This Article Full Text Full Text (PDF) Online Video Supplement All Versions of this Article: 200806-981OCv1 179/10/962    most recent Alert me when this article is cited Alert me if a correction is posted Services Related articles in AJRCCM Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Guimarães, K. C. Articles by Lorenzi-Filho, G. Search for Related Content PubMed PubMed Citation Articles by Guimarães, K. C. Articles by Lorenzi-Filho, G.

Effects of Oropharyngeal Exercises on Patients with Moderate Obstructive Sleep Apnea Syndrome

¹ Sleep Laboratory, Pulmonary Division, Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil

Correspondence and requests for reprints should be addressed to Geraldo Lorenzi-Filho, M.D., Ph.D., Sleep Laboratory, Pulmonary Division, Heart Institute (InCor), University of São Paulo Medical School, Av Dr Enéas Carvalho de Aguiar, 44, CEP 05403-904, São Paulo, Brazil. E-mail: geraldo.lorenzi{at}incor.usp.br

Rationale: Upper airway muscle function plays a major role in maintenance of the upper airway patency and contributes to the genesis of obstructive sleep apnea syndrome (OSAS). Preliminary results suggested that oropharyngeal exercises derived from speech therapy may be an effective treatment option for patients with moderate OSAS.

Objectives: To determine the impact of oropharyngeal exercises in patients with moderate OSAS.

Methods: Thirty-one patients with moderate OSAS were randomized to 3 months of daily (30 min) sham therapy (n = 15, control) or a set of oropharyngeal exercises (n = 16), consisting of exercises involving the tongue, soft palate, and lateral pharyngeal wall.

Measurements and Main Results: Anthropometric measurements, snoring frequency (range 0–4), intensity (1–3), Epworth daytime sleepiness (0–24) and Pittsburgh sleep quality (0–21) questionnaires, and full polysomnography were performed at baseline and at study conclusion. Body mass index and abdominal circumference of the entire group were 30.3 ± 3.4 kg/m² and 101.4 ± 9.0 cm, respectively, and did not change significantly over the study period. No significant change occurred in the control group in all variables. In contrast, patients randomized to oropharyngeal exercises had a significant decrease (P < 0.05) in neck circumference (39.6 ± 3.6 vs. 38.5 ± 4.0 cm), snoring frequency (4 [4–4] vs. 3 [1.5–3.5]), snoring intensity (3 [3–4] vs. 1 [1–2]), daytime sleepiness (14 ± 5 vs. 8 ± 6), sleep quality score (10.2 ± 3.7 vs. 6.9 ± 2.5), and OSAS severity (apnea-hypopnea index, 22.4 ± 4.8 vs. 13.7 ± 8.5 events/h). Changes in neck circumference correlated inversely with changes in apnea-hypopnea index (r = 0.59; P < 0.001).

Conclusions: Oropharyngeal exercises significantly reduce OSAS severity and symptoms and represent a promising treatment for moderate OSAS.

Clinical trial registered with www.clinicaltrials.gov (NCT 00660777).

Key Words: obstructive sleep apnea • treatment • oropharyngeal exercises

AT A GLANCE COMMENTARY Scientific Knowledge on the Subject Continuous positive airway pressure is the treatment of choice for obstructive sleep apnea syndrome (OSAS) but is not suitable for a large proportion of patients. Alternative treatments for OSAS have shown variable results. What This Study Adds to the Field This randomized controlled trial showed that oropharyngeal exercises developed for the treatment of OSAS significantly reduced OSAS severity and symptoms. This novel modality of OSAS treatment represents a promising approach for moderate OSAS.

 

Related articles in AJRCCM:

On the Plausibility of Upper Airway Remodeling as an Outcome of Orofacial Exercise

Catriona M. Steele
AJRCCM 2009 179: 858-859. [Full Text]  

This article has been cited by other articles:

				Oropharyngeal Exercises for Sleep Apnea? Journal Watch (General), May 19, 2009; 2009(519): 2 - 2. [Full Text]

				C. M. Steele On the Plausibility of Upper Airway Remodeling as an Outcome of Orofacial Exercise Am. J. Respir. Crit. Care Med., May 15, 2009; 179(10): 858 - 859. [Full Text] [PDF]