Effects of One-Week Tongue-Task Training on Sleep Apnea Severity: A Pilot Study

Rousseau, Éric; César, Sergi; Gakwaya, Simon; Sériès, Frédéric

doi:10.1155/2015/583549

Cited by 15 publications

(15 citation statements)

References 13 publications

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“…This has been documented for the masseter muscle, whose mechanical performance improved following low-intensity motor task training (17). These results are consistent with the decrease in AHI observed after 1 wk of tongue task training (35).…”

Section: Clinical and Physiological Implicationssupporting

confidence: 85%

Assessment of tongue mechanical properties using different contraction tasks

Gakwaya

Saey

et al. 2017

Journal of Applied Physiology

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Inadequate upper airway (UA) dilator muscle function may play an important role in the pathophysiology of obstructive sleep apnea (OSA). To date, tongue mechanical properties have been assessed mainly using protrusion protocol with conflicting results. Performance during elevation tasks among patients with OSA remains unknown. This study aimed at assessing tongue muscle strength, strength stability, endurance time, fatigue indices, and total muscle work, using elevation and protrusion tasks with repetitive isometric fatiguing contractions in 12 normal plus mild, 17 moderate, and 11 severe patients with OSA, and to assess the influence of body mass index (BMI) and age. Endurance time was longer in protrusion than elevation task ( = 0.01). In both tasks, endurance time was negatively correlated with baseline value of strength coefficient of variation ( < 0.01). Compared with other groups, patients with moderate OSA had the lowest total muscle work for protrusion ( = 0.01) and shortest endurance time ( = 0.04), regardless of the type of task. Additionally, in patients with moderate-severe OSA, the total muscle work for both tasks was lower in nonobese compared with obese ( < 0.05). Total muscle work for protrusion was positively correlated with apnea hypopnea index (AHI) in obese subjects ( < 0.01). Endurance time was shorter ( < 0.01) and recovery time longer ( = 0.02) in the old compared with young subjects. In conclusion, the tongue is more prone to fatigue during the elevation task and in patients with moderate OSA. Obesity appeared to prevent alteration of tongue mechanical properties in patients with OSA. Baseline strength stability and endurance were related, illustrating the role of central neuromuscular output in tongue resistance to fatigue. To our knowledge, this is the first study to assess and compare tongue function using both elevation and protrusion tasks with repetitive isometric fatiguing contractions in subjects with different OSA status. Tongue mechanical performance seemed to differ between protrusion and elevation tasks and depend on the severity of OSA.

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Section: Clinical and Physiological Implicationssupporting

confidence: 85%

Assessment of tongue mechanical properties using different contraction tasks

Gakwaya

Saey

et al. 2017

Journal of Applied Physiology

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“…One reported that one-week tongue task training improved disordered breathing in OSA patients (OSA severity decreased from moderate to mild in 50% of subjects, and a 48% decrease of obstructive breathing disturbance was observed during rapid eye movement stage), while maximum protruding force training remained unchanged. [27] Our research further confirmed that tongue task training is not oriented toward strength gain, but rather toward an enhancement in genioglossus cortical excitability and improvement in the coordination of the genioglossus protrusion task. There are still some issues deserves further investigation, such as who will benefit more from this approach and the design of the suitable upper airway muscle training?…”

Section: Upper Airway Muscle Trainingsupporting

confidence: 76%

Therapeutic approaches of obstructive sleep apnea in China

Wang

2018

Journal of Translational Internal Medicine

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“…These abnormalities may contribute to obstructive events during sleep by promoting upper airways unstability [ 16 ]. This probably explains why “functional” treatment, such as pharyngeal muscle retraining which acts via a combination of increased strength of the genioglossus, the main dilator muscle of the upper airways, and neuromodulating adaptations [ 17 ], has been shown to effectively reduce the apnoea-hypopnoea index (AHI) [ 18 ].…”

Section: Introductionmentioning

confidence: 99%

Upper airway stabilization by osteopathic manipulation of the sphenopalatine ganglion versus sham manipulation in OSAS patients: a proof-of-concept, randomized, crossover, double-blind, controlled study

Jacq

Arnulf

Similowski

et al. 2017

BMC Complement Altern Med

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BackgroundOsteopathic manipulative treatment (OMT) of the sphenopalatine ganglion (SPG) is used empirically for the treatment of rhinitis and snoring and is thought to increase pharyngeal stability. This trial was designed to study the effects of this treatment on pharyngeal stability evaluated by critical closing pressure in obstructive sleep apnoea syndrome.MethodsThis single-centre, randomized, crossover, double-blind study compared active manipulation and sham manipulation of the SPG. Randomization was computer-generated. Patients each received one active manipulation and one sham manipulation at an interval of 21 days and were evaluated 30 min and 48 h after each session administered by a qualified osteopath. Neither the patients, nor the investigator performing the evaluations were informed about the order of the two techniques (double-blind). The primary endpoint was the percentage of responding patients presenting increased pharyngeal stability defined by a variation of critical closing pressure (Pcrit) of at least −4 cmH2O at 30 min. Secondary endpoints were the variation of Pcrit in absolute values, sleepiness and snoring. Others endpoints were lacrimation (Schirmer’s test), induced pain, sensations experienced during OMT.ResultsTen patients were included and nine (57 [50; 58] years, comprising 7 men, with an apnoea-hypopnoea index of 31.0 [25.5; 33.2]/h; (values are median [quartiles])) were analysed. Seven patients were analysed for the primary endpoint and nine patients were analysed for secondary endpoints. Five patients responded after active manipulation versus no patients after sham manipulation (p = 0.0209). Active manipulation induced more intense pain (p = 0.0089), increased lacrimation (ns) and more tactile, nociceptive and gustatory sensations (13 versus 1) compared to sham manipulation. No significant difference was observed for the other endpoints.ConclusionsOsteopathic manipulative treatment of the SPG may improve pharyngeal stability in obstructive sleep apnoea syndrome. This trial validates the feasibility of the randomized, controlled, double-blind methodology for evaluation of this osteopathic treatment. Studies on a larger sample size must specify the efficacy on the apnoea-hypopnoea index.Trial registrationThe study was retrospectively registered in the clinicaltrial.gov registry under reference NCT01193738 on 1st September 2010 (first inclusion May 19, 2010).Electronic supplementary materialThe online version of this article (doi: 10.1186/s12906-017-2053-0) contains supplementary material, which is available to authorized users.

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Effects of One-Week Tongue-Task Training on Sleep Apnea Severity: A Pilot Study

Cited by 15 publications

References 13 publications

Assessment of tongue mechanical properties using different contraction tasks

Assessment of tongue mechanical properties using different contraction tasks

Therapeutic approaches of obstructive sleep apnea in China

Upper airway stabilization by osteopathic manipulation of the sphenopalatine ganglion versus sham manipulation in OSAS patients: a proof-of-concept, randomized, crossover, double-blind, controlled study

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