Smartphone-based delivery of oropharyngeal exercises for treatment of snoring: a randomized controlled trial
Upper airway exercises for snoring treatment can be effective but difficult to administer and monitor. We hypothesized that a brief, relatively simple daily upper airway exercise regimen, administered by a smartphone application, would reduce snoring and encourage compliance.
Targeted vowel sounds causing tongue base movements were incorporated into a voice-controlled smartphone game application. Participants with habitual snoring, apnea hypopnea index (AHI) ≤ 14 events/h, and BMI ≤ 32 kg/m2 were randomly assigned to perform 15 min of daily gameplay (intervention group) or 5 s of daily voice recording (control group) and to audio record their snoring for 2 nights/week for up to 12 weeks. Sounds above 60 dB were extracted from recordings for snore classification with machine learning support vector machine classifiers.
Sixteen patients (eight in each group) completed the protocol. Groups were similar at baseline in gender distribution (five males, three females), mean BMI (27.5 ± 3.8 vs 27.4 ± 3.8 kg/m2), neck circumference (15.1 ± 1.6 vs 14.7 ± 1.7 in.), Epworth Sleepiness Score (8 ± 3.5 vs 7 ± 4.0), and AHI (9.2 ± 4.0 vs 8.2 ± 3.2 events/h). At 8 weeks, the absolute change in snoring rate (> 60 dB/h) was greater for the intervention group than the control group (− 49.3 ± 55.3 vs − 6.23 ± 23.2; p = 0.037), a 22 and 5.6% reduction, respectively. All bed partners of participants in the intervention group reported reduced snoring volume and frequency, whereas no change was reported for the control group.
Smartphone application-administered upper airway training reduces objective and subjective snoring measures and improves sleep quality.
KeywordsSnoring Oropharyngeal exercise Smartphone application Randomized controlled trial
The authors would like to acknowledge Dr. Peter Watson for his guidance in ultrasound imaging studies, Andrew Byrne for helping with microphone calibration, Dr. Steven Reinitz for contribution to study design, Max Anderson for contribution to participant recruitment, and Dr. Anne Webber-Main for feedback on manuscript writing.
This study was funded by NIH Research Evaluation and Commercialization Hub (MN-REACH) Grant no. 5U01HL127479-03.
Compliance with ethical standards
The protocol was approved by the University of Minnesota’s Institutional Review Board (IRB#1606S88671).
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual participants included in the study.
Conflict of interest
Umesh Goswami: holds equity in the entity aimed at commercialization of the technology described in this manuscript; Adam Black: holds the provisional patent of the technology described in this manuscript and holds equity in the entity aimed at commercialization of the technology; Brian Krohn: holds the provisional patent of the technology described in this manuscript and holds equity in the entity aimed at commercialization of the technology; Wendy Meyers: none; Conrad Iber: none.
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