Improving Adherence to Myofunctional Therapy in the Treatment of Sleep-Disordered Breathing

• Published in: Journal of clinical medicine Vol. 10; no. 24; p. 5772
• Main Authors: O'Connor-Reina, Carlos, Ignacio Garcia, Jose María, Rodriguez Alcala, Laura, Rodríguez Ruiz, Elisa, Garcia Iriarte, María Teresa, Casado Morente, Juan Carlos, Baptista, Peter, Plaza, Guillermo
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 09.12.2021; MDPI
• Subjects: adherence; apnea hypopnea index; Body mass index; Clinical medicine; Continuous positive airway pressure; Feedback; Iowa oral performance instrument; myofunctional therapy; obstructive sleep apnoea; Patients; Physical fitness; Sleep disorders; Smartphones; Telemedicine; Tongue; obstructive sleep apnoea; adherence; myofunctional therapy; apnea hypopnea index; Iowa oral performance instrument
• ISSN: 2077-0383; 2077-0383
• DOI: 10.3390/jcm10245772

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 ( < 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 O saturation (80.91% ± 6.1% to 85.09% ± 5.3%). IOPI scores correlated significantly with AHI after the therapy (Pearson = 0.4; = 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.