Casado-Morente, J.C. (Juan Carlos)

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    Risk of diabetes in patients with sleep apnea: comparison of surgery versus CPAP in a long-term follow-up study
    (2023) Garcia-Iriarte, M.T. (Maria Teresa); Ignacio, J.M. (José María); Casado-Morente, J.C. (Juan Carlos); Marban-Álvarez, I.(Irene); Rodriguez-Alcala, L. (Laura); O’Connor-Reina, C. (Carlos); Pérez-del-Rey, D. (David); Baptista, P.M. (Peter M.); Hernandez-Ibarburu, G. (Gema); Carrasco-Llatas, M. (Marina); Plaza-Mayor, G. (Guillermo)
    This study aimed to obtain a comprehensive view of the risk of developing diabetes in patients with obstructive sleep apnea (OSA) and to compare this risk between patients receiving continuous positive airway pressure (CPAP) therapy versus upper airway surgery (UAS). We used local and the global-scale federated data research network TriNetX to obtain access to electronic medical records, including those for patients diagnosed with OSA, from health-care organizations (HCOs) worldwide. Using propensity score matching and the score-matched analyses of data for 5 years of follow-up, we found that patients who had undergone UAS had a lower risk of developing diabetes than those who used CPAP (risk ratio 0.415, 95% confidence interval (CI) 0.349-0.493). The risk for newly diagnosed diabetes patients showed a similar pattern (hazard ratio 0.382; 95% CI 0.317-0.459). Both therapies seem to protect against diabetes (Risk 0.081 after UAS vs. 0.195 after CPAP). Analysis of the large data sets collected from HCOs in Europe and globally lead us to conclude that, in patients with OSA, UAS can prevent the development of diabetes better than CPAP.
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    Myofunctional therapy app for severe apnea-hypopnea sleep obstructive syndrome: Pilot randomized controlled trial
    (2020) Garcia-Iriarte, M.T. (Maria Teresa); Casado-Morente, J.C. (Juan Carlos); Barrios, V.I. (Victoria Ignacio); Plaza, G. (Guillermo); O’Connor-Reina, C. (Carlos); Baptista-Jardin, P. (Peter); Rodriguez-Ruiz, E. (Elisa); Morillo-Dominguez, M.C. (Maria-Del-Carmen); Garcia, J.M.I. (José Maria Ignacio)
    Background: Myofunctional therapy has demonstrated efficacy in treating sleep-disordered breathing. We assessed the clinical use of a new mobile health (mHealth) app that uses a smartphone to teach patients with severe obstructive sleep apnea–hypopnea syndrome (OSAHS) to perform oropharyngeal exercises. Objective: We conducted a pilot randomized trial to evaluate the effects of the app in patients with severe OSAHS. Methods: Forty patients with severe OSAHS (apnea–hypoxia index [AHI]>30) were enrolled prospectively and randomized into an intervention group that used the app for 90 sessions or a control group. Anthropometric measures, Epworth Sleepiness Scale (0-24), Pittsburgh Sleep Quality Index (0-21), Iowa Oral Performance Instrument (IOPI) scores, and oxygen desaturation index were measured before and after the intervention. Results: After the intervention, 28 patients remained. No significant changes were observed in the control group; however, the intervention group showed significant improvements in most metrics. AHI decreased by 53.4% from 44.7 (range 33.8-55.6) to 20.88 (14.02-27.7) events/hour (P<.001). The oxygen desaturation index decreased by 46.5% from 36.31 (27.19-43.43) to 19.4 (12.9-25.98) events/hour (P=.003). The IOPI maximum tongue score increased from 39.83 (35.32-45.2) to 59.06 (54.74-64.00) kPa (P<.001), and the IOPI maximum lip score increased from 27.89 (24.16-32.47) to 44.11 (39.5-48.8) kPa (P<.001). The AHI correlated significantly with IOPI tongue and lip improvements (Pearson correlation coefficient −0.56 and −0.46, respectively; both P<.001). The Epworth Sleepiness Scale score decreased from 10.33 (8.71-12.24) to 5.37 (3.45-7.28) in the app group (P<.001), but the Pittsburgh Sleep Quality Index did not change significantly. Conclusions: Orofacial exercises performed using an mHealth app reduced OSAHS severity and symptoms, and represent a promising treatment for OSAHS. Trial Registration: Spanish Registry of Clinical Studies AWGAPN-2019-01, ClinicalTrials.gov NCT04438785; https://clinicaltrials.gov/ct2/show/NCT04438785
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    Floppy closing door epiglottis treated successfully with an mhealth application based on myofunctional therapy: a case report
    (Hindawi Limited, 2019) Garcia-Iriarte, M.T. (Maria Teresa); Casado-Morente, J.C. (Juan Carlos); O’Connor-Reina, C. (Carlos); Ignacio-Garcia, J.M. (Jose Maria); Baptista, P.M. (Peter M.); Plaza-Mayor, G. (Guillermo)
    We introduce the first case reported to date of a floppy closing door epiglottis in an OSA (obstructive sleep apnea) patient treated successfully with an Mhealth smartphone application based on myofunctional therapy.