{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,15]],"date-time":"2025-12-15T18:25:47Z","timestamp":1765823147738,"version":"3.48.0"},"reference-count":26,"publisher":"BMJ","issue":"12","license":[{"start":{"date-parts":[[2021,12,1]],"date-time":"2021-12-01T00:00:00Z","timestamp":1638316800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2021,10,12]]},"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>The main treatment for sleep apnoeas and hypopnoeas syndrome (SAHS) is continuous positive airway pressure (CPAP). However, patients sometimes do not adhere to the treatment protocol. Supplementary and complementary therapies have appeared as alternatives. Some of the therapies which are especially important are those related to myofunctional (MFT) and postural therapy (PT), as all of them are non-invasive, and their application is simpler than that of CPAP. We aim to present a protocol for a systematic review and meta-analysis for investigating new SAHS treatments, including the protocols and frequency of use and the effects they have on patient signs, symptoms and quality of life.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and analysis<\/jats:title>\n                    <jats:p>The literature search will be conducted using the Cochrane, Web of Science, Medline (via PubMed) and Scopus databases, from January 2020 to December 2020. All types of studies written in English and Spanish that investigate the use of alternative SAHS treatments related to MFT, or more importantly, the combination of MFT and PRT, will be selected. To evaluate their quality, the Critical Appraisal Checklist for Analytical Cross-Sectional will be applied. The primary factor valued in the studies will be the inclusion of MFT and PT reeducation in the treatment. Subgroup analyses will be carried out evaluating the specific type of treatments chosen and the improvements or deteriorations in the level of health and quality of life in the patients. Finally, several patient-related outcomes, namely sleep quality, quality of life and sleep Apnoeas and Hypoapnoeas Index, will be examined.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethics and dissemination<\/jats:title>\n                    <jats:p>In this case, ethical approval is not necessary. The data used in the review will be exclusively obtained from published studies, implying there are no privacy concerns. The information obtained will be relevant to understand if the new treatments applied in SAHS are effective, and if postural and MFT therapy used together can be considered an appropriate approach to treat this disease.<\/jats:p>\n                    <jats:p>The results will be published in a peer-reviewed journal.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2021-049286","type":"journal-article","created":{"date-parts":[[2021,12,2]],"date-time":"2021-12-02T11:33:13Z","timestamp":1638444793000},"page":"e049286","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Alternatives to continuous positive airway pressure treatment in sleep apnoeas and hypopnoeas syndrome related to myofunctional and postural reeducation therapy: protocol for a systematic review"],"prefix":"10.1136","volume":"11","author":[{"given":"Marta Maria","family":"Guijarro-Herr\u00e1iz","sequence":"first","affiliation":[{"name":"Faculty of Nursing, Universidad de Castilla-La Mancha, Cuenca, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5004-3197","authenticated-orcid":false,"given":"Natalia Mar\u00eda","family":"Arias-Palencia","sequence":"additional","affiliation":[{"name":"Faculty of Education, Universidad de Castilla-La Mancha, Cuenca, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lidia","family":"Lucas- de la Cruz","sequence":"additional","affiliation":[{"name":"Faculty of Nursing, Universidad de Castilla-La Mancha, Cuenca, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Beatriz","family":"Guijarro-Herr\u00e1iz","sequence":"additional","affiliation":[{"name":"Internity Medicine, Hospital Virgen de la Luz, Cuenca, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Blanca","family":"Notario-Pacheco","sequence":"additional","affiliation":[{"name":"Faculty of Nursing, Universidad de Castilla-La Mancha, Cuenca, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4034-2585","authenticated-orcid":false,"given":"Rocio","family":"Palomo-Carri\u00f3n","sequence":"additional","affiliation":[{"name":"Faculty of Phsysiotheray, Universidad de Castilla-La Mancha - Campus de Toledo, Toledo, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jose Luis","family":"Garc\u00eda-Klepzig","sequence":"additional","affiliation":[{"name":"Facultad de Farmacia, Universidad Complutense de Madrid, Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Montserrat","family":"Solera-Mart\u00ednez","sequence":"additional","affiliation":[{"name":"Faculty of Nursing, Universidad de Castilla-La Mancha, Cuenca, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2021,12,2]]},"reference":[{"key":"2025121510165063000_11.12.e049286.1","first-page":"855","article-title":"[Long-term continuous positive airway pressure (CPAP) use in obstructive sleep apnea]","volume":"135","author":"Sant\u00edn M","year":"2007","journal-title":"Rev Med Chil"},{"key":"2025121510165063000_11.12.e049286.2","doi-asserted-by":"publisher","DOI":"10.1097\/00005537-200306000-00011"},{"key":"2025121510165063000_11.12.e049286.3","unstructured":"\u00c1lvarez-Sala Walter J , Garc\u00eda Moch\u00f3n L , Gonz\u00e1lez N\u00fa\u00f1ez J . Evaluaci\u00f3n sanitaria y socioecon\u00f3mica del s\u00edndrome de apneas e hipopneas del sue\u00f1o (SAHS) en Espa\u00f1a [Internet], 2020. Madrid: Alberto Alcocer. Available: http:\/\/ses.org.es\/docs\/libro-blanco-apneas-hipopneas.pdf"},{"key":"2025121510165063000_11.12.e049286.4","doi-asserted-by":"crossref","first-page":"925","DOI":"10.4317\/medoral.17706","article-title":"Obstructive sleep apnea syndrome (OSAS). review of the literature","volume":"17","author":"Azagra-Calero","year":"2012","journal-title":"Med Oral Patol Oral Cir Bucal"},{"key":"2025121510165063000_11.12.e049286.5","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1157\/13096996","article-title":"[Continuous positive airway pressure used by adults with obstructive sleep apneas after prescription in a public referral hospital in Mexico City]","volume":"43","author":"Torre Bouscoulet","year":"2007","journal-title":"Arch Bronconeumol"},{"key":"2025121510165063000_11.12.e049286.6","doi-asserted-by":"publisher","DOI":"10.1097\/01.mlg.0000237674.66716.a7"},{"key":"2025121510165063000_11.12.e049286.7","first-page":"140","article-title":"[Treatment compliance with continuous positive airway pressure device among adults with obstructive sleep apnea (OSA): how many adhere to treatment?]","volume":"152","author":"Sarrell","year":"2013","journal-title":"Harefuah"},{"key":"2025121510165063000_11.12.e049286.8","doi-asserted-by":"crossref","DOI":"10.3390\/jcm8101754","article-title":"Obstructive sleep apnea: emerging treatments targeting the genioglossus muscle","volume":"8","author":"Mediano","year":"2019","journal-title":"J Clin Med"},{"key":"2025121510165063000_11.12.e049286.9","doi-asserted-by":"publisher","DOI":"10.5665\/sleep.4652"},{"key":"2025121510165063000_11.12.e049286.10","doi-asserted-by":"crossref","first-page":"150","DOI":"10.1111\/j.1479-8425.2011.00500.x","article-title":"Positional therapy for the reduction of obstructive sleep apnea","volume":"9","author":"Kim","year":"2011","journal-title":"Sleep Biol Rhythms"},{"key":"2025121510165063000_11.12.e049286.11","first-page":"83","article-title":"S\u00edndromes Y reeducaci\u00f3n posturales en Los Trastornos temporo mandibulares","volume":"7","author":"Rodr\u00edguez-Romero","year":"2004","journal-title":"Revista Iberoamericana de Fisioterapia y Kinesiolog\u00eda"},{"key":"2025121510165063000_11.12.e049286.12","doi-asserted-by":"publisher","DOI":"10.1186\/2046-4053-4-1"},{"key":"2025121510165063000_11.12.e049286.13","unstructured":"National Heart, Lung, and Blood Institute . Study quality assessment tools, 2019. Available: https:\/\/www.nhlbi.nih.gov\/health-topics\/study-quality-assessment-tools"},{"key":"2025121510165063000_11.12.e049286.14","doi-asserted-by":"publisher","DOI":"10.1177\/1094428106291059"},{"key":"2025121510165063000_11.12.e049286.15","doi-asserted-by":"crossref","first-page":"2295","DOI":"10.1002\/sim.1048","article-title":"A Bayesian fixed effects analysis of the Mantel-Haenszel model applied to meta-analysis","volume":"21","author":"Leonard","year":"2002","journal-title":"Stat Med"},{"key":"2025121510165063000_11.12.e049286.16","unstructured":"Higgins J . Cochrane Handbook for systematic reviews of interventions version. The Cochrane Collaboration, 2011: 2\u20133."},{"key":"2025121510165063000_11.12.e049286.17","doi-asserted-by":"publisher","DOI":"10.1002\/sim.1186"},{"key":"2025121510165063000_11.12.e049286.18","doi-asserted-by":"crossref","first-page":"433","DOI":"10.1016\/S0014-2565(09)72516-0","article-title":"[Therapeutic alternatives to CPAP in the sleep apnea-hypopnea syndrome. Scientific evidence]","volume":"209","author":"Abad Fern\u00e1ndez","year":"2009","journal-title":"Rev Clin Esp"},{"key":"2025121510165063000_11.12.e049286.19","doi-asserted-by":"crossref","first-page":"139","DOI":"10.5664\/jcsm.4460","article-title":"Sleep position trainer versus tennis ball technique in positional obstructive sleep apnea syndrome","volume":"11","author":"Eijsvogel","year":"2015","journal-title":"J Clin Sleep Med"},{"key":"2025121510165063000_11.12.e049286.20","doi-asserted-by":"publisher","DOI":"10.1097\/00005537-200306000-00011"},{"key":"2025121510165063000_11.12.e049286.21","first-page":"16","article-title":"Positional therapy for obstructive sleep apnea","volume":"101","author":"Clebak","year":"2020","journal-title":"Am Fam Physician"},{"key":"2025121510165063000_11.12.e049286.22","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2869.2011.00974.x"},{"key":"2025121510165063000_11.12.e049286.23","doi-asserted-by":"crossref","first-page":"307","DOI":"10.17711\/SM.0185-3325.2013.037","article-title":"Adaptaci\u00f3n y validaci\u00f3n psicom\u00e9trica del Cuestionario de Consecuencias Funcionales del Dormir (Functional Outcomes Sleep Questionnaire [FOSQ]) en habitantes de la Ciudad de M\u00e9xico","volume":"36","author":"Rodr\u00edguez-P\u00e9rez","year":"2013","journal-title":"Salud Ment"},{"key":"2025121510165063000_11.12.e049286.24","doi-asserted-by":"crossref","first-page":"256","DOI":"10.1157\/13101951","article-title":"Valores de la versi\u00f3n espa\u00f1ola del Cuestionario del Impacto Funcional del Sue\u00f1o (FOSQ) en sujetos sanos Y en pacientes Con apnea obstructiva del sue\u00f1o","volume":"43","author":"Vidal","year":"2007","journal-title":"Archivos de Bronconeumolog\u00eda"},{"key":"2025121510165063000_11.12.e049286.25","doi-asserted-by":"crossref","first-page":"431","DOI":"10.1016\/j.arbres.2012.05.004","article-title":"Internal consistency and validity of the Spanish version of the quality of life questionnaire specific for obstructive sleep apnea: sleep apnea quality of life index","volume":"48","author":"Catal\u00e1n","year":"2012","journal-title":"Arch Bronconeumol"},{"key":"2025121510165063000_11.12.e049286.26","doi-asserted-by":"publisher","DOI":"10.1016\/j.sleep.2017.08.026"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2021-049286","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,15]],"date-time":"2025-12-15T18:16:58Z","timestamp":1765822618000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2021-049286"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,12]]},"references-count":26,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2021,12,2]]},"published-print":{"date-parts":[[2021,12]]}},"alternative-id":["10.1136\/bmjopen-2021-049286"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2021-049286","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"type":"print","value":"2044-6055"},{"type":"electronic","value":"2044-6055"}],"subject":[],"published":{"date-parts":[[2021,12]]}}}