Oropharyngeal exercises to reduce symptoms of OSA after AT

Villa, Maria Pia; Brasili, Luca; Ferretti, Alessandro; Vitelli, Ottavio; Rabasco, Jole; Mazzotta, Anna Rita; Pietropaoli, Nicoletta; Martella, Susy

doi:10.1007/s11325-014-1011-z

Cited by 92 publications

(100 citation statements)

References 28 publications

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“…e) One retrospective cohort study evaluated the efficacy of an intranasal corticosteroid combined with oral montelukast for persistent OSAS post-operatively (class IV) [225]. Myofunctional re-education by nasal and oropharyngeal exercises has been implemented following adenotonsillectomy to treat residual OSAS or to prevent its recurrence but the published evidence involves only two studies of low methodological quality (class III and IV) [226,227]. Orofacial muscular training is used to: prevent tongue and orofacial muscles hypotonia; encourage their appropriate position during wakefulness and sleep; re-establish nasal breathing; and eliminate mouth-breathing and pharyngeal airway obstruction [228].…”

Section: Literature Reviewmentioning

confidence: 99%

Obstructive sleep disordered breathing in 2- to 18-year-old children: diagnosis and management

et al. 2015

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This document summarises the conclusions of a European Respiratory Society Task Force on the diagnosis and management of obstructive sleep disordered breathing (SDB) in childhood and refers to children aged 2-18 years. Prospective cohort studies describing the natural history of SDB or randomised, double-blind, placebo-controlled trials regarding its management are scarce. Selected evidence (362 articles) can be consolidated into seven management steps. SDB is suspected when symptoms or abnormalities related to upper airway obstruction are present (step 1). Central nervous or cardiovascular system morbidity, growth failure or enuresis and predictors of SDB persistence in the long-term are recognised (steps 2 and 3), and SDB severity is determined objectively preferably using polysomnography (step 4). Children with an apnoea-hypopnoea index (AHI) >5 episodes·h, those with an AHI of 1-5 episodes·h −1 and the presence of morbidity or factors predicting SDB persistence, and children with complex conditions (e.g. Down syndrome and Prader-Willi syndrome) all appear to benefit from treatment (step 5). Treatment interventions are usually implemented in a stepwise fashion addressing all abnormalities that predispose to SDB (step 6) with re-evaluation after each intervention to detect residual disease and to determine the need for additional treatment (step 7). @ERSpublications Management of obstructive sleep disordered breathing in childhood should follow a stepwise approach

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Section: Literature Reviewmentioning

confidence: 99%

Obstructive sleep disordered breathing in 2- to 18-year-old children: diagnosis and management

et al. 2015

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“…It is interesting to point out that 4 studies involve specifically the applicability and results of OMT for children [11][12][13][14] , two case-control reports 13,14 and two retrospective studies 11,12 .…”

Section: Literature Reviewmentioning

confidence: 99%

Effects of orofacial myofunctional therapy on the symptoms and physiological parameters of sleep breathing disorders in adults: a systematic review

Kayamori

Bianchini

2017

Rev. CEFAC

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Recently, the orofacial myofunctional therapy (OMT) has appeared as a possible alternative treatment for obstructive sleep apnea (OSA). Systematic reviews are required to achieve scientific evidence, seeking to direct the decision on therapeutic issues. The aim of this study was to systematically review the literature about the OMT proposals in adults with OSA related to symptoms and physiological parameters. Data sources were Lilacs, MEDLINE, Pubmed, Cochrane and Scielo using the descriptors: obstructive sleep apnea; myofunctional therapy; oropharyngeal exercises; breathing exercises; upper airway exercises; speech therapy. Studies published from 2000 to 2017 that evaluated the treatment with isolated OMT in subjects with OSA were included, obligatorily with polysomnographic data, pre and post therapy. Eight studies, out of 124 articles, were eligible according to the criteria adopted. Two systematic reviews, one clinical trial, three randomized clinical trials, and two case reports were included. Six studies showed a decrease in the Apnea and Hypopnea Index (AHI), five studies showed improvement in the minimum SpO2, decrease in the Epworth Sleepiness Scale (ESS) and in snoring. OMT proposals refer to a three-month program changing the parameters related to partial reduction of AHI, ESS index, snoring, and partial increase of SpO2. There are few randomized studies.

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“…Researchers have also observed OMDs in patients (children and adults) with obstructive sleep apnea (OSA) (5)(6)(7)(8)(9)(10)(11)(12). Obstructive sleep apnea is a complex sleep disorder, the pathogenesis of which is not yet fully understood; it is characterized by repetitive episodes of upper airway occlusion during sleep, and its typical symptoms include snoring during sleep and excessive daytime sleepiness (13).…”

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Validity and reliability of a protocol of orofacial myofunctional evaluation for patients with obstructive sleep apnea

2015

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There is no standardized protocol for the clinical evaluation of orofacial components and functions in patients with obstructive sleep apnea. The aim of this study was to examine the validity, reliability, and psychometric properties of the Expanded Protocol of Orofacial Myofunctional Evaluation with Scores (OMES-expanded) in subjects with obstructive sleep apnea. Patients with obstructive sleep apnea and control subjects were evaluated, and the validity of OMES-expanded was tested by construct validity (i.e. the ability to discriminate orofacial status between apneic and control subjects) and criterion validity (i.e. correlation between OMES-expanded and a reference instrument). Construct validity was adequate; the apneic group showed significantly worse orofacial status than did control subjects. Criterion validity of OMES-expanded was good, as was its reliability. The OMES-expanded is valid and reliable for evaluating orofacial myofunctional disorders of patients with obstructive sleep apnea, with adequate psychometric properties. It may be useful to plan a therapeutic strategy and to determine whether the effects of therapy are related to improved muscle and orofacial functions.

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Oropharyngeal exercises to reduce symptoms of OSA after AT

Abstract: Oropharyngeal exercises may be considered as complementary therapy to adenotonsillectomy to effectively treat pediatric OSA.

Cited by 92 publications

References 28 publications

Obstructive sleep disordered breathing in 2- to 18-year-old children: diagnosis and management

Obstructive sleep disordered breathing in 2- to 18-year-old children: diagnosis and management

Effects of orofacial myofunctional therapy on the symptoms and physiological parameters of sleep breathing disorders in adults: a systematic review

Validity and reliability of a protocol of orofacial myofunctional evaluation for patients with obstructive sleep apnea

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