Accepted for/Published in: JMIR mHealth and uHealth
Date Submitted: Aug 2, 2020
Date Accepted: Oct 22, 2020
Date Submitted to PubMed: Oct 23, 2020
Myofunctional Therapy App for Severe Apnea–Hypopnea Sleep Obstructive Syndrome: A Pilot Randomized Controlled Trial
ABSTRACT
Background:
Background:
Myofunctional therapy has demonstrated efficacy in treating sleep-disordered breathing. We assessed the clinical use of a new mobile health (mHealth) app that uses a smartphone to teach patients with severe obstructive sleep apnea–hypopnea syndrome (OSAHS) to perform oropharyngeal exercises.
Objective:
To examine the effects of the app in patients with severe OSAHS.
Methods:
Forty patients with severe OSAHS (apnea–hypoxia index [AHI] >30) were enrolled prospectively and randomized into an intervention group that used the app for 90 sessions or a control group. Anthropometric measures, Epworth Sleepiness Scale (0-24), Pittsburgh Sleep Quality Index (0-21), and Iowa Oral Performance Instrument (IOPI) scores, and oxygen desaturation index were obtained before and after the intervention.
Results:
After the intervention, 28 patients remained. No significant changes were observed in the control group. The intervention group showed significant improvements. AHI decreased 53.4% from 44.7 (range 33.8-55.6) to 20.88 (14.02-27.7) events/h (P<.001). Oxygen desaturation index decreased 46.5% from 36.31 (27.19-43.43) to 19.4 (12.9-25.98) events/h (P=.003). IOPI maximum tongue score increased from 39.83 (35.32-45.20) to 59.06 (54.74-64.00) kPa (P<.001). IOPI maximum lip score increased from 27.89 (24.16-32.47) to 44.11 (39.5-48.80) kPa (P<.001). The AHI correlated significantly with IOPI tongue and lip improvements (Pearson coefficient −0.560, P<.001, and −0.460, P<.001, respectively).
Conclusions:
Orofacial exercises performed using an mHealth app reduce OSAHS severity and symptoms, and represent a promising treatment for OSAHS. Clinical Trial: Spanish Gov AWGAPN-2019-01; ClinicalTrials.gov NCT04438785.
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