Journal of Otolaryngology and Ophthalmology of Shandong University ›› 2021, Vol. 35 ›› Issue (4): 108-114.doi: 10.6040/j.issn.1673-3770.0.2020.286

Previous Articles     Next Articles

Advancements in orofacial myofunctional therapy for obstructive sleep apnea

LI Danyang,LIANG Hui   

  1. Department of Otorhinolaryngology, The First Hospital Affiliated Hospital of Shandong First Medical University/Shandong provincial Qianfoshan Hospital, Jinan 250000, Shandong, China
  • Published:2021-08-05

PDF (PC)

421

Abstract: Objective The purpose of this study was to systematically review exercises of orofacial myofunctional therapy(OMT)and the mechanism of OMT to treat obstructive sleep apnea(OSA). Methods Studies extracted from PubMed, China National Knowledge Infrastructure, and Wanfang Medical Online up to June 2020 were included. Results Twenty-four studies involving adults and children were analyzed. Among them, 14 studies were on OSA in adults, while 10 were on OSA in children. Twenty studies measured the Apnea-Hypopnea Index and showed improvement, but the degree of improvement varied with the OSA severity and treatment time. Conclusion This study showed that OMT significantly affected simple snoring and mild to severe OSA in adults and pediatric OSA and could be used as an alternative treatment for OSA. However, the mechanism of OSA is unclear, and further studies are required because of the small number of clinical trials and sample size.

Key words: Sleep apnea, obstructive, Oroficial myofunctional therapy, Oropharyngeal exercises, Adult, Children

CLC Number: 

  • R766.7
[1] Patil SP, Schneider H, Schwartz AR, et al. Adult obstructive sleep apnea[J]. Chest, 2007, 132(1): 325-337. doi:10.1378/chest.07-0040.
[2] Afsharpaiman S, Shahverdi E, Vahedi E, et al. Continuous positive airway pressure compliance in patients with obstructive sleep apnea[J]. Tanaffos, 2016, 15(1): 25-30.
[3] Schwartz AR, Gold AR, Schubert N, et al. Effect of weight loss on upper airway collapsibility in obstructive sleep apnea[J]. Am Rev Respir Dis, 1991, 144(3 pt 1): 494-498. doi:10.1164/ajrccm/144.3_pt_1.494.
[4] Schmidt-Nowara W, Lowe A, Wiegand L, et al. Oral appliances for the treatment of snoring and obstructive sleep apnea: a review[J]. Sleep, 1995, 18(6): 501-510. doi:10.1093/sleep/18.6.501.
[5] Langin T, Pépin JL, Pendlehury S, et al. Upper airway changes in snorers and mild sleep apnea sufferers after uvulopalatopharyngoplasty(UPPP)[J]. Chest, 1998, 113(6): 1595-1603. doi:10.1378/chest.113.6.1595.
[6] Wiegand DA, Latz B, Zwillich CW, et al. Upper airway resistance and geniohyoid muscle activity in normal men during wakefulness and sleep[J]. J Appl Physiol, 1990, 69(4): 1252-1261. doi:10.1152/jappl.1990.69.4.1252.
[7] 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.
[8] Mohamed AS, Sharshar RS, Elkolaly RM, et al. Upper airway muscle exercises outcome in patients with obstructive sleep apnea syndrome[J]. Egypt J Chest Dis Tuberc, 2017, 66(1): 121-125. doi:10.1016/j.ejcdt.2016.08.014.
[9] Ieto V, Kayamori F, Montes MI, et al. Effects of oropharyngeal exercises on snoring: a randomized trial[J]. Chest, 2015, 148(3): 683-691. doi:10.1378/chest.14-2953.
[10] Baz H, Elshafey M, Elmorsy M, et al. The role of myofunctional therapy in maneging patients with mild to moderate obstructive sleep apnea[J]. PAN Arab Journal of Rhinology, 2012, 2(1):17-22.
[11] Diaféria G, Badke L, Santos-Silva R, et al. Effect of speech therapy as adjunct treatment to continuous positive airway pressure on the quality of life of patients with obstructive sleep apnea[J]. Sleep Med, 2013, 14(7): 628-635. doi:10.1016/j.sleep.2013.03.016.
[12] Diaféria G, Santos-Silva R, Truksinas E, et al. Myofunctional therapy improves adherence to continuous positive airway pressure treatment[J]. Sleep Breath, 2017, 21(2): 387-395. doi:10.1007/s11325-016-1429-6.
[13] Verma RK, Johnson J JR, Goyal M, et al. Oropharyngeal exercises in the treatment of obstructive sleep apnoea: our experience[J]. Sleep Breath, 2016, 20(4): 1193-1201. doi:10.1007/s11325-016-1332-1.
[14] 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.
[15] Eckert DJ, White DP, Jordan AS, et al. Defining phenotypic causes of obstructive sleep apnea. identification of novel therapeutic targets[J]. Am J Respir Crit Care Med, 2013, 188(8): 996-1004. doi:10.1164/rccm.201303-0448oc.
[16] McSharry DG, Saboisky JP, DeYoung P, et al. Physiological mechanisms of upper airway hypotonia during REM sleep[J]. Sleep, 2014, 37(3): 561-569. doi:10.5665/sleep.3498.
[17] Genta PR, Sands SA, Butler JP, et al. Airflow shape is associated with the pharyngeal structure causing OSA[J]. Chest, 2017, 152(3): 537-546. doi:10.1016/j.chest.2017.06.017.
[18] Hirata RP, Schorr F, Kayamori F, et al. Upper airway collapsibility assessed by negative expiratory pressure while awake is associated with upper airway anatomy[J]. J Clin Sleep Med, 2016, 12(10): 1339-1346. doi:10.5664/jcsm.6184.
[19] Osman AM, Carter SG, Carberry JC, et al. Obstructive sleep apnea: current perspectives[J]. Nat Sci Sleep, 2018, 10: 21-34. doi:10.2147/nss.s124657.
[20] 沈翎, 林宗通, 林兴, 等. 儿童阻塞性睡眠呼吸暂停低通气综合征危险因素的病例对照研究[J]. 山东大学耳鼻喉眼学报, 2018, 32(2): 25-29. doi:10.6040/j.issn.1673-3770.0.2018.086. SHEN Ling, LIN Zongtong, LIN Xing, et al. Risk factors associated with obstructive sleep apnea-hypopnea syndrome in children: a retrospective case-control study[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2018, 32(2): 25-29. doi:10.6040/j.issn.1673-3770.0.2018.086.
[21] Shepherd KL, Jensen CM, Maddison KJ, et al. Relationship between upper airway and inspiratory pump muscle force in obstructive sleep apnea[J]. Chest, 2006, 130(6): 1757-1764. doi:10.1378/chest.130.6.1757.
[22] Engelke W, Engelhardt W, Mendoza-Gärtner M, et al. Functional treatment of snoring based on the tongue-repositioning manoeuvre[J]. Eur J Orthod, 2010, 32(5): 490-495. doi:10.1093/ejo/cjp135.
[23] Cori JM, O'Donoghue FJ, Jordan AS. Sleeping tongue: current perspectives of genioglossus control in healthy individuals and patients with obstructive sleep apnea[J]. Nat Sci Sleep, 2018, 10: 169-179. doi:10.2147/nss.s143296.
[24] Blottner D, Salanova M, Püttmann B, et al. Human skeletal muscle structure and function preserved by vibration muscle exercise following 55 days of bed rest[J]. Eur J Appl Physiol, 2006, 97(3): 261-271. doi:10.1007/s00421-006-0160-6.
[25] Steele CM, Alsanei WA, Ayanikalath S, et al. The influence of food texture and liquid consistency modification on swallowing physiology and function: a systematic review[J]. Dysphagia, 2015, 30(1): 2-26. doi:10.1007/s00455-014-9578-x.
[26] Suzuki H, Watanabe A, Akihiro Y, et al. Pilot study to assess the potential of oral myofunctional therapy for improving respiration during sleep[J]. J Prosthodont Res, 2013, 57(3): 195-199. doi:10.1016/j.jpor.2013.02.001.
[27] Vranish JR, Bailey EF. Inspiratory muscle training improves sleep and mitigates cardiovascular dysfunction in obstructive sleep apnea[J]. Sleep, 2016, 39(6): 1179-1185. doi:10.5665/sleep.5826.
[28] Kuo YC, Song TT, Bernard JR, et al. Short-term expiratory muscle strength training attenuates sleep apnea and improves sleep quality in patients with obstructive sleep apnea[J]. Respir Physiol Neurobiol, 2017, 243: 86-91. doi:10.1016/j.resp.2017.05.007.
[29] Herkenrath SD, Treml M, Priegnitz C, et al. Effects of respiratory muscle training(RMT)in patients with mild to moderate obstructive sleep apnea(OSA)[J]. Sleep Breath, 2018, 22(2): 323-328. doi:10.1007/s11325-017-1582-6.
[30] Matsumura E, Vecina ALC, Inocêncio LB, et al. Perception of the bed partner and the individual suffering from SNORING/OSAS before and after speech therapy[J]. Rev Cefac, 2014, 16. doi: 10.1590/1982-0216201425612.
[31] Atilgan E, Kunter E, Algun ZC. Are oropharyngeal exercises effective in Obstructive Sleep Apnea Syndrome?[J]. J Back Musculoskelet Rehabil, 2020, 33(2): 209-216. doi:10.3233/bmr-171101.
[32] 刘文君, 于雪莹, 吕丹, 等. 不同性别阻塞性睡眠呼吸暂停低通气综合征患者与上气道影像学相关性的研究[J]. 山东大学耳鼻喉眼学报, 2017, 31(4): 54-59. doi:10.6040/j.issn.1673-3770.0.2017.100. LIU Wenjun, YU Xueying, LYU Dan, et al. Correlation between obstructive sleep apnea hypopnea syndrome and upper airway measurements of different genders[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2017, 31(4): 54-59. doi:10.6040/j.issn.1673-3770.0.2017.100.
[33] Katz ES, D'Ambrosio CM. Pathophysiology of pediatric obstructive sleep apnea[J]. Proc Am Thorac Soc, 2008, 5(2): 253-262. doi:10.1513/pats.200707-111mg.
[34] Camacho M, Certal V, Abdullatif J, et al. Myofunctional therapy to treat obstructive sleep apnea: a systematic review and meta-analysis[J]. Sleep, 2015, 38(5): 669-675. doi:10.5665/sleep.4652.
[35] Villa MP, Brasili L, Ferretti A, et al. Oropharyngeal exercises to reduce symptoms of OSA after AT[J]. Sleep Breath, 2015, 19(1): 281-289. doi:10.1007/s11325-014-1011-z.
[36] Guilleminault C, Huang YS, Monteyrol PJ, et al. Critical role of myofascial reeducation in pediatric sleep-disordered breathing[J]. Sleep Med, 2013, 14(6): 518-525. doi:10.1016/j.sleep.2013.01.013.
[37] Lee SY, Guilleminault C, Chiu HY, et al. Mouth breathing, “nasal disuse, ” and pediatric sleep-disordered breathing[J]. Sleep Breath, 2015, 19(4): 1257-1264. doi:10.1007/s11325-015-1154-6.
[38] von Lukowicz M, Herzog N, Ruthardt S, et al. Effect of a 1-week intense myofunctional training on obstructive sleep apnoea in children with Down syndrome[J]. Arch Dis Child, 2019, 104(3): 275-279. doi:10.1136/archdischild-2018-315064.
[39] Levrini L, Salone GS, Ramirez-Yanez GO. Pre-fabricated myofunctional appliance for the treatment of mild to moderate pediatric obstructive sleep apnea: a preliminary report[J]. J Clin Pediatr Dent, 2018, 42(3): 236-239. doi:10.17796/1053-4628-42.3.13.
[40] Chuang LC, Lian YC, Hervy-Auboiron M, et al. Passive myofunctional therapy applied on children with obstructive sleep apnea: a 6-month follow-up[J]. J Formos Med Assoc, 2017, 116(7): 536-541. doi:10.1016/j.jfma.2016.08.002.
[41] Chuang LC, Hwang YJ, Lian YC, et al. Changes in craniofacial and airway morphology as well as quality of life after passive myofunctional therapy in children with obstructive sleep apnea: a comparative cohort study[J]. Sleep Breath, 2019, 23(4): 1359-1369. doi:10.1007/s11325-019-01929-w.
[42] Huang YS, Hsu SC, Guilleminault C, et al. Myofunctional therapy: role in pediatric OSA[J]. Sleep Med Clin, 2019, 14(1): 135-142. doi:10.1016/j.jsmc.2018.10.004.
[43] Huang YS, Chuang LC, Hervy-Auboiron M, et al. Neutral supporting mandibular advancement device with tongue bead for passive myofunctional therapy: a long term follow-up study[J]. Sleep Med, 2019, 60: 69-74. doi:10.1016/j.sleep.2018.09.013.
[44] Villa MP, Evangelisti M, Martella S, et al. Can myofunctional therapy increase tongue tone and reduce symptoms in children with sleep-disordered breathing?[J]. Sleep Breath, 2017, 21(4): 1025-1032. doi:10.1007/s11325-017-1489-2.
[45] Arens R, McDonough JM, Corbin AM, et al. Upper airway size analysis by magnetic resonance imaging of children with obstructive sleep apnea syndrome[J]. Am J Respir Crit Care Med, 2003, 167(1):65-70.
[1] WANG Xingxin, YANG Xinyu, ZHENG Xiaojun, DING Lin, SHENG Yawen, BI Xiaoyun, YANG Jiguo. Acupoint application therapy for adenoid hypertrophy in children: a case report [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(5): 122-124.
[2] ZHANG Fengzhen, WANG Guixiang, WEI Yunyun, ZHANG Yamei, ZHAO Jing, WANG Hua, LI Hongbin, LI Xiaodan, ZHANG Jie. Perioperative management of children with mild bleeding disorders undergoing adenotonsillectomy procedures [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(4): 66-72.
[3] LU Weili, JIANG Tao, LI Xianhua. Analysis of sIgE in polysensitized children with allergic rhinitis [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(3): 260-265.
[4] YANG Yang, WANG Xiaoxu, ZHANG Jie. Progress on diagnosis and treatment of middle ear cholesteatoma in children [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(1): 1-6.
[5] GAO Xinzhong, LING Zongtong, SHEN Ling, LIU Pingfang, LIN Xin, XU Yangyang. Analysis of the efficacy of balloon eustachian tuboplasty combined with adenoidectomy in the treatment of otitis media with effusion in children [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(1): 7-12.
[6] HU Chunyan, DANG Panhong, ZHANG Rui, FAN Mengyun. Analysis of audiological and imaging characteristics of 149 children with unilateral sensorineural hearing loss [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(1): 31-36.
[7] DANG Panhong, ZHANG Rui, HU Chunyan, WANG Jie, FAN Mengyun. Clinical analysis of facial nerve decompression via an external transmastoid-subtemporal labyrinth approach in eight children [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(1): 37-42.
[8] LIU Shanshan, HAN Shujing, WANG Xiaoxu, LI Yanhong, NI Xin, ZHANG Jie. Hearing loss in children after bacterial meningitis: a systematic review and meta-analysis [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(1): 48-54.
[9] JIAO Xuemei, YANG Yang, LI Chunfeng, ZHANG Xiaolin. Effect of tympanic membrane insertion on the function of eustachian tube in children with secretory otitis media [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(1): 60-63.
[10] WANG Pengpeng, GE Wentong, TANG Lixing, YANG Xiaojian, ZHANG Wei, XIAO Xiao, HAN Yang. Four cases of open rhinoplasty approach for congenital nasal dermoid and sinus cysts in children and literature review [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(1): 64-69.
[11] LI Menghui, ZHI Lili, QI Kaiwen, WANG Shanshan, GAO Qian, BU Meiling,. Clinical research of subcutaneous immunotherapy on children with allergic asthma caused by dust mites and combined with mold allergen [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(1): 75-80.
[12] CHEN Kun, LU Hui, HUANG Qi, LI Lei, MENG Guozhen, YANG Jun, HOU Dongming. Clinical diagnosis and treatment of congenital nasal sinus mass in children [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(1): 81-85.
[13] SHI Xiaoli, MU Hong. Multidisciplinary diagnosis and treatment of a child with severe obstructive sleep apnea syndrome complicated by pulmonary hypertension [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(1): 116-119.
[14] ZHAO Xinghe, FAN Mingyue, DOU Xunwu, JIA Guangbiao. Primary large B-cell lymphoma of tonsil in children: a case report and document review [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(1): 120-124.
[15] YUAN Chenyang, LIU Yan, FANG Zhensheng. Advances on the effect of OSAHS on pulmonary function in children [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(1): 143-148.
Viewed
Full text


Abstract

Cited
  Shared   
  Discussed   
[1] . [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2006, 20(1): 84 -87 .
[2] NIU Shanli,CHAI Maowen,LI Zhenxiu . Endoscopic rhinoplasty of inferior turbinate in 60 patients with chronic hypertrophic rhinitis[J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2006, 20(1): 16 -18 .
[3] MENG Qing-guo,LU Yong-tian,FAN Xian-liang .

Association of killer cell immunoglobulin-like receptor gene polymorphisms with nasopharyngeal carcinoma

[J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2008, 22(3): 196 -199 .
[4] . [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2008, 22(3): 199 -199 .
[5] WAN Li-jia,LU Hai-tao,JIANG Yi-dao,LIU Hui,LI Qin,SHE La-zhi . Effect of H-uvulopalatopharyngoplasty on obstructive sleep apnea
hypopnea syndrome[J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2008, 22(3): 204 -205 .
[6] . [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2008, 22(3): 222 -224 .
[7] JI Xiao-bin,DENG Jia-de,ZANG Lin-quan,WANG Lei,XIE Jun . Blood histamine in guinea pigs with allergic rhinitis[J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2008, 22(3): 228 -230 .
[8] XIANG Deng,LU Yong-tian,SUN Huan-ji . Endoscopic repair for cerebrospinal fluid rhinorrhea in 19 cases and a literature review [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2008, 22(3): 234 -236 .
[9] . [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2008, 22(3): 253 -257 .
[10]
YIN Guo-hua,ZHONG Xiao . Long-term effect of laser reduction on lingua adenoids
[J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2008, 22(3): 280 -282 .
Website Copyright: Editorial Office of Journal of Otolaryngology and Ophthalmology of Shandong University
Address: No.27 Shanda South Road, Jinan, Shandong, China. Post code: 250100 Tel: +86-0531-88366912 Email: ebhxb@sdu.edu.cn Supported by Beijing Magtech Co.Ltd