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.
Myofunctional therapy (MT) is a recent treatment option for obstructive sleep apnea (OSA). The Iowa Oral Performance Instrument (IOPI) is a useful but expensive tool for measuring tongue strength in patients with OSA. We validated the Tongue Digital Spoon (TDS) to monitor tongue hypotonia in patients with OSA. Measurements with the IOPI and TDS were compared in patients with OSA before and after MT for tongue hypotonia. Baseline mean tongue strength measured with the IOPI in patients with moderate and severe OSA were 35.36 ± 9.05 and 33.83 ± 12.05, respectively, and that with the TDS were 168.55 ± 42.8 and 129.61 ± 53.7, respectively. After MT, mean tongue strength significantly improved: measured with the IOPI in patients with moderate and severe OSA were 53.85 ± 10.09 and 55.50 ± 9.64 (p = 0.8), and that with the TDS were 402.36 ± 52.92 and 380.28 ± 100.75 (p = 0.01), respectively. The correlation between the IOPI and TDS was high (r = 0.74; p = 0.01 pre-treatment, and r = 0.25; p = 0.05 post-treatment). The TDS is a useful tool for monitoring the efficacy of MT in patients with short-term OSA. Future randomized studies will determine the effectiveness of MT for the treatment of OSA.
Ankyloglossia (tongue-tie) is a condition of the oral cavity in which an abnormally short lingual frenulum affects the tongue’s mobility. Literature on the correlation between ankyloglossia and obstructive sleep apnea (OSA) is scarce. The main objective of this study was to report our preliminary experience in adult OSA patients before and after ankyloglossia treatment, using drug-induced sleep endoscopy (DISE) to evaluate the upper airway modifications resulting after treatment, and to present a systematic review of the impact of ankyloglossia and its treatment on OSA adults. We found that, after frenotomy, regarding the DISE findings, and according to the VOTE classification, two of the three patients showed an improvement in tongue level, from 2A-P (complete anteroposterior collapse) to 1ap (partial anteroposterior collapse). The third patient showed no changes in his UA after frenotomy, neither worsening nor showing improvement. Thus, the results of this study suggest that frenotomy in OSA patients with ankyloglossia could reduce tongue collapse, probably by allowing the tongue to take into the physiological position in the oral cavity. These patients should undergo speech therapy and oropharyngeal exercises prior to any surgical procedure, in order to avoid glossoptosis and to improve the quality of life and sleep apnea results.
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