{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T03:04:17Z","timestamp":1791947057319,"version":"4.3.4"},"reference-count":38,"publisher":"MDPI AG","issue":"24","license":[{"start":{"date-parts":[[2021,12,9]],"date-time":"2021-12-09T00:00:00Z","timestamp":1639008000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Myofunctional therapy (MT) is used to treat sleep-disordered breathing. However, MT has low adherence\u2014only ~10% in most studies. We describe our experiences with MT delivered through a mobile health app named Airway Gym\u00ae, 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 (p &lt; 0.05) in the apnoea\u2013hypopnoea index (AHI; 32.97 \u00b1 1.8 to 21.9 \u00b1 14.5 events\/h); IOPI score (44.4 \u00b1 11.08 to 49.66 \u00b1 10.2); and minimum O2 saturation (80.91% \u00b1 6.1% to 85.09% \u00b1 5.3%). IOPI scores correlated significantly with AHI after the therapy (Pearson r = 0.4; p = 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.<\/jats:p>","DOI":"10.3390\/jcm10245772","type":"journal-article","created":{"date-parts":[[2021,12,9]],"date-time":"2021-12-09T21:46:58Z","timestamp":1639086418000},"page":"5772","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":34,"title":["Improving Adherence to Myofunctional Therapy in the Treatment of Sleep-Disordered Breathing"],"prefix":"10.3390","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1670-4235","authenticated-orcid":false,"given":"Carlos","family":"O\u2019Connor-Reina","sequence":"first","affiliation":[{"name":"Otorhinolaryngology Department, Hospital Quironsalud Marbella, 29603 Marbella, Spain"},{"name":"Otorhinolaryngology Department, Hospital Quironsalud Campo de Gibraltar, 11379 Palmones, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jose Mar\u00eda","family":"Ignacio Garcia","sequence":"additional","affiliation":[{"name":"Pulmonology Department, Hospital Quironsalud Marbella, 29603 Marbella, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5148-5111","authenticated-orcid":false,"given":"Laura","family":"Rodriguez Alcala","sequence":"additional","affiliation":[{"name":"Otorhinolaryngology Department, Hospital Quironsalud Marbella, 29603 Marbella, Spain"},{"name":"Otorhinolaryngology Department, Hospital Quironsalud Campo de Gibraltar, 11379 Palmones, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisa","family":"Rodr\u00edguez Ruiz","sequence":"additional","affiliation":[{"name":"Pulmonology Department, Hospital Quironsalud Marbella, 29603 Marbella, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda Teresa","family":"Garcia Iriarte","sequence":"additional","affiliation":[{"name":"Otorhinolaryngology Department, Hospital Virgen de Valme, 41014 Sevilla, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan Carlos","family":"Casado Morente","sequence":"additional","affiliation":[{"name":"Otorhinolaryngology Department, Hospital Quironsalud Marbella, 29603 Marbella, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6601-5331","authenticated-orcid":false,"given":"Peter","family":"Baptista","sequence":"additional","affiliation":[{"name":"Otorhinolaryngology Department, Cl\u00ednica Universitaria de Navarra, 31008 Pamplona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guillermo","family":"Plaza","sequence":"additional","affiliation":[{"name":"Otorhinolaryngology Department, Hospital Universitario de Fuenlabrada, Universidad Rey Juan Carlos, 28942 Madrid, Spain"},{"name":"Otorhinolaryngology Department, Hospital Sanitas la Zarzuela, 28942 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,12,9]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Mediano, O., Gonz\u00e1lez Mangado, N., Montserrat, J.M., Alonso-\u00c1lvarez, M.L., Almendros, I., Alonso-Fern\u00e1ndez, A., Barb\u00e9, F., Borsini, E., Caballero-Eraso, C., and Cano-Pumarega, I. 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