Tongue peak pressure: a tool to aid in the identification of obstruction sites in patients with obstructive sleep apnea/hypopnea syndrome

O’Connor-Reina, Carlos; Plaza, Guillermo; Garcia-Iriarte, Maria Teresa; Ignacio-Garcia, Jose Maria; Baptista, Peter; Casado-Morente, Juan Carlos; Vicente, Eugenio Fernández

doi:10.1007/s11325-019-01952-x

Cited by 28 publications

(34 citation statements)

References 27 publications

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“…Third, we could not evaluate sleep apnea in the subjects of this study. It has been reported that people with sleep apnea have decreased tongue strength and increased tongue thickness due to excessive fat deposition, which causes tongue collapse [24,25]. In the present study, there were 3 subjects whose BMI was over 30 kg/m 2 and were not diagnosed with obstructive sleep apnea hypopnea syndrome (OSAHS).…”

Section: Plos Onementioning

confidence: 69%

Tongue thickness measured by ultrasonography is associated with tongue pressure in the Japanese elderly

Nakamori¹,

Imamura²,

Fukuta³

et al. 2020

PLoS ONE

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The term "oral frailty" reflects the fact that oral health is associated with physical frailty and mortality. The gold standard methods for evaluating the swallowing function have several problems, including the need for specialized equipment, the risk of radiation exposure and aspiration, and general physicians not possessing the requisite training to perform the examination. Hence, several simple and non-invasive techniques have been developed for evaluating swallowing function, such as those for measuring tongue pressure and tongue thickness. The aim of this study was to investigate the relationship between tongue thickness ultrasonography and tongue pressure in the Japanese elderly. We evaluated 254 elderly patients, who underwent tongue ultrasonography and tongue pressure measurement. To determine tongue thickness, we measured the vertical distance from the surface of the mylohyoid muscle to the tongue dorsum using ultrasonography. The results of the analyses revealed that tongue thickness was linearly associated with tongue pressure in both sexes. In male participants, dyslipidemia, lower leg circumference, and tongue pressure were independently and significantly associated with tongue thickness. In female participants, body mass index and tongue pressure were independently and significantly associated with tongue thickness. The optimal cutoff for tongue thickness to predict the tongue pressure of < 20 kPa was 41.3 mm in males, and 39.3 mm in females. In the Japanese elderly, tongue thickness using ultrasonography is associated with tongue pressure. Tongue thickness and tongue pressure, which are sensitive markers for oral frailty, decrease with age. We conclude that tongue ultrasonography provides a less invasive technique for determining tongue thickness and predicts oral frailty for elderly patients.

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Section: Plos Onementioning

confidence: 69%

Tongue thickness measured by ultrasonography is associated with tongue pressure in the Japanese elderly

Nakamori¹,

Imamura²,

Fukuta³

et al. 2020

PLoS ONE

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“…In addition, it is not yet clear how MFT contributes to improving OSA. Tongue pressure is lower in young to middle‐aged patients with severe OSA compared with healthy controls 9 . MFT may contribute to improvement in sleep‐disordered breathing by increasing tongue pressure; however, the evidence has been limited to studies including children 10 …”

Section: Introductionmentioning

confidence: 99%

Efficacy of oral myofunctional therapy in middle‐aged to elderly patients with obstructive sleep apnoea treated with continuous positive airway pressure

Suzuki

Okamoto

Akagi

et al. 2020

J of Oral Rehabilitation

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Background Oral myofunctional therapy (MFT) is an effective treatment for mild‐to‐moderate obstructive sleep apnoea (OSA) in middle‐aged patients. However, few reports have described its use in elderly patients with moderate and severe OSA. Moreover, no studies have examined the relationship between changes in tongue pressure with MFT and the severity of OSA. Objective We conducted an interventional study using MFT to evaluate the effect of MFT on middle‐to‐senior‐aged patients with moderate or severe OSA and compared changes in apnoea‐hypopnea index (AHI) and tongue pressure. Methods Thirty‐two OSA patients (≥45 years) treated with continuous positive airway pressure (CPAP) were included. MFT was performed in parallel with CPAP. Three days after CPAP discontinuation, polysomnographies were performed and tongue pressures were measured before and after MFT. Results Patients were 69.3 ± 1.5 years old. After 6 months of MFT, AHI decreased significantly from 34.7 to 29.0/h (P = .03), while tongue pressure significantly increased from 35.9 to 45.6 kPa (P < .01). Seven patients (22%), including 6 of the 12 patients with moderate OSA (50%), experienced successful CPAP discontinuation. Conclusions MFT can be a useful intervention even among middle‐aged to elderly patients with OSA. Increased tongue pressure may have contributed to the AHI improvement. Clinical trials: Trial registration at http://www.umin.ac.jp UMIN000027547.

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“…The review reveals that studies with control groups report little or no improvement in AHI for controls compared with improvements in participants treated with MT. The authors also clearly demonstrate improvements in lowest oxygen saturation of between 3 and 4%, with data from a number of independent studies recording a mean difference in SPO 2 before and after MT of 4.19% [113]. The manuscripts included in this review do not share a single methodology or group of exercises, but outcomes were considered consistent.…”

Section: Breathing Re-education Myofunctional Therapy and Upper Airwmentioning

confidence: 85%

“…This indicates that there may be a place for MT in the treatment of OSAHS. However, MT is very demanding, as demonstrated by the important percentage of dropouts in studies that are commonly cited to illustrate its efficacy [111,113]. Therefore, the strategy of BRE should not be to add on MT maneuvers but to refine which components are most effective in order to facilitate acceptance and long-term adherence to such programs.…”

Section: Breathing Re-education Myofunctional Therapy and Upper Airwmentioning

confidence: 99%

“…In a review of the relevant literature, Camacho et al concluded that MT yields a reduction in AHI of around 50% in adults and 62% in children [113]. The review reveals that studies with control groups report little or no improvement in AHI for controls compared with improvements in participants treated with MT.…”

Section: Breathing Re-education Myofunctional Therapy and Upper Airwmentioning

confidence: 99%

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Breathing Re-Education and Phenotypes of Sleep Apnea: A Review

McKeown

O’Connor-Reina

Plaza

2021

JCM

Self Cite

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Four phenotypes of obstructive sleep apnea hypopnea syndrome (OSAHS) have been identified. Only one of these is anatomical. As such, anatomically based treatments for OSAHS may not fully resolve the condition. Equally, compliance and uptake of gold-standard treatments is inadequate. This has led to interest in novel therapies that provide the basis for personalized treatment protocols. This review examines each of the four phenotypes of OSAHS and explores how these could be targeted using breathing re-education from three dimensions of functional breathing: biochemical, biomechanical and resonant frequency. Breathing re-education and myofunctional therapy may be helpful for patients across all four phenotypes of OSAHS. More research is urgently needed to investigate the therapeutic benefits of restoring nasal breathing and functional breathing patterns across all three dimensions in order to provide a treatment approach that is tailored to the individual patient.

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Tongue peak pressure: a tool to aid in the identification of obstruction sites in patients with obstructive sleep apnea/hypopnea syndrome

Cited by 28 publications

References 27 publications

Tongue thickness measured by ultrasonography is associated with tongue pressure in the Japanese elderly

Tongue thickness measured by ultrasonography is associated with tongue pressure in the Japanese elderly

Efficacy of oral myofunctional therapy in middle‐aged to elderly patients with obstructive sleep apnoea treated with continuous positive airway pressure

Breathing Re-Education and Phenotypes of Sleep Apnea: A Review

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