What is myofunctional therapy?
Myofunctional therapy teaches people to do daily exercises to strengthen their tongue and throat muscles. Myofunctional therapy may reduce the intensity of the OSA symptoms and reduce daytime sleepiness on its own, or combined with CPAP. Therapy can include exercises involving several muscles and areas of the mouth, pharynx and upper respiratory tract, working on functions such as speaking, breathing, blowing, sucking, chewing or swallowing. Read the full review here.
What is OSA?
Obstructive sleep apnoea (OSA) is a sleeping 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.
Continuous positive airway pressure (CPAP) is considered the first treatment option for most people with OSA. However, adherence to CPAP is often poor. A CPAP machine uses a hose and mask or nosepiece to deliver constant and steady air pressure. People who use CPAP often say that using the machine is uncomfortable, causes nasal congestion and abdominal bloating. They can feel claustrophobic and the machine is noisy. The noise can disturb bed partners. Therefore alternative treatments are needed.
What was the aim of the review?
The review aimed to evaluate the benefits and harms of myofunctional therapy (oropharyngeal exercises) for the treatment of obstructive sleep apnoea.
What was found in the review?
Review authors found nine RCT studies that analysed a total of 347 participants, 69 of them women, and 13 children.
- In adults, compared to sham therapy, myofunctional therapy probably reduces daytime sleepiness, may increase sleep quality, may result in a large reduction in Apnoea‐Hypopnoea Index (the number of apnoea’s or hypopnoeas recorded during the polysomnography study per hour of sleep), may have little to no effect in reduction of snoring frequency and probably reduces subjective snoring intensity slightly.
- Compared to waiting list, myofunctional therapy may reduce daytime sleepiness, may result in little to no difference in sleep quality and may reduce AHI.
- Compared to CPAP, myofunctional therapy may result in little to no difference in daytime sleepiness and may increase AHI.
- Compared to CPAP plus myofunctional therapy, myofunctional therapy alone may result in little to no difference in daytime sleepiness and may increase AHI.
- Compared to 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.
- Compared to standard medical treatment, myofunctional therapy may reduce daytime sleepiness and may increase sleep quality.
- In children, compared to nasal washing alone, adding myofunctional therapy to nasal washing may result in little to no difference in AHI.
The authors assigned all results to be from moderate to very low certainty. Mainly due to problems related to risk of bias (for inadequate blinding of participants and incomplete outcome data in some studies) and imprecision. Most of the participants in the studies were men and authors could not undertake separate analyses for women.
Compared to sham therapy, myofunctional therapy probably reduces daytime sleepiness and may increase sleep quality in the short term in patients with obstructive sleep apnoea. New blinded studies, with more participants and longer times of treatment and follow‐up, are needed.
This summary was prepared by Emma Dennett and it is adapted from the plain language summary provided with the review.