# A Novel mHealth Approach for the Monitoring and Assisted Therapeutics of Obstructive Sleep Apnea
## 1 Introduction
There are studies that report a decrease in AHI by adhering to a low-calorie diet. However, there is some controversy as to whether specific human body variants, such as neck or waist circumference, are more reliable than BMI. This highlights the need to implement effective dietary education strategies and long-term weight loss programs in order to prevent OSA and address one of the 21 st-century pandemics: obesity [18; 19]. * Smoking--The relationship between smoking habits and OSA is still controversial. Smoking is known to impair the respiratory system by causing airway inflammation and breathing instability. A study published in 2015, in which 964 patients, including smokers and non-smokers, were included. Reports have stated that the disease was diagnosed at earlier ages in smoking individuals and that individuals who smoked 25 or more cigarettes per day had more severe OSA levels [20]. * Alcoholism--Alcohol consumption has only recently begun to be evaluated as a risk factor for OSA. Alcohol, by itself, is not a direct factor of OSA; however, in conjunction with other systemic factors, it can lead to a worsening in snoring, can alter sleep architecture, worsen AHI, drive the oropharyngeal wall to collapse, and induce lower oxygen saturation in patients who are more susceptible to OSA [21]. Despite the growing recognition of OSA as a contributor to a range of problems, in the literature, there is still a paucity of data regarding the prevalence of this disease worldwide [22]. It is estimated that this prevalence in the general population ranges from 9% to 38%, yet approximately 80% to 90% of cases remain undiagnosed or misdiagnosed [23]. It eventually became too complex to create a study of the evolution of OSA over the years, as there is a discrepancy in the data obtained by the studies that have been conducted. This discrepancy is due to the fact that there are three different guidelines. According to the American Academy of Sleep Medicine (AASM), there are differences in the scoring rules for hypopmeas [24]. The 1999 and 2007 guidelines have been replaced by their 2012 successors, currently in effect. The 2012 guidelines state that, to prove the existence of hypopnea, the decrease in oxygen flow must be \(\geq\)30% and associated with an oxygen desaturation of \(\geq\)3%, or else there should be an associated awakening. By using the 2012 AASM criteria in conjunction with an AHI criterion of \(\geq\)5 events per hour, then, an estimated 936 million (at 95% confidence), both males and females, aged 30-69 years, suffer from OSA, worldwide. With an AHI criterion of \(\geq\)15 events per hour, the estimated figure is 425 million sufferers of this disease. The global estimate shows that China is the country with the largest number of individuals with OSA, followed by the USA, Brazil, and India [22]. This paper proposes a device for the treatment and prevention of OSA. This device, unlike existing treatments, will not involve any type of surgical intervention; is minimally invasive; and does not produce headaches, a dry mouth and throat, or the nocturnal noise usually associated with the non-invasive treatment technologies on the market. The device will take the form of a customizable mouth guard, using the dimensions of each user's lower jaw dentition and programmed to the user's specific needs. In addition, this device should be able to detect, through electromyography, electrical signals from the brain, or, in this case, the lack of a weakening of them, and to stimulate the genioglossus muscle so that there is no collapse of the airways. Thus, most of the apnea or hypopnea events will be solved without the bearer of this condition noticing what has happened and waking up. This stimulation will occur through electrodes placed directly under the tongue, where the stimulation of this muscle will take place indirectly, as this is the most effective place, without resorting to surgery.