Journal of Otolaryngology and Ophthalmology of Shandong University ›› 2023, Vol. 37 ›› Issue (6): 153-158.doi: 10.6040/j.issn.1673-3770.0.2023.358

• Clinical Study • Previous Articles     Next Articles

Observation on the therapeutic effect of oropharyngeal exercise on adult obstructive sleep apnea hypopnea syndrome

DING Longqing1, LIU Yiming2, CHENG Zhuo3, SUN Ran3, LIANG Hui4   

  1. 1. Weifang Medical University, School of Clinical Medicine, Weifang 261053, Shandong, China2. Department of Otorhinolaryngology, Beijing Xiaotangshan Hospital, Beijing 102211, China3. Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan 250021, Shandong, China4. Department of Otorhinolaryngology & Head and Neck Surgery, the First Affiliated Hospital of Shandong First Medical University (Shandong Provincial Qianfoshan Hospital), Jinan 250014, Shandong, China
  • Published:2023-12-15

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Abstract: Objective This study aimed to observe the therapeutic effect of oropharyngeal exercise on adult obstructive sleep apnea hypopnea syndrome(OSAHS). Methods Sixty adult patients who met the diagnosis and inclusion criteria of OSAHS were randomly divided into the experimental and control groups. The experimental group was divided into the genioglossus, soft palate, and non-genioglossus groups and received pharyngeal muscle training with changes in the pharyngeal cavity for 12 weeks. The control group received oropharyngeal exercise training without changing the pharyngeal cavity for 12 weeks. The polysomnography indexes were collected before treatment and 12 weeks after treatment. Statistical software was used to analyze the difference of the curative effect of related indexes. Results There was no significant difference in the age, sex, and body mass index between the experimental and control groups(P=0.201, 0.439, 0.816, 0.326, 0.294). In the comparison of treatment effects, the apnea-hypopnea index(AHI)of each group was lower than that before treatment, and the difference was statistically significant(P=0.005, <0.001, 0.003, 0.001). The lowest oxygen saturation in the four groups was higher than that before treatment, and there was a significant difference between the four groups(P=0.019, 0.020, 0.001, 0.001). There was no significant difference in AHI and lowest oxygen saturation between the experimental and control groups(P=0.776, 0.770). Conclusion The mode of oropharyngeal exercise in the control and experimental groups is helpful in treating patients with OSAHS, and there is no significant difference among the four groups.

Key words: Obstructive sleep apnea hypopnea syndrome, Oropharyngeal exercise therapy, Polysomnography, Lowest oxygen saturation, Apnea-hypopnea index

CLC Number: 

  • R766.7
[1] Lv RJ, Liu XY, Zhang Y, et al. Pathophysiological mechanisms and therapeutic approaches in obstructive sleep apnea syndrome[J]. Signal Transduct Target Ther, 2023, 8(1): 218. doi:10.1038/s41392-023-01496-3
[2] Altay S, Fırat S, Peker Y, et al. A narrative review of the association of obstructive sleep apnea with hypertension: how to treat both when they coexist?[J]. J Clin Med, 2023, 12(12): 4144. doi:10.3390/jcm12124144
[3] Kurnool S, McCowen KC, Bernstein NA, et al. Sleep apnea, obesity, and diabetes-an intertwined trio[J]. Curr Diab Rep, 2023, 23(7): 165-171. doi:10.1007/s11892-023-01510-6
[4] Taylor KS, Murai H, Millar PJ, et al. Arousal from sleep and sympathetic excitation during wakefulness[J]. Hypertension, 2016, 68(6): 1467-1474. doi:10.1161/HYPERTENSIONAHA.116.08212
[5] Patil SP, Ayappa IA, Caples SM, et al. Treatment of adult obstructive sleep apnea with positive airway pressure: an American academy of sleep medicine clinical practice guideline[J]. J Clin Sleep Med, 2019, 15(2): 335-343. doi:10.5664/jcsm.7640
[6] Redline S, Azarbarzin A, Peker Y. Obstructive sleep apnoea heterogeneity and cardiovascular disease[J]. Nat Rev Cardiol, 2023, 20(8): 560-573. doi:10.1038/s41569-023-00846-6
[7] Kholdani C, Fares WH, Mohsenin V. Pulmonary hypertension in obstructive sleep apnea: is it clinically significant? A critical analysis of the association and pathophysiology[J]. Pulm Circ, 2015, 5(2): 220-227. doi:10.1086/679995
[8] Nokes B, Cooper J, Cao M. Obstructive sleep apnea: personalizing CPAP alternative therapies to individual physiology[J]. Expert Rev Respir Med, 2022, 16(8): 917-929. doi:10.1080/17476348.2022.2112669
[9] Lajoie AC, Gu Y, Lim A, et al. Adherence to continuous positive airway pressure for the treatment of obstructive sleep apnea in neurodegenerative diseases: a systematic review[J]. Sleep Med Rev, 2023, 71: 101836. doi:10.1016/j.smrv.2023.101836
[10] Carneiro-Barrera A, Díaz-Román A, Guillén-Riquelme A, et al. Weight loss and lifestyle interventions for obstructive sleep apnoea in adults: systematic review and meta-analysis[J]. Obes Rev, 2019, 20(5): 750-762. doi:10.1111/obr.12824
[11] Hamoda MM, Almeida FR, Pliska BT. Long-term side effects of sleep apnea treatment with oral appliances: nature, magnitude and predictors of long-term changes[J]. Sleep Med, 2019, 56: 184-191. doi:10.1016/j.sleep.2018.12.012
[12] Pang KP, Vicini C, Montevecchi F, et al. Long-term complications of palate surgery: a multicenter study of 217 patients[J]. Laryngoscope, 2020, 130(9): 2281-2284. doi:10.1002/lary.28432
[13] Hsu B, Emperumal CP, Grbach VX, et al. Effects of respiratory muscle therapy on obstructive sleep apnea: a systematic review and meta-analysis[J]. J Clin Sleep Med, 2020, 16(5): 785-801. doi:10.5664/jcsm.8318
[14] Guimarães KC, Drager LF, Genta PR, et al. Effects of oropharyngeal exercises on patients with moderate obstructive sleep apnea syndrome[J]. Am J Respir Crit Care Med, 2009, 179(10): 962-966. doi:10.1164/rccm.200806-981OC
[15] 中华医学会,中华医学会杂志社,中华医学会全科医学分会,等. 成人阻塞性睡眠呼吸暂停基层诊疗指南(2018年)[J]. 中华全科医师杂志, 2019, 18(1): 21-29. doi:10.3760/cma.j.issn.1671-7368.2019.01.007
[16] 李丹阳, 梁辉. 口面肌功能治疗对阻塞性睡眠呼吸暂停研究进展[J]. 山东大学耳鼻喉眼学报, 2021, 35(4): 108-114. doi: 10.6040/j.issn.1673-3770.0.2020.286 LI Danyang, LIANG Hui. Advancements in orofacial myofunctional therapy for obstructive sleep apnea[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2021, 35(4): 108-114. doi: 10.6040/j.issn.1673-3770.0.2020.286
[17] Lavie L. Oxidative stress in obstructive sleep apnea and intermittent hypoxia: revisited: the bad ugly and good: implications to the heart and brain[J]. Sleep Med Rev, 2015, 20: 27-45. doi:10.1016/j.smrv.2014.07.003
[18] Azagra-Calero E, Espinar-Escalona E, Barrera-Mora JM, et al. Obstructive sleep apnea syndrome(OSAS). Review of the literature[J]. Med Oral Patol Oral Cir Bucal, 2012, 17(6): e925-e929. doi:10.4317/medoral.17706
[19] Pan L, Meng FQ, Zhang L, et al. Global research trends of obstructive sleep apnea from 2011 to 2020: a 10-year bibliometric analysis[J]. Ann Palliat Med, 2022, 11(5): 1671-1686. doi:10.21037/apm-21-2237
[20] Senaratna CV, Perret JL, Lodge CJ, et al. Prevalence of obstructive sleep apnea in the general population: a systematic review[J]. Sleep Med Rev, 2017, 34: 70-81. doi:10.1016/j.smrv.2016.07.002
[21] Jordan AS, McSharry DG, Malhotra A. Adult obstructive sleep apnoea[J]. Lancet, 2014, 383(9918): 736-747. doi:10.1016/S0140-6736(13)60734-5
[22] de Felício CM, da Silva Dias FV, Trawitzki LVV. Obstructive sleep apnea: focus on myofunctional therapy[J]. Nat Sci Sleep, 2018, 10: 271-286. doi:10.2147/NSS.S141132
[23] Verma RK, Johnson J JR, Goyal M, et al. Oropharyngeal exercises in the treatment of obstructive sleep apnoea: our experience[J]. Schlaf Atmung, 2016, 20(4): 1193-1201. doi:10.1007/s11325-016-1332-1
[24] Tang SX, Qing J, Wang YW, et al. Clinical analysis of pharyngeal musculature and genioglossus exercising to treat obstructive sleep apnea and hypopnea syndrome[J]. J Zhejiang Univ Sci B, 2015, 16(11): 931-939. doi:10.1631/jzus.B1500100
[25] Bonsignore MR. Obesity and obstructive sleep apnea[J]. Handb Exp Pharmacol, 2022, 274: 181-201. doi:10.1007/164_2021_558
[26] Kong DQ, Hu CH, Zhu HL. Oxygen desaturation index, lowest arterial oxygen saturation and time spent below 90% oxygen saturation as diagnostic markers for obstructive sleep apnea[J]. Am J Transl Res, 2023, 15(5): 3597-3606
[27] 中华耳鼻咽喉头颈外科杂志编辑委员会,中华医学会耳鼻咽喉头颈外科学分会咽喉学组. 阻塞性睡眠呼吸暂停低通气综合征诊断和外科治疗指南[J]. 中华耳鼻咽喉头颈外科杂志, 2009, 44(2): 95-96. doi:10.3760/cma.j.issn.1673-0860.2009.02.003
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