Effects of Soft Cervical Collar on Apnea-Hypopnea Index in Patients With Obstructive Sleep Apnea

Abstract

Background: Obstructive sleep apnea (OSA) is a sleep disorder characterized by recurrent upper airway obstruction, leading to intermittent hypoxia and sleep fragmentation. Continuous positive airway pressure (CPAP) is the criterion standard treatment, but adherence remains a significant challenge. This study aimed to evaluate whether a soft cervical collar could reduce the apnea-hypopnea index (AHI) and improve oxygen saturation by preventing excessive neck flexion and airway collapse, potentially serving as an alternative or adjunctive therapy for OSA. Material/Methods: Ethical approval was obtained, and 34 OSA-diagnosed participants underwent polysomnography (PSG) and CPAP titration. Exclusion criteria ensured a focused cohort. Demographic data, including age, sex, and BMI, were collected. The first night, a 16-channel Embla device was used for PSG, and the apnea-hypopnea index (AHI) was calculated. The second night, patients were monitored with a neck brace for 2 hours, followed by standard PAP titration for the rest of the night during the PSG recording. Results: The mean AHI decreased from 44.44 +/- 26.3 to 36.69 +/- 37.48 with the cervical collar, although this difference was not statistically significant (p=0.08). However, in patients with BMI <30 kg/m2, AHI significantly decreased (p=0.02). The lowest oxygen saturation improved from 76.35 +/- 10.26 to 83.74 +/- 5.02 (p=0.01), indicating better oxygenation with the cervical collar. Conclusions: Although CPAP is the criterion standard for OSA treatment, this study suggests that a neck collar could be an alternative treatment, especially for patients with a BMI below 30. The findings support further exploration of neck collars as a potential intervention in cases where CPAP accessibility or adherence is challenging.