Effects of an Oral-Pharyngeal Motor Training Programme on Children with Obstructive Sleep Apnea Syndrome in Hong Kong: A Retrospective Pilot Study

Abstract

BackgroundThis study aimed to investigate the effects of an oropharyngeal motor training programme on children with Obstructive Sleep Apnea Syndrome (OSAS) in Hong Kong.MethodsIn this retrospective study, we reviewed the outcomes of 10 children with OSAS who had received an oropharyngeal motor training programme in Occupational Therapy Department of an acute hospital in Hong Kong over a 1-year programme. Each participant attended an individual oropharyngeal motor training programme plus a follow-up session after 2 months. The training programme consisted of 10 individual mobilization exercises involving the orofacial and pharyngeal area for 45 minutes. Each exercise had to be repeated for 10 times. Three outcome measures were chosen to study the effectiveness of the training programme including tongue strength, tongue endurance level and orofacial function. Tongue strength and tongue endurance level were assessed using the Iowa Oral Pressure Instrument (IOPI). The Nordic Orofacial Test-Screening (NOT-S) Assessment was used to assess the orofacial function. Seven out of 10 participants completed the training programme and attended the follow-up session after two months.ResultsThe tongue strength and the scores of NOT-S of the 7 participants were found to have significant improvement after training. However, there was no significant difference in tongue endurance level.ConclusionThe findings of this study support the role of occupational therapist in oromotor training modalities to improve the respiratory function for children with OSAS in Hong Kong. Copyright © 2017, Hong Kong Occupational Therapy Association. Published by Elsevier (Singapore) Pte Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

Craniofacial Sleep Medicine: The Important Role of Dental Providers in Detecting and Treating Sleep Disordered Breathing in Children

“…Treatment using these exercises is aimed to reduce mouth breathing and improve the tongue position at rest and during sleep, especially in the context of dental skeletal malocclusion. There have been improvements noted when nasal breathing has been recovered [ 90 , 91 , 92 ]. The idea behind these interventions is that function alters form and form affects function, and these interventions support a bidirectional model of care.…”

Alternatives to surgery in children with mild OSA

“…In most of these studies, improvement in tongue function within 2 months of oropharyngeal exercises was accompanied by better oximetry parameters during sleep among those children who followed the recommendations of oropharyngeal exercises, with an aim to eliminate mouth breathing and recover nasal breathing. 68 , 69 , 70 …”

“…Other open studies in which mouth breathing and altered tongue position at rest and during sleep are identified in children with OSA and are more often associated with dento‐skeletal malocclusions, have led to implementation of MT. In most of these studies, improvement in tongue function within 2 months of oropharyngeal exercises was accompanied by better oximetry parameters during sleep among those children who followed the recommendations of oropharyngeal exercises, with an aim to eliminate mouth breathing and recover nasal breathing 68–70 …”

Correlação entre a pressão e a atividade eletromiográfica da língua na deglutição em indivíduos com diferentes alterações da motricidade orofacial

“…Apesar de quase a totalidade da amostra de paciente incluídas no presente estudo ter a oclusão classificada como Classe I, existem pacientes que tiveram a oclusão classificada como Classe II e III (58) , fato que interferiu nos resultados da avaliação clínica de motricidade orofacial e nas medidas antropométricas e de amplitude mandibular. Muitos estudos (60)(61)(62)(63)(64) já foram realizados relacionando a forma com a função do sistema estomatognático. As anomalias esqueléticas faciais, normalmente relacionadas à maloclusão, tem impacto em diversas funções orofaciais, incluindo o posicionamento dos ossos, dentes e músculos (64) .…”

“…As anomalias esqueléticas faciais, normalmente relacionadas à maloclusão, tem impacto em diversas funções orofaciais, incluindo o posicionamento dos ossos, dentes e músculos (64) . Como resultado, as funções de mastigação, articulação dos sons da fala, deglutição e respiração se modificaram como forma de adaptação à configuração dentofacial (42,60,61,64,65) . Considerando as maloclusões de Classe III, a literatura aponta que é frequente encontrar nesta população alteração mastigatória, com predominância de movimentos verticalizados e uso do dorso da língua para amassamento do alimento; lábios flácidos e entreabertos no repouso; língua flácida, alargada e em assoalho bucal (42,60,61,66) .Todas essas alterações têm impacto nas áreas de avaliação do AMIOFE-E, principalmente no que se refere à mobilidade dos órgãos fonoarticulatórios e às funções orofaciais (mastigação e deglutição).…”