Myofunctional therapy (oropharyngeal exercises) for obstructive sleep apnoea

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

doi:10.1002/14651858.cd013449.pub2

Cited by 40 publications

(41 citation statements)

References 73 publications

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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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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 results from a meta-analysis showed that oropharyngeal exercises decrease the apnea-hypopnea index (AHI) in mild-to-moderate OSA patients when compared to sham therapy, but the certainty of the evidence is low. 7 Verma et al 8 found that 3-month oropharyngeal exercise therapy could significantly improve the minimum oxygen saturation and time duration of SaO2 < 90% of OSA patients, while the average AHI of OSA patients after training was similar to pre-treatment. Many studies indicated that progressive tongue strength training (TST) could elevate tongue strength and functional dietary intake by mouth in older individuals.…”

Section: Introductionmentioning

confidence: 98%

Tongue Strength Training Increases Daytime Upper Airway Stability in Rats

Jin

Zhang

et al. 2021

NSS

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Purpose Tongue strength training (TST) has been shown to decrease the apnea-hypopnea index in some patients with obstructive sleep apnea (OSA). However, whether TST modulates the central regulation of genioglossus and influences the stability of the upper airway remains unknown. The purpose of this study was to dynamically assess the effect of TST on the upper airway. Methods Sixteen adult male Sprague–Dawley rats were studied to explore the mechanism of TST improving the upper airway function. The rats were randomly assigned to the normal control (NC) and TST groups. The TST group underwent 8-week progressive resistance tongue exercise training. Transcranial magnetic stimulation (TMS) responses and EMG activities were consistently recorded for 2 h on days 0, 14, 28, and 56 of the experiments in both groups. Theoretical critical pressure (Pcrit) value was measured on days 0, 14, 28, and 56. Results The TST group showed shorter TMS latency and higher genioglossus EMG activity, which lasted from 5 min to 80 min after training on day 56 of training, than the NC group. The TST group showed significantly lower theoretical Pcrit values on days 28 and 56 of training than the NC group (-4.07±0.92 vs -3.12±0.77 cmH 2 O, P < 0.05, -4.66±0.74 vs -3.07±0.38 cmH 2 O, P < 0.01). Conclusion This study revealed that an 8-week TST could gradually and transiently increase corticomotor excitability of genioglossus, elevate the genioglossus EMG activity, and ultimately enhance the stability of the upper airway during daytime. Moreover, improved neuromuscular excitability occurred prior to the enhanced upper airway stability. These findings provide a theoretical foundation for TST as a promising treatment for OSA patients.

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“…This concept of considering individual anatomy guiding treatment is also evident in a study which developed a pediatric OSA algorithm and demonstrated that tonsil size was the strongest predictor of adenotonsillectomy (AT) [ 25 ]. Myofunctional therapy (MT) is another treatment option which involves oropharyngeal exercises and has been shown to decrease AHI by 50% in adults [ 26 , 27 ].…”

Section: Introductionmentioning

confidence: 99%

Barriers of artificial intelligence implementation in the diagnosis of obstructive sleep apnea

Brennan

Kirby

2022

Journal of Otolaryngology - Head & Neck Surgery

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Background Obstructive sleep apnea is a common clinical condition and has a significant impact on the health of patients if untreated. The current diagnostic gold standard for obstructive sleep apnea is polysomnography, which is labor intensive, requires specialists to utilize, expensive, and has accessibility challenges. There are also challenges with awareness and identification of obstructive sleep apnea in the primary care setting. Artificial intelligence systems offer the opportunity for a new diagnostic approach that addresses the limitations of polysomnography and ultimately benefits patients by streamlining the diagnostic expedition. Main body The purpose of this project is to elucidate the barriers that exist in the implementation of artificial intelligence systems into the diagnostic context of obstructive sleep apnea. It is essential to understand these challenges in order to proactively create solutions and establish an efficient adoption of this new technology. The literature regarding the evolution of the diagnosis of obstructive sleep apnea, the role of artificial intelligence in the diagnosis, and the barriers in artificial intelligence implementation was reviewed and analyzed. Conclusion The barriers identified were categorized into different themes including technology, data, regulation, human resources, education, and culture. Many of these challenges are ubiquitous across artificial intelligence implementation in any medical diagnostic setting. Future research directions include developing solutions to the barriers presented in this project. Graphical abstract

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Myofunctional therapy (oropharyngeal exercises) for obstructive sleep apnoea

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

Cited by 40 publications

References 73 publications

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

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

Tongue Strength Training Increases Daytime Upper Airway Stability in Rats

Barriers of artificial intelligence implementation in the diagnosis of obstructive sleep apnea

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