Tongue-muscle Training by Intraoral Electrical Neurostimulation in Patients with Obstructive Sleep Apnea

Randerath, Winfried; Galetke, Wolfgang; Domanski, U; Weitkunat, Rolf; Rühle, K. H.

doi:10.1093/sleep/27.2.254

Cited by 87 publications

(84 citation statements)

References 36 publications

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“…Changes in morphology and proportion of fiber type consistent with muscle injury have been observed in the upper airway dilator muscles, both in animal models of OSA 15 and in OSA patients. 16 Randerath et al 5 found that training of the tongue muscles by electrostimulation was effective in reducing snoring in OSA patients. A significant reduction in symptoms and overall severity was demonstrated in patients with moderate OSA following an extensive oropharyngeal exercise program, derived from speech therapy.…”

Section: Discussionmentioning

confidence: 99%

“…In 2002, Mann and colleagues 4 demonstrated that electrical stimulation of the genioglossus muscle causes an increase in diameter of the hypopharyngeal airway. In a similar study, Randernath and associates 5 also showed that stimulation training of the tongue can be effective in reducing snoring, but they failed to fi nd an effect for OSA. Although it would be impractical to propose a similar electrical shock-based treatment for OSA at this time, these studies do suggest that increasing muscle tone of the upper airway could be benefi cial for patients with OSA.…”

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confidence: 95%

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Risk of Obstructive Sleep Apnea Lower in Double Reed Wind Musicians

Ward

York

McCoy

2012

Journal of Clinical Sleep Medicine

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Study Objectives: Obstructive sleep apnea (OSA) is caused by a collapse of the upper airway. Respiratory muscle training with a wind instrument (didgeridoo) in patients with moderate OSA has been previously shown to improve OSA symptomology. However, a survey of orchestra members did not indicate a difference in OSA risk between wind and non-wind instrumentalist. The present study examines whether playing of different wind instrument types may affect the risk of OSA. Methods: A national sample of active musicians (n = 906) was surveyed through the internet. Participants' risk for OSA was determined by the Berlin Questionnaire. Additional survey items included questions about general health and musical experience. Results: A binary logistic regression was conducted to determine if OSA risk was predicted by gender, age, number of years playing instrument, number of hours per week playing instrument, and instrument type. Musicians who played a double reed instrument had a lower risk of OSA (p = 0.047) than non-wind instrumentalists. Additionally, in double reed instrumentalists, the number of hours spent playing the instrument predicted lower OSA risk (p = 0.020). The risk for OSA in other wind instruments (i.e., single reed, high brass, and low brass) was not signifi cantly different from non-wind musicians. Conclusions: Playing a double reed musical instrument was associated with a lower risk of OSA.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 95%

Risk of Obstructive Sleep Apnea Lower in Double Reed Wind Musicians

Ward

York

McCoy

2012

Journal of Clinical Sleep Medicine

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“…Preliminary results of case studies and one cohort showed improvements of the AHI, daytime sleepiness and snoring [122,123]. The only placebo-controlled double-blind study on tongue muscle training found an improvement of snoring but no significant reduction of AHI [124].…”

Section: Tongue Muscle Training By Electrical Stimulationmentioning

confidence: 99%

Non-CPAP therapies in obstructive sleep apnoea

Randerath

Verbraecken²,

Andreas³

et al. 2011

Eur Respir J

309

179

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In view of the high prevalence and the relevant impairment of patients with obstructive sleep apnoea syndrome (OSAS) lots of methods are offered which promise definitive cures for or relevant improvement of OSAS.This report summarises the efficacy of alternative treatment options in OSAS.An interdisciplinary European Respiratory Society task force evaluated the scientific literature according to the standards of evidence-based medicine.Evidence supports the use of mandibular advancement devices in mild to moderate OSAS. Maxillomandibular osteotomy seems to be as efficient as continuous positive airway pressure (CPAP) in patients who refuse conservative treatment. Distraction osteogenesis is usefully applied in congenital micrognathia or midface hypoplasia. There is a trend towards improvment after weight reduction. Positional therapy is clearly inferior to CPAP and long-term compliance is poor. Drugs, nasal dilators and apnoea triggered muscle stimulation cannot be recommended as effective treatments of OSAS at the moment. Nasal surgery, radiofrequency tonsil reduction, tongue base surgery, uvulopalatal flap, laser midline glossectomy, tongue suspension and genioglossus advancement cannot be recommended as single interventions. Uvulopalatopharyngoplasty, pillar implants and hyoid suspension should only be considered in selected patients and potential benefits should be weighed against the risk of long-term side-effects. Multilevel surgery is only a salvage procedure for OSA patients.

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“…Although such approaches may lead to reduced severity of OSA for some patients, as is discussed below, given the heterogeneity of OSA pathogenesis such an approach will likely not resolve sleep-disordered breathing for all patients. Nonetheless, there is evidence to suggest that novel training exercises of upper airway muscles may lead to some improvement in sleep-disordered breathing (36,37). However, on the basis of the state dependence of OSA, muscle training during wakefulness is unlikely to have major effects on airway patency during sleep unless the increased muscle activity/efficiency is maintained during sleep.…”

Section: Upper Airway Dilator Muscle Activity and Reflex Responsivenessmentioning

confidence: 99%

Pathophysiology of Adult Obstructive Sleep Apnea

Eckert¹,

Malhotra²

2008

Proceedings of the American Thoracic Society

524

321

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Obstructive sleep apnea (OSA) is a common disorder characterized by repetitive narrowing or collapse of the pharyngeal airway during sleep. The disorder is associated with major comorbidities including excessive daytime sleepiness and increased risk of cardiovascular disease. The underlying pathophysiology is multifactorial and may vary considerably between individuals. Important risk factors include obesity, male sex, and aging. However, the physiological mechanisms underlying these risk factors are not clearly understood. This brief review summarizes the current understanding of OSA pathophysiology in adults and highlights the potential mechanisms underlying the principal risk factors. In addition, some of the pathophysiological characteristics associated with OSA that may modulate disease severity are illustrated. Finally, the potential for novel treatment strategies, based on an improved understanding of the underlying pathophysiology, is also discussed with the ultimate aim of stimulating research ideas in areas where knowledge is lacking.

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Tongue-muscle Training by Intraoral Electrical Neurostimulation in Patients with Obstructive Sleep Apnea

Abstract: Although tongue-muscle training cannot generally be recommended for the treatment of sleep apnea, the method has proven to be effective in the treatment of snoring.

Cited by 87 publications

References 36 publications

Risk of Obstructive Sleep Apnea Lower in Double Reed Wind Musicians

Risk of Obstructive Sleep Apnea Lower in Double Reed Wind Musicians

Non-CPAP therapies in obstructive sleep apnoea

Pathophysiology of Adult Obstructive Sleep Apnea

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