Myofunctional therapy for OSA: a meta-analysis

Meghpara, Sanket; Chohan, Moeed R.; Bandyopadhyay, Anuja; Kozlowski, Conrad; Casinas, Jameson; Kushida, Clete A.; Camacho, Macario

doi:10.1080/17476348.2021.2001332

Cited by 10 publications

(11 citation statements)

References 23 publications

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“…The MFT is a multi‐component intervention that typically comprises a combination of exercises covering various oropharyngeal structures, such as tongue, palate, pharynx, or epiglottis, 12 and aims to act positively on the impaired sensorimotor deficits in the upper airway muscles encountered in patients with OSA 9,11,13–15 . The efficacy of MFT in reducing the severity of OSA, daytime sleepiness and quality of life has been demonstrated in several reviews and meta‐analyses 5,16–19 . Two previous randomised controlled trials conducted in patients with moderate OSA showed that, compared to sham therapy, MFT including soft palate, tongue, facial muscle exercises, as well as stomatognathic function exercises (i.e.…”

Section: Introductionmentioning

confidence: 99%

“… 9 , 11 , 13 , 14 , 15 The efficacy of MFT in reducing the severity of OSA, daytime sleepiness and quality of life has been demonstrated in several reviews and meta‐analyses. 5 , 16 , 17 , 18 , 19 Two previous randomised controlled trials conducted in patients with moderate OSA showed that, compared to sham therapy, MFT including soft palate, tongue, facial muscle exercises, as well as stomatognathic function exercises (i.e. suction, breathing, speech, swallowing, chewing) resulted in a reduction of apnoea‐hypopnea index (AHI) by 50% of its initial value.…”

Section: Introductionmentioning

confidence: 99%

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The effect of tongue elevation muscle training in patients with obstructive sleep apnea: A randomised controlled trial

Poncin

Correvon

Tam

et al. 2022

J of Oral Rehabilitation

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Background: Oropharyngeal myofunctional therapy is a multi-component therapy effective to reduce the severity of obstructive sleep apnoea (OSA). However, existing protocols are difficult to replicate in the clinical setting. There is a need to isolate the specific effectiveness of each component of the therapy. Objective: To assess the effects of a 6 weeks tongue elevation training programme in patients with OSA. Methods: We conducted a multicentre randomised controlled trial. Eligible participants were adults diagnosed with moderate OSA who presented low adherence to continuous positive airway pressure therapy (mean use <4 h per night). The intervention group completed a 6 weeks tongue elevation training protocol that consisted in anterior tongue elevation strength and endurance tasks with the Iowa Oral Performance Instrument. The control group completed a 6 weeks sham training protocol that involved expiratory muscle training at very low intensity. Polygraphy data, tongue force and endurance, and OSA symptoms were evaluated pre-and postintervention. The primary outcome was apneoa-hypopnea index (AHI).Results: Twenty-seven patients (55 ± 11 years) were recruited. According to modified intention-to-treat analysis (n = 25), changes in AHI and c did not significantly differ between groups. Daytime sleepiness (Epworth Sleepiness Scale) and tongue endurance significantly improved in the intervention group compared to the control group (p = .015 and .022, respectively). In the intervention group, 75% of participants had a decrease in daytime sleepiness that exceeded the minimal clinically important difference. Conclusion:Six weeks of tongue elevation muscle training had no effect on OSA severity.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The effect of tongue elevation muscle training in patients with obstructive sleep apnea: A randomised controlled trial

Poncin

Correvon

Tam

et al. 2022

J of Oral Rehabilitation

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“…A surgical response in this trial was defined by the decrease in the apnea-hypopnea index (AHI) by more than 50% from the baseline and less than 20 events per hour [ 28 ]. Other therapeutic methods can also be considered an alternative or adjunctive treatment in mild–moderate OSA, such as oral appliances for patients with malocclusion, myofunction therapy [ 29 ], weight loss, and behavioral change, expiratory positive airway pressure (EPAP) therapy to help in preventing airway collapse during sleep. AHI increases with a supine position in more than half of the patients with OSA [ 30 ].…”

Section: Interventions For Osamentioning

confidence: 99%

Patient-Centered Therapy for Obstructive Sleep Apnea: A Review

Taweesedt¹,

Najeeb

Surani

2022

Medicina

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Obstructive sleep apnea (OSA) is one of the most common sleep problems defined by cessation or decreased airflow despite breathing efforts. It is known to be related to multiple adverse health consequences. Positive airway pressure (PAP) is considered an effective treatment that is widely used. Various modes of PAP and other emerging treatment options are now available. A multidisciplinary approach, understanding diverse phenotypes of OSA, and shared decision-making are necessary for successful OSA treatment. Patient-centered care is an essential modality to support patient care that can be utilized in patients with OSA to help improve outcomes, treatment adherence, and patient satisfaction.

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“…The efficacy of MT in OSA patients is difficult to quantify, and long-term sleep studies (respiratory polygraphy and polysomnography (PSG)) are needed to monitor its results. Recent meta-analysis studies show that MT reduces the AHI by 34% in adults and improves the Epworth Sleepiness Scale (ESS) by 4 points and the lowest oxygen (O 2 ) saturation by 2% [8]. The main drawback of MT is its low adherence, reported as being as high as 40% [4][5][6].…”

Section: Introductionmentioning

confidence: 99%

Evaluation of the Muscle Strength of the Tongue with the Tongue Digital Spoon (TDS) in Patients with Obstructive Sleep Apnea

Alcalá

Benjumea

Casado-Morente

et al. 2022

Life

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Myofunctional therapy (MT) is a recent treatment option for obstructive sleep apnea (OSA). The Iowa Oral Performance Instrument (IOPI) is a useful but expensive tool for measuring tongue strength in patients with OSA. We validated the Tongue Digital Spoon (TDS) to monitor tongue hypotonia in patients with OSA. Measurements with the IOPI and TDS were compared in patients with OSA before and after MT for tongue hypotonia. Baseline mean tongue strength measured with the IOPI in patients with moderate and severe OSA were 35.36 ± 9.05 and 33.83 ± 12.05, respectively, and that with the TDS were 168.55 ± 42.8 and 129.61 ± 53.7, respectively. After MT, mean tongue strength significantly improved: measured with the IOPI in patients with moderate and severe OSA were 53.85 ± 10.09 and 55.50 ± 9.64 (p = 0.8), and that with the TDS were 402.36 ± 52.92 and 380.28 ± 100.75 (p = 0.01), respectively. The correlation between the IOPI and TDS was high (r = 0.74; p = 0.01 pre-treatment, and r = 0.25; p = 0.05 post-treatment). The TDS is a useful tool for monitoring the efficacy of MT in patients with short-term OSA. Future randomized studies will determine the effectiveness of MT for the treatment of OSA.

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Myofunctional therapy for OSA: a meta-analysis

Cited by 10 publications

References 23 publications

The effect of tongue elevation muscle training in patients with obstructive sleep apnea: A randomised controlled trial

The effect of tongue elevation muscle training in patients with obstructive sleep apnea: A randomised controlled trial

Patient-Centered Therapy for Obstructive Sleep Apnea: A Review

Evaluation of the Muscle Strength of the Tongue with the Tongue Digital Spoon (TDS) in Patients with Obstructive Sleep Apnea

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