitation, Department of Respiratory Medicine, Faculty of Medicine, University of Thessaly, Larissa, Greece.Stavrou 1, Fotini Bardaka 5, Chaido Pastaka 5 and Konstantinos I. ![]() Vavougios 1,4,5, Eirini Papayianni 1, Ilias T. Stavrou 1 *, Yiannis Koutedakis 2,3, Kyriaki Astara 1, George D.
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