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

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 AND 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.