Authors: (including presenting author): :
Chan KW(1), Ho SY(2), Chung CKJ(2), Chan KP(3), Lui MS(3)
Affiliation: :
(1)Department of Speech Therapy, Queen Mary Hospital (2)Department of Ear, Nose and Throat, Queen Mary Hospital (3)Department of Medicine, Queen Mary Hospital
Keyword 1: :
obstructive sleep apnea
Keyword 2: :
orofacial myofunctional therapy
Introduction: :
One of the pathophysiology of obstructive sleep apnoea (OSA) were recurrent upper airway collapse during sleep, resulting in hypoxemia or apnoea during sleep. Orofacial myofunctional therapy (OMT) was considered a potential alternative treatment for patients with mild-to-moderate OSA, especially for those who were unable to tolerate continuous positive airway pressure (CPAP) and oral appliance (OA). A meta‑analysis demonstrated approximate 50% reduction in apnoea–hypopnea index (AHI) in adults after OMT, alongside improvements in minimum oxygen saturation, snoring, and Epworth Sleepiness Scale scores (Camacho et al., 2015).
Objectives: :
OMT encompasses a special set of orofacial exercise targeted to strengthen oral and pharyngeal muscles and improve tongue posture and nasal breathing. This retrospective study aimed to evaluate the effects of OMT in the management of OSA in the local population.
Methodology: :
From September 2023 to December 2025, 16 patients were referred by Department of Ear, Nose and Throat and Department of Medicine at the Queen Mary Hospital for OMT. Inclusion criteria included mild-to-moderate OSA and intolerance of CPAP and OA as conventional OSA treatment. Exclusion criteria included obesity and history of neurological diseases, including but not limited to stroke and brain tumour. Patients who met the inclusion criteria completed 5-8 sessions of OMT therapy sessions by speech therapist. Patients completed pre- and post-treatment orofacial myofunctional evaluation and sleep study, either by in-lab polysomnography or home sleep apnoea test, to assess for treatment efficacy in sleep and orofacial myology. Sleep study parameters including AHI, sleep efficiency and minimum oxygen saturation, and jaw range of opening, anterior and posterior tongue range of motion ratio from orofacial myofunctional evaluation were compared by non-parametric and parametric tests based on their properties.
Result & Outcome: :
Sixteen patients (10 females and 6 males) aged between 52-76 years old were recruited. AHI dropped from 18.8+/-6,4 (Median = 20.2) to 13.7+/-7.7 (Median = 11.5) after completion of the treatment course, (z = -2.707, p < .05), with a moderate effect size (r = -0.656). Sleep efficiency and minimum oxygen saturation before and after OMT did not show statistically significant change. Jaw range of opening and anterior tongue range of motion ratio also did not show significant improvement. However, posterior tongue range of motion ratio improved from 56.9%+/-16.9% to 62.3%+/-12.1% (p < .05) and daytime sleepiness improved from 10.3+/-5.3 to 8.0+/-4.4 (p < .05) after OMT. The study showed promising results in the implementation of OMT in the management of mild-to-moderate OSA in non-obese patients. OMT could be a safe and tolerable treatment modality for OSA patients, especially for those who did not tolerate conventional treatment modalities.
