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Sleep. 2015 May 1;38(5):669-75. doi: 10.5665/sleep.4652.

Myofunctional Therapy to Treat Obstructive Sleep Apnea: A Systematic Review and Meta-analysis.

Author information

1
Department of Psychiatry, Division of Sleep Medicine, Stanford Hospital and Clinics, Redwood City, CA.
2
Department of Otorhinolaryngology/ Sleep Medicine Centre, Hospital CUF Porto; CINTESIS, Center for Research in Health Technologies and Information Systems, University of Porto, Porto, Portugal.
3
Department of Otorhinolaryngology, Hospital Bernardino Rivadavia, Buenos Aires, Argentina.
4
Department of Head and Neck Surgery, University of California, Los Angeles, CA.
5
Department of Otolaryngology, Head and Neck Surgery, Sleep Surgery Division, Stanford University Medical Center, Stanford, CA.

Abstract

OBJECTIVE:

To systematically review the literature for articles evaluating myofunctional therapy (MT) as treatment for obstructive sleep apnea (OSA) in children and adults and to perform a meta-analysis on the polysomnographic, snoring, and sleepiness data.

DATA SOURCES:

Web of Science, Scopus, MEDLINE, and The Cochrane Library.

REVIEW METHODS:

The searches were performed through June 18, 2014. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement was followed.

RESULTS:

Nine adult studies (120 patients) reported polysomnography, snoring, and/or sleepiness outcomes. The pre- and post-MT apneahypopnea indices (AHI) decreased from a mean ± standard deviation (M ± SD) of 24.5 ± 14.3/h to 12.3 ± 11.8/h, mean difference (MD) -14.26 [95% confidence interval (CI) -20.98, -7.54], P < 0.0001. Lowest oxygen saturations improved from 83.9 ± 6.0% to 86.6 ± 7.3%, MD 4.19 (95% CI 1.85, 6.54), P = 0.0005. Polysomnography snoring decreased from 14.05 ± 4.89% to 3.87 ± 4.12% of total sleep time, P < 0.001, and snoring decreased in all three studies reporting subjective outcomes. Epworth Sleepiness Scale decreased from 14.8 ± 3.5 to 8.2 ± 4.1. Two pediatric studies (25 patients) reported outcomes. In the first study of 14 children, the AHI decreased from 4.87 ± 3.0/h to 1.84 ± 3.2/h, P = 0.004. The second study evaluated children who were cured of OSA after adenotonsillectomy and palatal expansion, and found that 11 patients who continued MT remained cured (AHI 0.5 ± 0.4/h), whereas 13 controls had recurrent OSA (AHI 5.3 ± 1.5/h) after 4 y.

CONCLUSION:

Current literature demonstrates that myofunctional therapy decreases apnea-hypopnea index by approximately 50% in adults and 62% in children. Lowest oxygen saturations, snoring, and sleepiness outcomes improve in adults. Myofunctional therapy could serve as an adjunct to other obstructive sleep apnea treatments.

KEYWORDS:

exercise therapy/methods; myofunctional therapy/methods; obstructive sleep apnea; sleep apnea syndromes

PMID:
25348130
PMCID:
PMC4402674
DOI:
10.5665/sleep.4652
[Indexed for MEDLINE]
Free PMC Article

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