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The Effect of Orofacial Myofunctional Therapy With Autofeedback on Obstructive Sleep Apnea

Not Applicable
Completed
Conditions
Sleep Apnea, Obstructive
Interventions
Behavioral: Orofacial myofunctional therapy with autofeedback
Registration Number
NCT06079073
Lead Sponsor
University Hospital, Akershus
Brief Summary

The overall aim of this study is to estimate the effect of orofacial myofunctional therapy (OMT) plus auto-monitoring compared to auto-monitoring alone. Moreover, the investigators aim to identify anatomical and behavioural predictors of OMT adherence

Detailed Description

The overall aim will be addressed by reqruiting 100 participants to orofacial myofunctional therapy. 50 will be randomized to immediate treatment after the baseline consultation while 50 will get access to the treatment module after 3 monts of waiting. Outcomes will be assessed by a researcher blinded for the randomization result.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
106
Inclusion Criteria
  • Patients referred to Ahus or the Fertilitas clinic

    • A diagnosis of obstructive sleep apnea according to the current International Classsification of Sleep Disorders (ICSD) version 3 criteria {Berry, 2020, The AASM Manual for the Scoring of Sleep and Associated Events: Rules', Terminology and Technical Specifications', Version 2.6.;, 2014, International classification of sleep disorders', 3rd ed.}, with a respiratory event index (REI) <30.
    • Not previously or currently treated with PAP or MAD
    • Signed informed, written consent.
    • Owning a mobile phone with software compatible for the study application Age ≥18 year.
    • Body mass index <30
    • Ability to breathe through the nose
    • Ability to read and willingness to follow the protocol as described in the written consent form
    • Teeth 5-to 5 should be present or fixed by prosthesis or implants.
    • No botulinium toxin in facial muscles last three months
Exclusion Criteria
  • Failure to fill in at least 70% of days in the electronic sleep diary provided in the mobile app for two weeks.

    • Medical or psychiatric conditions which may interfere with the study protocol in the opinion of the investigator. Examples are acute psychosis, drug abuse and dementia. This will be noted in the study inclusion-exclusion document for each approached candidate for the study. The information will then be discussed in an exlusion committee consisting of dr. Skirbekk, Jagomägi, Dammen and Hrubos-Strøm.
    • Tongue-tie as described below. Participants with mouth opening of <50% with the tip of the tongue at the incisive papilla compared to total mouth opening will be excluded.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Application plus treatment moduleOrofacial myofunctional therapy with autofeedbackThe following exercises are pre-recorded and presented in the treatment module: Tongue 1. Tongue brushing 2. Tongue sliding 3. Tongue suction 4. Tongue down Soft palate 1. Elevate soft palate and uvula 2. Balloon blow Facial 1. Put your finger in the oral cavity against your cheek. Pull against your finger with the cheek muscles. 2. Air pump Exercise adherence is registered in a study application
Primary Outcome Measures
NameTimeMethod
Apnea hypopnea index reduction3 months

Measured by self-applied somnography. The index represents number of apneas or hypopneas per hour from 0/h. Higher values represents more severe disease.

Secondary Outcome Measures
NameTimeMethod
Change in desaturation severity parameter measured by medical device3 months

Measured by photoplethysmography obtained by self-applied somnography. More severity represents more disease.

Change in desaturation duration measured by medical device3 months

Measured by photoplethysmography obtained by self-applied somnography. Longer duration represents more disease.

Change in the Epworth Sleepines scale3 months

The scale is a validated tool measuring sleepiness between 0-24. Higher values represent more sleepiness

Orofacial myofunctional therapy adherence3 months

Measured by application registration between 1-3 per day. Three exercises per day is the maximum score

Change in objective sleep quality3 months

Measured by self-applied somnography. Sleep quality is the ratio between total sleep time and time in bed. A higher ratio is better.

Change in desaturation duration measured by wearable3 months

Measured by photoplethytsmography obtained by Withings Scan Watch. Longer duration represents more disease.

Change in stroop test3 months

Measured by Flexibility game in application. More correct answers is better

Changes in tongue strength3 months

Objective strength measured by the Iowa Oral Pressure Inventory. A higher score represents more strenght.

Change in reaction test3 months

Measured by reaction game in application. Shorter reaction time is better

Changes in tongue endurance3 months

Objective endurance measured by the Iowa Oral Pressure Inventory. A higher score represents more endurance.

Change in memory test3 months

Measured by memory game in application. Longer sequences memorized is better

Change general health status3 months

Measured by a visual analogue scale in the BEAMER questionnaire, two visio analogue scales on general health and 3 items on acceptance and control scored 1-6 respectively.

Changes in the Orofacial Myofunctional Evaluation with Scores3 months

Measured by scorer blinded for randomization. Range 37-103. A lower score represents more dysfunction.

Change in desaturation severity parameter measured by wearable3 months

Measured by photoplethytsmography obtained by Withings Scan Watch. More severity represents more disease.

Change in perception test3 months

Measured by perception game in application. More correct answers is better.

Trial Locations

Locations (2)

Fertilitas clinic

🇪🇪

Tallinn, Estonia

Akershus University Hospital

🇳🇴

Lørenskog, Akershus, Norway

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