Otorhinolaryngology Department, Hospital Quironsalud Marbella, Marbella, Spain.
Otorhinolaryngology Department, Hospital Quironsalud Campo de Gibraltar, Palmones (Cadiz), Spain.
JMIR Mhealth Uhealth. 2020 Nov 9;8(11):e23123. doi: 10.2196/23123.
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.
We conducted a pilot randomized trial to evaluate the effects of the app in patients with severe OSAHS.
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), Iowa Oral Performance Instrument (IOPI) scores, and oxygen desaturation index were measured before and after the intervention.
After the intervention, 28 patients remained. No significant changes were observed in the control group; however, the intervention group showed significant improvements in most metrics. AHI decreased by 53.4% from 44.7 (range 33.8-55.6) to 20.88 (14.02-27.7) events/hour (P<.001). The oxygen desaturation index decreased by 46.5% from 36.31 (27.19-43.43) to 19.4 (12.9-25.98) events/hour (P=.003). The IOPI maximum tongue score increased from 39.83 (35.32-45.2) to 59.06 (54.74-64.00) kPa (P<.001), and the 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 correlation coefficient -0.56 and -0.46, respectively; both P<.001). The Epworth Sleepiness Scale score decreased from 10.33 (8.71-12.24) to 5.37 (3.45-7.28) in the app group (P<.001), but the Pittsburgh Sleep Quality Index did not change significantly.
Orofacial exercises performed using an mHealth app reduced OSAHS severity and symptoms, and represent a promising treatment for OSAHS.
Spanish Registry of Clinical Studies AWGAPN-2019-01, ClinicalTrials.gov NCT04438785; https://clinicaltrials.gov/ct2/show/NCT04438785.
肌功能疗法已被证明在治疗睡眠呼吸障碍方面有效。我们评估了一种新的移动健康（mHealth）应用程序的临床应用，该应用程序使用智能手机来教授患有严重阻塞性睡眠呼吸暂停低通气综合征（OSAHS）的患者进行口咽运动。
我们进行了一项初步的随机试验，以评估该应用程序在严重 OSAHS 患者中的效果。
前瞻性纳入 40 名严重 OSAHS（呼吸暂停低通气指数[AHI]>30）患者，并随机分为干预组（使用应用程序进行 90 次治疗）和对照组。在干预前后测量了人体测量指标、嗜睡量表（0-24）、匹兹堡睡眠质量指数（0-21）、爱荷华口腔表现仪器（IOPI）评分和氧减指数。
干预后，28 名患者仍在继续治疗。对照组无明显变化；然而，干预组在大多数指标上均显示出显著改善。AHI 从 44.7（范围 33.8-55.6）降至 20.88（14.02-27.7）事件/小时（P<.001），降低了 53.4%。氧减指数从 36.31（27.19-43.43）降至 19.4（12.9-25.98）事件/小时（P=.003），降低了 46.5%。IOPI 最大舌压评分从 39.83（35.32-45.2）增加到 59.06（54.74-64.00）kPa（P<.001），IOPI 最大唇压评分从 27.89（24.16-32.47）增加到 44.11（39.5-48.8）kPa（P<.001）。AHI 与 IOPI 舌部和唇部改善显著相关（Pearson 相关系数分别为-0.56 和-0.46，均 P<.001）。应用程序组的嗜睡量表评分从 10.33（8.71-12.24）降至 5.37（3.45-7.28）（P<.001），但匹兹堡睡眠质量指数无明显变化。
使用移动健康应用程序进行的口面部运动降低了 OSAHS 的严重程度和症状，是治疗 OSAHS 的一种有前途的方法。
西班牙临床研究 AWGAPN-2019-01，ClinicalTrials.gov NCT04438785；https://clinicaltrials.gov/ct2/show/NCT04438785。
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