Myofunctional Therapy App for Severe Apnea-Hypopnea Sleep Obstructive Syndrome: A Pilot Randomized Controlled Trial
Carlos O'Connor-Reina 1 , Jose Maria Ignacio-Garcia 2 , Elisa Rodriguez-Ruiz 3 , Maria Del Carmen Morillo Dominguez 3 , Victoria Ignacio Barrios 4 , Peter Baptista Jardin 5 , Juan Carlos Casado Morente 6 , Maria Teresa Garcia Iriarte 7 , Guillermo Plaza 8
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: We conducted a pilot randomized trial to evaluate 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 (35.32-45.2) 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 (39.5-48.8) kPa (P<.001). The AHI correlated significantly with IOPI tongue and lip improvements (Pearson coefficient -0.56, P<.001, and -0.46, P<.001, respectively). The Epworth Sleepiness Scale score decreased from 10.33 (8.71-12.24) to 5.37 (3.45-7.28) (P<.001) in the app group, but the Pittsburgh Sleep Quality Index did not change significantly.
Conclusions: Orofacial exercises performed using an mHealth app reduce OSAHS severity and symptoms, and represent a promising treatment for OSAHS.
CITA DEL ARTÍCULO JMIR Mhealth Uhealth. 2020 Oct 22.doi: 10.2196/23123