Chye, Gan Boon
(2018)
Oropharyngeal exercises as adjunct therapy to the management of obstructive sleep apnea.
Masters thesis, Universiti Sains Malaysia.
Abstract
Introduction
Obstructive sleep apnea (OSA) can be treated with weight reduction through diet and exercise,
usage of intraoral lingual retainer and mandibular advancement device and continuous positive
airway pressure (CPAP) machine. Most common operations such as adenotonsillectomy can reach
only about 50% effectiveness. Due to the difficulty in losing substantial weight, financial factor in
getting CPAP machine as well as high risk for operative procedures, there is a role for a more
favorable alternative treatment such as oropharyngeal exercises. Oropharyngeal exercises consist
of 4 tongue exercises, 1 soft palate exercise and 5 facial muscles exercises that will increase the
tone of oropharyngeal and tongue muscles that collapse during sleep after 3 months of exercises.
Objectives
To determine the effectiveness of oropharyngeal exercises as an adjunct therapy in the
management of OSA.
Methodology
A prospective randomized controlled trial study was carried out on age 18 to 80 years old patients
with confirmed diagnosis of OSA through PSG in Hospital Sultan Abdul Halim, Sungai Petani,
Kedah from March 2016 to February 2017.
Fifty consented OSA patients who fulfilled inclusion criteria were randomized into 2 groups,
where therapy group of patients were taught oropharyngeal exercises while the control group were
taught deep breathing exercises. After 3 months of 3 times daily exercises, patient will bereassessed by repeat interview using Epworth Sleepiness Scale, Thornton Snoring scale, flexible
scope with Muller’s maneuver and subsequently repeat PSG with blinded sleep technician.
Result
There was no significant changes in control group of 25 patients. In the group that performed
oropharyngeal exercises, there were significant reduction of Epworth Sleepiness Scale and
Thornton Snoring Scale scored (p = 0.001 and p < 0.001) respectively. There was improvement in
modified Mallampati grading (p = 0.030). Flexible endoscopy with Muller’s maneuver also
showed reduction of collapse over retropalatal level (p = 0.022). In PSG, the apnea-hypopnea index
showed significant reduction (p < 0.001).
Conclusion
Oropharyngeal exercises significantly improve snoring, daytime somnolence and lifestyle based
on subjective scoring from questionnaires and objective measurement through scope findings and
PSG results. Oropharyngeal exercises can be used as an alternative or adjunct therapy in the
management of OSA.
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