NightShift Device

The Night Shift device is worn around the neck or chest during sleep, and it monitors which position the patient is sleeping in. If the patient rolls into the supine position, the device will deliver a subtle vibration, slowly increasing in intensity until the patient changes position. Through continual use patients gradually become trained to avoid sleeping in the supine position.

The device measures the 3-dimensional position of the neck and makes a position call based on the angles and any ongoing movement. Once the device recognizes that the patient is in the supine position, it will continue to register supine even if there is a small change in position, erring on the side of registering supine rather than less during the period of transition. This approach helps reduce unnecessary position changes during brief or subtle adjustments. 

To better understand how and when the device triggers vibrations, we recommend performing a vibration test by follow the steps below: 

1. Ensure the device is powered off.
2. Press and hold the power button for approximately 7 seconds, or until the device vibrates.
3. Position the device to simulate a supine (on your back) posture:
   1. If using the neck strap, hold the device with the blue label facing down.
   2. If using the chest best, hold the device with the blue label facing up.
4. Place two fingers on the blue label to feel for vibrations.
5. After about 30 seconds, the device should begin vibrating.
6. Move the device in and out of the supine position to observe when vibrations start and stop based on orientation.
7. Power off the device once the test is complete. 

There is a small microphone embedded in the device.

NightShift is clinically proven to treat Positional Obstructive Sleep Apnoea and positional snoring.

NightShift can also be used as a combination therapy for patients who struggle with compliance or efficacy on their primary therapy due to increased severity of their apnoea in the supine position. IE: the patient requires a CPAP pressure of 15cm when they are in the supine position and are unable to tolerate this pressure. In non-supine positions the patient requires a lower pressure that they can tolerate. Use Night shift in conjunction with CPAP in this instance to keep the patient in the non-supine position where pressure requirements are lower.

It uses a built-in tri-axes accelerometer.

No,  a prescription is not required.

Night Shift users should not:

• Have cardiac arrhythmia with an artificial pacemaker
• Have skin sensitivity or an open wound around their neck
• Have a neck size that is very small (less than 12in/30cm) or a very large (greater than 22in/55cm)
• Sleep with their head in a near upright position
• Or suffer from tics or tremors of the head.

The Night Shift devices generates localised magnetic fields (less than 0.02mT) that must be kept at least 6in/15cm from an implanted medical device of the user or bed partner.

The neck strap can be adjusted to accommodate a maximum of a 22 inch (56 cm) neck. The Night Shift Chest Belt can also be used as an alternative to the Neck Strap and can accommodate chest sizes up to 59 inches.

The device can store up to 8 nights (7 most recent + base line, if it exists) of detailed daily reports, up to 90-nights of compliance data, and 365 nights of data used for the monthly and yearly reports.

Yes, NightShift can be used for multiple patients in properly sterilized between patients.

Yes, Night Shift is TGA registered.

The NightShift straps should be replaced when they start to show signs of wear (between 6-12 months) or are no longer securing the device in place.

The NightShift device should be replaced approximately every 2 years.

Strap: Detach the straps from the device. Wash each strap separately by submerging in solution of 1 teaspoon (5 ml) of mild dish detergent (ie: Dawn) per gallon (4 liters) of water. Agitate slightly for one to two minutes. Rinse with clear warm tap water for one minute. Dry with a clean paper towel.

Device: Wipe all surface areas of the device enclosure with a 70% isopropyl alcohol wipe. All surface areas should remain wet for at least 15 seconds. Using a new alcohol wipe, repeat the cleaning; allow to remain wet for 15-seconds. If any visible soil remains, repeat as needed. Allow to air-dry.

When the device is turned on, it will vibrate 1-3 times and blink green 1-3 times, depending upon how many nights the device has battery charge sufficient to record. The device will then continue to blink green for 5 minutes. After 5 minutes, the LED will display a solid green light which means the device is recording as expected.

The Battery is flat. Please charge for 6 hours from a wall charger or until the solid green LED
switches off. (A solid green LED means that the device battery is charging, when it switches off the battery is fully charged). If you don’t believe the Night shift is charging please try another cord and charging from a wall outlet.

To conserve the battery and increase the accuracy of your report, the Night Shift automatically turns off after 10 hours. If you need to change the setting to 12 hours instead of 10 hours, follow these steps:

1. Open the Night Shift Portal Software (or follow the directions above to download, install and open the software)
2. Plug in your Night Shift device
3. Click Manage Device
4. Click F12 on your keyboard and the Max Recording Time option will appear
   
5. Click 12 hours and click Save

You can access the free Online Clinicians Portal for report downloads here  – * PC or MAC compatible – Requires Java

Download the guide: Interpreting Monthly and Daily Reports.

Sleep/wake is derived entirely by actigraphy

When we detect supine position AND feedback is off we mark as gray.  The device is defaulted to delay delivery of feedback until 15-minutes after the device has been turned on (this allows the person to fall asleep on their back.  This 15-min period is also classified as ‘wake’ independent of the actigraphy.

When the device is worn in Trial Mode, on Night 1 of the trial, position feedback is not delivered.  The idea behind the ‘trial’ mode is to obtain a baseline night to see how often the patient sleeps on their back.  When Feedback is on, Supine = Red.  When feedback is off, Supine = Grey.

We can save six nights of detailed (30-sec epoch) data.  When the device is in ‘trial’ mode, it saves the first “Feedback Off” night permanently and then saves the 5 most recent detailed “Feedback On” reports.

We count the number of times in each 30 sec epoch that a snore passes the 40, 50 and 60 dB threshold.  We plot one line of snoring for each 30-sec period.  Darker (lighter) lines indicate greater (fewer) numbers of snores within the 30-sec period at the plotted snore loudness.

This is number of feedbacks delivered.  A feedback interval is 2-seconds.  Feedback is delivered at the same level of intensity for 3 consecutive times (6 seconds), then increases in intensity for each following level.

There are a total of seven levels of feedback intensity. The maximum helps to identify when a user is non-responsive to the feedback.  We have seen isolated instances when the user is non-responsive for up to 1/2 hour.  It usually occurs at the end of the night, possibly when the user is in REM sleep.

• Location services must also be enabled on the mobile device and for the Night Shift app
• The Bluetooth must be active on both the mobile device and the Night Shift device. The Bluetooth in the Night Shift LE device is active in the following circumstances:
  • Night Shift LE device is plugged into a power source 
  • During the first 15 minutes after the Night Shift LE device is turned OFF.