Do oropharyngeal exercises reduce sleepiness in people with sleep apnoea?

Do oropharyngeal exercises reduce sleepiness in people with sleep apnoea?

Vanessa Jordan
PEARLS No.
667
Clinical question

What are the benefits and harms of myofunctional therapy (oropharyngeal exercises) for the treatment of obstructive sleep apnoea?

Bottom line

Compared with sham therapy, waiting list or standard medical treatment in adults, myofunctional therapy may improve daytime sleepiness and sleep quality in the short term.

Compared with continuous positive airway pressure (CPAP) or myofunctional therapy in combination with CPAP, myofunctional therapy alone may result in little to no difference in daytime sleepiness, may increase apnoea–hypopnoea index (AHI) and may result in little to no difference in snoring frequency and snoring intensity.

Compared with respiratory exercises plus nasal dilator strip, myofunctional therapy may result in little to no difference in daytime sleepiness, probably increases sleep quality slightly and may result in little to no difference in AHI.

In children, compared with nasal washing alone, adding myofunctional therapy may result in little to no difference in AHI.

Caveat

None of the studies looked at morbidity (including accidents and cardiovascular diseases), mortality or quality of life. The length of interventions and follow‐up periods in the included studies were short (fewer than 4 months). Therefore, it is not clear whether potential beneficial effects of the treatment will endure in the medium and long term, or whether compliance with the treatment will persist.

Context

Obstructive sleep apnoea is a sleep disorder. People with OSA have periods where their breathing stops during the night. OSA can cause snoring, unsatisfactory rest, daytime sleepiness, low energy or fatigue, tiredness, initial insomnia and morning headaches. Myofunctional therapy teaches people to do daily exercises to strengthen their tongue and throat muscles. Myofunctional therapy may reduce the intensity of OSA symptoms, including daytime sleepiness, on its own or in combination with CPAP.

Cochrane Systematic Review

Rueda J-R, et al. Myofunctional therapy (oropharyngeal exercises) for obstructive sleep apnoea. Cochrane Database Syst Rev 2020, Issue 11. Art. No.: CD013449. DOI: 10.1002/14651858.CD013449.pub2. This review contains 9 trials with a total of 425 participants.