Myofunctional Therapy (Oropharyngeal Exercises) For Obstructive Sleep Apnoea

Cochrane Database of Systematic Reviews

Rueda, J. R., Mugueta-Aguinaga, I., et al. (2020).

Cochrane Database of Systematic Reviews, 11(11), Cd013449.

This systematic review and meta-analysis investigates the benefits and harms of orofacial myofunctional therapy (OMT) in children and adults with obstructive sleep apnea (OSA). Of note, obstructive sleep apnea measurement and outcomes are not within the speech-language pathologist's scope of practice, but providing OMT is within the purview of the speech-language pathologist.

No funding received

From database inception to May 1, 2020

Randomized Controlled Trials

9, with 8 included in meta-analysis

<div>Of note, limitations to this review include low overall certainty of evidence, risk of bias, and overall paucity of research. Interpret conclusions with cautions. Further research is needed. In adults, orofacial myofunctional therapy:</div> <ul> <li><span style="color: #333333;">When compared to sham treatment, probably reduces daytime sleepiness, may increase sleep quality, may reduced subjective snoring intensity, may have little to no effect in reduction of snoring frequency, and may result in a large reduction the number of apnea or hypopnea events recorded during the polysomnography study per hour of sleep (Apnea-Hypopnea Index [AHI]; Very Low to Moderate Certainty of Evidence). </span></li> <li><span style="color: #333333;">When compared to waiting list, may reduce daytime sleepiness, may result in little to no difference in sleep quality and may reduce AHI (Low Certainty of Evidence). </span></li> <li><span style="color: #333333;">When compared to CPAP, may result in little to no difference in daytime sleepiness and may increase AHI (Low Certainty of Evidence). </span></li> <li><span style="color: #333333;">When compared to CPAP plus myofunctional therapy, may result in little to no difference in daytime sleepiness and may increase AHI (Low to Moderate Certainty of Evidence). </span></li> <li><span style="color: #333333;">When compared to respiratory exercises plus nasal dilator strip, 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 (Low Certainty of Evidence). </span></li> <li><span style="color: #333333;">When compared to standard medical treatment, may reduce daytime sleepiness and may increase sleep quality (Low Certainty of Evidence).</span></li> </ul>

<div>Limited research was found regarding the effect of orofacial myofunctional therapy in children with sleep apnea. Results consisted of a singular study with a sample size of 13. Conclusions should be interpreted with caution. In children, compared to nasal washing alone, adding myofunctional therapy to nasal washing may result in little to no difference in AHI (Low Certainty of Evidence).</div>