New mHealth application software based on myofunctional therapy applied to sleep-disordered breathing in non-compliant subjects

Abstract

Background: Myofunctional therapy (MT) is a therapeutic option with demonstrated efficacy for treating sleepdisordered breathing. We assessed the clinical application of a newly developed m-Health App, which aimed to allow patients with OSAHS (obstructive sleep apnea/hypopnea syndrome) to perform oropharyngeal exercises only by interacting with their smartphone without no other devices. Methods: We offered to treat the OSAHS of 20 patients with the App for 90 sessions. Inclusion criteria were adult patients diagnosed with OSAHS who rejected, or could not tolerate or afford treatment for their OSAHS with other modalities. The App was used by 15 patients, while 5 were noncompliant and then were used as a control group. Polygraphy was performed at the beginning of the study, and after 90 sessions in the App group or after 3 months in the control group. Data for adherence to treatment, sex, body mass index (BMI), age, O 2MIN (oxygen minimal saturation) and apnea-hypopnea index (AHI) were collected for both groups. Results: 15 (75%) patients showed adherence to the treatment as measured as performing the exercises daily 5 days a week. In patients who performed the exercises, AHI decreased from 25.78 ± 12.6 to 14.1 ± 7,7 (p = 0.002), Epworth changed from 18,2 ± 1,98 to 14,2 ± 7,7(p = 0,002) and (O 2MIN) changed from 84,87 ± 7.02 to 89,27 ± 3,77 (p = 0.0189). In the control group, there was no significant change. Conclusions: To our knowledge, this is the first study reported where a mHealth App based on MT could be by itself a therapeutic option in selected patients with OSAHS.

The Role of Myofunctional Therapy in Treating Sleep-Disordered Breathing: A State-of-the-Art Review

“…The search strategy identified 23 studies that met the inclusion criteria [ 5 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 ]. The mean sample size (excluding systematic reviews and meta-analyses) was 38.28.…”

“…The mean age pondered by the sample size and excluding systematic reviews and meta-analyses was 51.19 years. The search strategy retrieved three meta-analyses [ 5 , 10 , 15 ], one systematic review [ 23 ], nine randomized clinical trials [ 8 , 11 , 12 , 13 , 19 , 21 , 24 , 25 , 26 ], seven quasi-experimental studies [ 9 , 16 , 17 , 18 , 20 , 22 , 29 ], one cohort study [ 14 ], one case series [ 27 ], and no case–control studies.…”

Sensorimotor tongue evaluation and rehabilitation in patients with sleep‐disordered breathing: a novel approach

“…This percentage was calculated from results reported in previous studies of this app. 17,19 Based on an alpha level of 0.05 and power of 0.80, we estimated that 60 participants would be required.…”

“…The Airway Gym ® app includes exercises to strengthen the tone of the lingual and pharyngeal muscles, which are mainly responsible for the collapse of the upper airway during sleep. [17][18][19] Furthermore, several works have demonstrated the effectiveness of the Airway Gym ® , improvement the sleep apnoea hypopnea index (AHI). [17][18][19][20] The objective of the study was to evaluate tone, apraxia and stereognosis dysfunctions in patients with SDB compared with healthy controls, and to monitor the effectiveness of Airway Gym ® as an easy-to-use MT modality in terms of the tongue's motor and sensory responses, comparing results before and after therapy.…”

Breathing Re-Education and Phenotypes of Sleep Apnea: A Review

“…Wishney et al state that MT offers a potential way to increase tone in the upper airway muscles and restore nasal breathing, and that it can provide a successful adjunct therapy for OSAHS in adults and children [ 114 ]. The debate surrounding MT remains unresolved due to a lack of quality research.…”