Myofunctional therapy (oropharyngeal exercises) for obstructive sleep apnoea

Rueda, José‐Ramón; Mugueta-Aguinaga, Iranzu; Vilaró, Jordi; Rueda-Etxebarria, Mikel

doi:10.1002/14651858.cd013449

Cited by 13 publications

(18 citation statements)

References 47 publications

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“…MT is a promising treatment for SDB and is based on daily exercises to strengthen the oropharyngeal muscles and facilitate the opening of the airway [6][7][8][9][10][11][12][13]. However, the main drawbacks of MT are the low adherence, which has been reported to be as low as 10% [18][19][20][21], and the absence of objective feedback [9,11,12].…”

Section: Discussionmentioning

confidence: 99%

“…As mentioned above, because OSAHS originates from the suboptimal function of the dilator muscles of the airway, MT is designed, theoretically, to treat the mechanism underlying this disease. Several papers have reported its effectiveness, including randomized controlled trials, meta-analyses, and reviews [6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21].…”

Section: Introductionmentioning

confidence: 99%

“…In most cases, patients complete the exercises independently at home without substantial feedback and without providing precise information about their performance of the exercises to the therapist. Thus, the main drawback of MT is the low patient adherence, which has been reported to be as low as 10% in some investigations [18][19][20][21].…”

Section: Introductionmentioning

confidence: 99%

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Improving Adherence to Myofunctional Therapy in the Treatment of Sleep-Disordered Breathing

O’Connor-Reina

García

Alcalá

et al. 2021

JCM

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Myofunctional therapy (MT) is used to treat sleep-disordered breathing. However, MT has low adherence—only ~10% in most studies. We describe our experiences with MT delivered through a mobile health app named Airway Gym®, which is used by patients who have rejected continuous positive airway pressure and other therapies. We compared ear, nose, and throat examination findings, Friedman stage, tongue-tie presence, tongue strength measured using the Iowa oral performance instrument (IOPI), and full polysomnography before and after the 3 months of therapy. Participants were taught how to perform the exercises using the app at the start. Telemedicine allowed physicians to record adherence to and accuracy of the exercise performance. Fifty-four patients were enrolled; 35 (64.8%) were adherent and performed exercises for 15 min/day on five days/week. We found significant changes (p < 0.05) in the apnoea–hypopnoea index (AHI; 32.97 ± 1.8 to 21.9 ± 14.5 events/h); IOPI score (44.4 ± 11.08 to 49.66 ± 10.2); and minimum O2 saturation (80.91% ± 6.1% to 85.09% ± 5.3%). IOPI scores correlated significantly with AHI after the therapy (Pearson r = 0.4; p = 0.01). The 19 patients who did not adhere to the protocol showed no changes. MT based on telemedicine had good adherence, and its effect on AHI correlated with IOPI and improvement in tongue-tie.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Improving Adherence to Myofunctional Therapy in the Treatment of Sleep-Disordered Breathing

O’Connor-Reina

García

Alcalá

et al. 2021

JCM

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“…In a recent meta-analysis evaluating the benefits of myofunctional therapy for the treatment of OSA, the authors concluded that myofunctional therapy may reduce daytime sleepiness and may increase sleep quality in the short term, and the certainty of the evidence ranges from moderate to very low, due to a lack of blinding, incomplete data and imprecision [23].…”

Section: Discussionmentioning

confidence: 99%

A Pilot Randomized Controlled Trial of Effect of Genioglossus Muscle Strengthening on Obstructive Sleep Apnea Outcomes

Maghsoudipour

Nokes

Bosompra

et al. 2021

JCM

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The genioglossus is a major upper airway dilator muscle. Our goal was to assess the efficacy of upper airway muscle training on Obstructive Sleep Apnea (OSA) as an adjunct treatment. Sixty-eight participants with OSA (AHI > 10/h) were recruited from our clinic. They fall into the following categories: (a) Treated with Automatic Positive Airway Pressure (APAP), (n = 21), (b) Previously failed APAP therapy (Untreated), (n = 25), (c) Treated with Mandibular Advancement Splint (MAS), (n = 22). All subjects were given a custom-made tongue strengthening device. We conducted a prospective, randomized, controlled study examining the effect of upper airway muscle training. In each subgroup, subjects were randomized to muscle training (volitional protrusion against resistance) or sham group (negligible resistance), with a 1:1 ratio over 3 months of treatment. In the baseline and the final visit, subjects completed home sleep apnea testing, Epworth Sleepiness Scale (ESS), Pittsburgh Sleep Quality Index (PSQI), SF-36 (36-Item Short Form Survey), and Psychomotor Vigilance Test (PVT). Intervention (muscle training) did not affect the AHI (Apnea-Hypopnea Index), (p-values > 0.05). Based on PSQI, ESS, SF-36 scores, and PVT parameters, the changes between the intervention and sham groups were not significant, and the changes were not associated with the type of treatment (p-value > 0.05). The effectiveness of upper airway muscle training exercise as an adjunct treatment requires further study.

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“…Other effective treatments include weight loss, oral appliances that hold the jaw forward during sleep, surgical modification of the pharyngeal soft tissues (i.e., lateral pharyngoplasty or uvulopalatopharyngoplasty) or facial skeleton to enlarge the upper airway, and exercise [ 5 , 7 ]. In addition, in recent years, comprehensive treatments that include general or specific muscle training have been suggested to lower the apnoea-hypopnea index (AHI) of the OSA patient population [ 8 , 9 , 10 ].…”

Section: Introductionmentioning

confidence: 99%

Respiratory Muscle Training in Patients with Obstructive Sleep Apnoea: A Systematic Review and Meta-Analysis

et al. 2022

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Background: Effective treatments for obstructive sleep apnoea (OSA) include positive pressure, weight loss, oral appliances, surgery, and exercise. Although the involvement of the respiratory muscles in OSA is evident, the effect of training them to improve clinical outcomes is not clear. We aimed to determine the effects of respiratory muscle training in patients with OSA. Methods: A systematic review was conducted in seven databases. Studies that applied respiratory muscle training in OSA patients were reviewed. Two independent reviewers analysed the studies, extracted the data and assessed the quality of evidence. Results: Of the 405 reports returned by the initial search, eight articles reporting on 210 patients were included in the data synthesis. Seven included inspiratory muscle training (IMT), and one included expiratory muscle training (EMT). Regarding IMT, we found significant improvement in Epworth sleepiness scale in −4.45 points (95%CI −7.64 to −1.27 points, p = 0.006), in Pittsburgh sleep quality index of −2.79 points (95%CI −4.19 to −1.39 points, p < 0.0001), and maximum inspiratory pressure of −29.56 cmH2O (95%CI −53.14 to −5.98 cmH2O, p = 0.01). However, the apnoea/hypopnea index and physical capacity did not show changes. We did not perform a meta-analysis of EMT due to insufficient studies. Conclusion: IMT improves sleepiness, sleep quality and inspiratory strength in patients with OSA.

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Myofunctional therapy (oropharyngeal exercises) for obstructive sleep apnoea

Abstract: Myofunctional therapy (oropharyngeal exercises) for obstructive sleep apnoea (Review)

Cited by 13 publications

References 47 publications

Improving Adherence to Myofunctional Therapy in the Treatment of Sleep-Disordered Breathing

Improving Adherence to Myofunctional Therapy in the Treatment of Sleep-Disordered Breathing

A Pilot Randomized Controlled Trial of Effect of Genioglossus Muscle Strengthening on Obstructive Sleep Apnea Outcomes

Respiratory Muscle Training in Patients with Obstructive Sleep Apnoea: A Systematic Review and Meta-Analysis

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