Abstract
Myofunctional therapy (MT) is used to treat sleep-disordered breathing. However, MT has low adherence—only ~10% in most studies. We describe our experiences with MT delivered through a mobile health app named Airway Gym®, which is used by patients who have rejected continuous positive airway pressure and other therapies. We compared ear, nose, and throat examination findings, Friedman stage, tongue-tie presence, tongue strength measured using the Iowa oral performance instrument (IOPI), and full polysomnography before and after the 3 months of therapy. Participants were taught how to perform the exercises using the app at the start. Telemedicine allowed physicians to record adherence to and accuracy of the exercise performance. Fifty-four patients were enrolled; 35 (64.8%) were adherent and performed exercises for 15 min/day on five days/week. We found significant changes (p < 0.05) in the apnoea–hypopnoea index (AHI; 32.97 ± 1.8 to 21.9 ± 14.5 events/h); IOPI score (44.4 ± 11.08 to 49.66 ± 10.2); and minimum O2 saturation (80.91% ± 6.1% to 85.09% ± 5.3%). IOPI scores correlated significantly with AHI after the therapy (Pearson r = 0.4; p = 0.01). The 19 patients who did not adhere to the protocol showed no changes. MT based on telemedicine had good adherence, and its effect on AHI correlated with IOPI and improvement in tongue-tie.
Highlights
IntroductionObstructive sleep apnoea–hypopnoea syndrome (OSAHS) is a chronic sleep-related condition, or sleep-disordered breathing (SDB), that is becoming increasingly widespread; it represents a significant health cost [1,2]
The Iowa oral performance instrument (IOPI) score changed significantly: Tongue pressure increased from 44.4 ± 11.08 to 50.66 ± 10.2 kPa (t = −3.8, p < 0.05)
Myofunctional therapy (MT) based on telemedicine delivered using the Airway Gym® ®app
Summary
Obstructive sleep apnoea–hypopnoea syndrome (OSAHS) is a chronic sleep-related condition, or sleep-disordered breathing (SDB), that is becoming increasingly widespread; it represents a significant health cost [1,2]. Recent reports show that people with OSAHS frequently present with impaired sensorimotor deficits in the upper airway muscles [4]. These deficits are associated with apraxia, hypotonia, and changes in muscle fibres, which lead to early fatigue of the upper airway muscles [4]. These deficits can lead to impaired proprioceptive acuity in the upper airway muscles.
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