Myofunctional therapy for obstructive sleep apnoea

Abstract

Failure of upper airway muscles to develop efficient dilating forces plays a key role in the occurrence of obstructive sleep apnoea in given patients. Thus, myofunctional therapy has been developed to improve the activity/efficacy of the upper airway (UA) dilator muscles, reduce its fatigability and improve mechanical performance. Various programmes, differing in the types of daytime exercises to be completed, as well as in their duration and intensity, have been evaluated. Meta-analysis confirmed the efficacy of myofunctional therapy, with mean apnoea hypopnoea index (AHI) scores decreasing from 28.0 ± 16.2/h to 18.6 ± 13.1/h, and lowest oxygen saturation (LSAT) values improving from 83.2% ± 6.1% to 85.1% ± 7.0%. In children, MT and nasal washing may result in little to no difference in AHI. Integrating oropharyngeal exercises with the use of a smartphone application to complete and record exercise performances represents an innovative turn in the development of ambulatory MT programmes. Since adherence to therapy is a weakness in conventional OSA strategies such as CPAP, this approach to MT is promising, as evidenced by a 90% mean adherence to it after 3 months of using a smart application. There is further need to determine the most effective combination of exercise algorithms and identify the target population most likely to benefit from MT in outpatient training programmes.

Keywords: Adherence; desaturation; upper airway.