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Sleep Breath. 2019 Dec 7. doi: 10.1007/s11325-019-01957-6. [Epub ahead of print]

Development and evaluation of myofunctional therapy support program (MTSP) based on self-efficacy theory for patients with obstructive sleep apnea.

Kim J1,2, Oh EG2,3, Choi M2,3, Choi SJ4, Joo EY5, Lee H6,7, Kim HY8.

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Strategy and Planning, Samsung Medical Center, Seoul, Republic of Korea.
College of Nursing, Yonsei University, 03722, Seoul, Republic of Korea.
Mo-Im Kim Nursing Research Institute, Yonsei University, Seoul, Republic of Korea.
Department of Nursing, Department of Clinical Nursing Science, Graduate School of Clinical Nursing Science, Samsung Medical Center, Sungkyunkwan University, Seoul, Republic of Korea.
Department of Neurology, Neuroscience Center, Samsung Biomedical Research Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
College of Nursing, Yonsei University, 03722, Seoul, Republic of Korea.
Mo-Im Kim Nursing Research Institute, Yonsei University, Seoul, Republic of Korea.
Department of Otorhinolaryngology - Head and Neck Surgery, Sungkyunkwan University School of Medicine, Samsung Medical Center, 06351, Seoul, Republic of Korea.



The aim of this study is to determine the impact of myofunctional therapy support program (MTSP) based on self-efficacy theory compared to no support during myofunctional therapy (MT) in patients with obstructive sleep apnea (OSA).


Thirty-one patients with OSA were randomized into two groups: 12 weeks of treatment with the MTSP developed in this study (experimental group) and one education session of MT (control group). Patients were evaluated at the beginning and the end of the study using questionnaires (self-efficacy scale, Epworth Sleepiness Scale, Pittsburgh Sleep Quality Index, snoring intensity and frequency, dry mouth) and polysomnography.


The control (n = 15) and experimental (n = 16) groups had similar results for all variables at study entry. The control group showed no significant change in any variables during the study period. In contrast, the experimental group showed a significant increase in self-efficacy 61.38 ± 9.50 to 65.56 ± 10.89 (p = 0.020) and a significant decrease in apnea-hypopnea index (AHI) 19.51 ± 11.41 to 14.11 ± 9.13 (p = 0.039), daytime sleepiness 9.88 ± 3.84 to 7.56 ± 3.42 (p = 0.028), snoring intensity 5.57 ± 3.13 to 4.44 ± 2.68 (p = 0.008), and dry mouth 6.44 ± 3.14 to 3.63 ± 2.33 (p = 0.005), compared to the baseline. No significant change in lowest SaO2 (p = 0.969), sleep quality (p = 0.307), and snoring frequency (p = 0.321) during the study period.


The intensive and interactive intervention of MTSP improved the self-efficacy of OSA patients, and consequently, resulted in sign and symptom relief, such as AHI, daytime sleepiness, snoring and dry mouth. The MTSP was dedicated to the nurse practitioner to improve the way to dispense the MT. This research has implications for the successful treatment of OSA.


Myofunctional therapy; Obstructive sleep apnea; Self-efficacy


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