Sleep medicine · London
Positional therapy for OSA - London.
A drug-free, mask-free option for positional-only obstructive sleep apnoea - fitted by a London sleep physician, confirmed with a repeat home sleep study, and reviewed at 3 months.
Why patients choose us
- 01
A named London sleep physician, in an accredited sleep unit
Not an over-the-counter gadget bought blind. A consultant sleep review confirms your OSA is truly positional before a device is fitted.
- 02
The right device for your sleep pattern
Night Shift, NightBalance or a chest strap. We recommend the device that matches how you actually sleep, not the loudest brand.
- 03
Independent, and free
We are paid by no clinic or manufacturer, so the recommendation is impartial and costs you nothing.
Indicative pricing
What private positional therapy costs in London.
Indicative ranges across our partner London sleep units. Send us your sleep-study report and we quote firm figures across two or three device options.
In short
A fitted positional device with London specialist review: £370–£1,130, worn from night one.
| Service or device | Indicative range | Typical duration | Turnaround |
|---|---|---|---|
| Sleep physician consultation and eligibility check | £150–£280 | 30–45 min | Same visit |
| Night Shift Sleep Positioner (neck-worn) + fitting | £220–£320 | 30–45 min | Same visit |
| NightBalance Sleep Position Trainer (Philips) | £450–£850 | 30–45 min | Same visit |
| Sleep Symphony chest strap | £120–£220 | 20–30 min | Same visit |
| Tennis-ball or foam-in-shirt DIY method | Free | n/a | Same night |
| Repeat home sleep study wearing the device | £280–£550 | 1 night | 5–7 days |
Prices vary by London sleep unit, by which device is fitted, and by whether a repeat home sleep study is included in the package. We come back with a firm quote within one working day.
What positional OSA is
Obstructive sleep apnoea that is largely a supine problem.
When gravity closes an airway that stays open on the side, position becomes therapy. Roughly half of mild to moderate OSA is position-dependent.
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AHI typically doubles supine
On a diagnostic sleep study, patients with positional OSA show an AHI at least twice as high sleeping on their back as they do sleeping on their side.
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About half of mild-moderate OSA
Around 50 percent of patients with mild to moderate OSA meet criteria for positional-dependent OSA - it is common, and often under-recognised.
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Restoring lateral sleep can normalise AHI
For true positional OSA, spending the night on the side rather than supine can bring the AHI back into the normal range without a mask.
How positional therapy works
From referral to a confirmed on-device sleep study - what happens, in order.
A gentle vibration alert, or a physical barrier, encourages side-sleeping. One team from first message to the repeat sleep study that proves it works.
Phase 1 · Before fitting
Concierge, off-stage for you
Phase 2 · Fitting and learning
Clinic visit, then two weeks at home
Phase 3 · After
Repeat study and review
- 01
Before
You send us the sleep-study report
A short, confidential form. Your AHI supine versus lateral, ODI, oxygen nadir and any prior CPAP or MAD experience.
- 02
Before
We come back with a recommendation
Within one working day: whether positional therapy fits, or whether CPAP, a mandibular device or Inspire is the better call. Indicative price. An honest read either way.
- 03
Before
We arrange the specialist review
Usually within one to two weeks. A London sleep physician confirms positional OSA, chooses the device and covers fitting and follow-up.
- 04
Fitting
Fitting and calibration
A 30 to 45 minute clinic visit. The device is fitted, the vibration threshold set, and the companion app paired to your phone.
- 05
Fitting
A learning fortnight at home
You wear the device every night for two weeks. It vibrates gently when you roll supine and you learn, in your sleep, to stay on your side.
- 06
After
Repeat sleep study to confirm response
A home sleep test wearing the device. We look for AHI dropping below 5 or 15 and supine time falling toward zero.
- 07
After
Long-term review and adherence
A follow-up at 3 months and yearly after that. App-tracked adherence, partner feedback and any change in weight or symptoms are all discussed.
Typical end-to-end: 1–2 weeks to fitting. Learning window: 4 weeks. Repeat study: 6–8 weeks.
Who benefits
When positional therapy is the right step - and when it is not.
The classic candidates for positional therapy, plus the sleep-study patterns that mean CPAP, a mandibular device or Inspire is the better call.
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Positional-only mild OSA
AHI 5–14 with almost all events supine and a lateral AHI under 5. Positional therapy alone can normalise the study.
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Positional-dominant moderate OSA
AHI 15–29 with a supine AHI at least twice the lateral AHI. Often responds well as a first-line, drug-free option.
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CPAP-refusing or CPAP-intolerant patients
A discreet, drug-free alternative when a mask is not tolerated and the sleep study shows a clear positional pattern.
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Adjunct to CPAP or a mandibular device
Adding positional therapy can lower residual AHI, reduce required CPAP pressure and improve overall comfort.
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Snoring only when on your back
Loud, disruptive snoring supine that vanishes on the side. A common presentation in partners and one that responds quickly.
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Post-bariatric or post-weight-loss OSA
Residual mild OSA after weight loss that becomes purely positional. Positional therapy can be enough to close the gap.
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Travel and shift-work friendly
A pocket-sized device that packs into a wash bag. Useful for frequent flyers and shift workers who cannot travel with CPAP.
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Red flag: severe or non-positional OSA
AHI over 30, significant desaturations or events across all positions need CPAP or Inspire, not a positional device.
Devices available
Positional therapy is a family of devices - not one product.
What each option actually feels like at 3am - and which fits which sleep pattern. For non-positional or severe OSA, we refer to CPAP, MAD or Inspire.
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Night Shift Sleep Positioner
A soft neck-worn device that vibrates gently when you roll onto your back. Companion app tracks position, adherence and snoring by night.
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NightBalance Sleep Position Trainer
A Philips chest-worn device with an escalating vibration cue. The best evidence base of any positional device for moderate OSA.
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Sleep Symphony chest strap
A budget-friendly chest strap that vibrates in the supine position. A reasonable step up from the tennis-ball shirt for the price.
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Tennis-ball or foam-in-shirt shirt
A historical DIY method: a tennis ball or foam wedge sewn into the back of a tight sleep shirt. Uncomfortable enough to stop supine sleep.
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Supine-alarm smartwatch apps
Free or low-cost apps for Garmin, Fitbit and Apple Watch that pulse or buzz when you roll supine. Less accurate than a dedicated device.
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Wedge pillows and body pillows
A full-length body pillow or a 30-degree wedge helps some people hold a lateral position, but does not actively cue you when you roll.
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Combination with CPAP or MAD
A positional device worn alongside CPAP or a mandibular advancement device can lower residual AHI and reduce required pressure.
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Second-opinion sleep review
A specialist review of your sleep study and current therapy - sometimes the answer is a device swap, not another purchase.
Our vetted London network
A small panel of London sleep physicians, we picked them.
Consultant sleep physicians at Royal Brompton Sleep and Ventilation Centre, The London Sleep Centre, HCA The Wellington Sleep and One Welbeck Sleep. Devices are supplied via specialist review, with Amazon and direct purchase available for device-only routes.
Selection criteria
How we choose every sleep physician in our network.
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Consultant sleep physicians, not sleep-tech shops selling one brand
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Sleep units accredited by the British Sleep Society or equivalent
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CPAP, MAD and Inspire pathways available when positional therapy is not the right call
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Repeat home sleep testing on-device, to prove the therapy actually works
Not suitable, and safety notes
What to expect - and when to look elsewhere.
Positional therapy is safe and gentle. It is not the answer for severe OSA, central sleep apnoea, non-positional OSA, or anyone who cannot maintain a lateral posture.
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Nightly wear for the first month
The learning effect needs consistency. Wear the device every night for the first four weeks - patchy use trains nothing.
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Skin marks and mild discomfort
A red mark under the neck or chest strap is common in week one and settles as the fit is tuned. Not a reason to abandon therapy.
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Partner disturbance is minimal
Vibration is silent to your partner and gentle enough that you rarely wake. Most partners notice only that the snoring has stopped.
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Confirm with a repeat sleep study
Do not assume it works. A home sleep test wearing the device shows whether AHI has dropped below 5 or 15 and whether supine time has fallen.
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Not for central sleep apnoea
Central events are not helped by position and can rise on some devices. A proper sleep-study interpretation matters before you buy.
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Restless legs and inability to lie lateral
If restless legs, hip pain or shoulder pain prevent you sleeping on your side, positional therapy will not be tolerated.
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Weight change resets the equation
Significant weight gain can turn positional OSA into non-positional OSA. A repeat study is sensible after any 10 percent change.
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Travel and battery life
Most devices run 2–3 nights per USB charge. Pack the charger, and remember airline security recognises the device as an ordinary consumer wearable.
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Red flags after starting therapy
New morning headaches, worsening daytime sleepiness, choking arousals or ankle swelling - contact the sleep clinic rather than persevering.
Titration and confirmation
Your positional-therapy report in four parts. Read the last one first.
After the four-week learning window, a repeat home sleep test worn with the device shows whether AHI has fallen below 5 or 15, depending on the target agreed with your sleep physician. App-based tracking of body position runs alongside.
A quiet reminder
Sleep-study language is precise and can read coldly - we translate it for you.
If you would like us to talk you through the report before your review, just ask.
- 01 Header
Total AHI, supine AHI and lateral AHI
The three numbers that decide whether positional therapy is worth trying. Look for supine AHI at least twice the lateral.
- 02 Technique
Device, threshold and adherence period
Which device was fitted, what vibration threshold was set, and the four-week nightly wear window agreed with the clinician.
- 03 Findings
On-device sleep study numbers
Repeat study wearing the device: new AHI, new supine time percentage, ODI, oxygen nadir and any residual events.
- 04 Impression
Response category and next step
Read this first: full response (AHI under 5), partial response (AHI under 15), or non-response with a plan to add CPAP or MAD.
Recognised by major UK insurers
Cover for positional therapy varies by insurer - the consultation and repeat sleep study are usually funded, the device sometimes. We confirm cover before booking.
Frequently asked
Everything we get asked about positional therapy.
Quick answers on wear time, insurance, repeat testing, partner disturbance, CPAP combination and travel.
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How many hours a night do I need to wear the device?
Every hour you are asleep, for at least the first four weeks. Adherence under 4 hours per night trains almost nothing, whereas 6 or 7 hours a night for a month typically produces a durable side-sleeping habit and the best AHI response on the repeat study.
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Will my private medical insurance cover positional therapy?
Cover varies. Bupa, AXA and Vitality often fund the sleep physician consultation and the confirmatory sleep study when OSA is medically indicated, but reimbursement for the device itself is patchy - some insurers cover NightBalance, others treat all positional devices as consumer wearables. We confirm cover in writing before you commit.
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Do I really need a repeat sleep study once I start wearing it?
Yes. A device that lowers supine time on the app is not the same as a device that lowers your AHI below the treatment threshold. A home sleep test worn with the device, usually at 6 to 8 weeks, is the only way to prove the therapy is working and to decide whether it is enough on its own.
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Will it disturb my partner?
Almost never. The vibration is silent, contained to the device and gentle enough that most partners never notice it. What they do notice is that the snoring stops as soon as you roll off your back - which for many couples is the reason positional therapy was tried in the first place.
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Can I use positional therapy alongside CPAP?
Yes, and it can be a useful combination. A positional device worn with CPAP often lowers the pressure the machine needs, reduces mask leaks that are worse supine, and can bring residual AHI down further. Discuss the combined settings with your sleep physician rather than adjusting CPAP yourself.
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Can I take the device on a plane?
Yes. Night Shift, NightBalance and chest-strap devices are treated as ordinary consumer wearables by airline security, run for 2 to 3 nights on a single USB charge, and weigh well under 100 grams. Pack the charger in your carry-on and you can maintain therapy through long trips and time-zone changes.
Ready when you are
Send us your sleep study - we come back within a working day.
A named London sleep physician, a device fitted properly, and a repeat sleep study to prove it works. No obligation, no cost to you.
Related
Looking for something else?
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CPAP titration and fitting clinic
Mask-based therapy for moderate-severe or non-positional OSA.
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Mandibular advancement device
A dental-fitted appliance for mild-moderate OSA and snoring.
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Inspire hypoglossal nerve stimulator
An implanted option for selected CPAP-intolerant OSA.
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Sleep study
The diagnostic that separates positional from non-positional OSA.
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Sleep apnoea
The full condition guide, from symptoms to treatment ladder.
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