Clin Exp Otorhinolaryngol.  2018 Sep;11(3):192-198. 10.21053/ceo.2017.01284.

Effect of Lifestyle Modification Using a Smartphone Application on Obesity With Obstructive Sleep Apnea: A Short-term, Randomized Controlled Study

• Cho SW
• Wee JH
• Yoo S
• Heo E
• Ryu B
• Kim Y
• Lee JS
• Kim JW

• KMID: 2429009
• DOI: http://doi.org/10.21053/ceo.2017.01284

Abstract

OBJECTIVES
To investigate the short-term effects of a lifestyle modification intervention based on a mobile application (app) linked to a hospital electronic medical record (EMR) system on weight reduction and obstructive sleep apnea (OSA).
METHODS
We prospectively enrolled adults (aged >20 years) with witnessed snoring or sleep apnea from a sleep clinic. The patients were randomized into the app user (n=24) and control (n=23) groups. The mobile app was designed to collect daily lifestyle data by wearing a wrist activity tracker and reporting dietary intake. A summary of the lifestyle data was displayed on the hospital EMR and was reviewed. In the control group, the lifestyle modification was performed as per usual practice. All participants underwent peripheral arterial tonometry (WatchPAT) and body mass index (BMI) measurements at baseline and after 4 weeks of follow-up.
RESULTS
Age and BMI did not differ significantly between the two groups. While we observed a significant decrease in the BMI of both groups, the decrease was greater in the app user group (P < 0.001). Apnea-hypopnea index, respiratory distress index, and oxygenation distress index did not change significantly in both groups. However, the proportion of sleep spent snoring at >45 dB was significantly improved in the app user group alone (P =0.014). In either group, among the participants with successful weight reduction, the apnea-hypopnea index was significantly reduced after 4 weeks (P =0.015). Multiple regression analyses showed that a reduction in the apnea-hypopnea index was significantly associated with BMI.
CONCLUSION
Although a short-term lifestyle modification approach using a mobile app was more effective in achieving weight reduction, improvement in OSA was not so significant. Long-term efficacy of this mobile app should be evaluated in the future studies.

Keyword

Obstructive Sleep Apnea; Mobile Applications; Weight Loss; Randomized Controlled Trial; Healthy Lifestyle

MeSH Terms

Adult
Body Mass Index
Electronic Health Records
Follow-Up Studies
Humans
Life Style*
Manometry
Mobile Applications
Obesity*
Oxygen
Prospective Studies
Sleep Apnea Syndromes
Sleep Apnea, Obstructive*
Smartphone*
Snoring
Weight Loss
Wrist
Oxygen

Figure

• 

  Fig. 1. User interfaces on the patient’s mobile application (app, A) and the physician’s electronic medical record (EMR) (B). Using the smartphone app and EMR interfaces, patients and physicians can check the daily status of and recommend goals for (1) the number of steps, (2) the user’s food intake, and (3) their body weight. (A) The app shows the food intake allowances remaining for the day and the amount of physical activity needed to reach the daily goal. (B) A summary of their lifestyle was displayed on the hospital EMR and reviewed by both, a physician and the app user. Further lifestyle modification was encouraged based on the electronically collected data.

• 

  Fig. 2. Flowchart of the study. App, application; BMI, body mass index.

• 

  Fig. 3. Rates of weight reduction. In the application (app) user and control groups, 22 (total n=24) and nine (total n=23) participants achieved weight reduction, respectively (P<0.001).

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