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A3985 - Smartphone Application Based Upper Airway Training for Treatment of Snoring: A Randomized Controlled Trial
Author Block: U. Goswami1, A. Black2, B. Krohn2, W. Meyer1, C. Iber3; 1Pulmonary Critical Care Medicine, University of Minnesota, Minneapolis, MN, United States, 2University of Minnesota, Minneapolis, MN, United States, 3Pulmonary and Critical Care Medicine, University of Minnesota, Minneapolis, MN, United States.
Introduction: Snoring is a common presenting complaint in a sleep medicine clinic. While most treatment modalities used for obstructive sleep apnea are also effective in treatment of snoring, they are highly invasive, cumbersome and are associated with poor adherence. Upper airway toning exercises have been proposed as a potential treatment but these are often difficult to administer and monitor. We hypothesized that daily upper airway exercise regimen administered by a smartphone application is effective in treatment of snoring. Methods: With the use of ultrasound imaging of tongue and upper airway structures during targeted articulations, specific phonemes were identified that resulted in movement of muscles involved in maintaining upper airway patency. A smartphone application that uses voice-controlled games was designed to engage and exercise the upper airway muscles aimed at improving their coordination and endurance. Participants with habitual snoring, apnea hypopnea index 0 to 14 events/hour, BMI ≤32 kg/m2 and without significant sleep or medical comorbidities were randomly assigned to perform 15 minutes of daily gameplay (intervention group) or to perform 5 seconds of daily check-in (control group). Participants in both groups completed audio recording of their sleep environment (snoring) for up to 2 nights/week. A questionnaire was administered at the end of study to evaluate self-reported and bed partner reported changes in snoring and sleep quality. Results: A total of 16 patients (8 in each group) completed at least 9 weeks of the study and were included in the analysis. No significant differences were noted in the intervention group vs the control group in gender distribution (5 males, 3 females in each group), BMI mean±SD kg/m2 (27.5±3.8 vs 27.4±3.8), neck circumference mean±SD inches (15.1±1.6 vs 14.7±1.7), Epworth Sleepiness Score mean±SD (8±3.5 vs 7±4.0) and AHI mean±SD events/hr (9.2±4.0 vs 8.2±3.2). All participants in the intervention group reported slightly reduced to greatly reduced snoring volume and frequency. 50% participants reported improved sleep continuity while 62% reported decreased sleepiness during the day. 3 out of 8 participants also reported significant improvement in throat dryness upon awakening. All participants in the control group reported no change to their snoring or sleep quality measures at the end of the study. Conclusions: Smartphone application administered upper airway training results in significant improvement in self-reported snoring, sleep continuity and daytime sleepiness.