Department of Child Psychiatry and Sleep Center, Chang Gung Memorial Hospital and College of Medicine, Taoyuan, Taiwan; Department of Craniofacial Research Center and Sleep Center, Chang Gung Memorial Hospital and College of Medicine, Chang Gung University, Taoyuan, Taiwan.
Department of Pediatric Dentistry, Chang Gung Memorial Hospital and College of Medicine, Taoyuan, Taiwan.
Sleep Med. 2019 Aug;60:69-74. doi: 10.1016/j.sleep.2018.09.013. Epub 2018 Sep 29.
Myofunctional therapy has been reported to be a valid adjunct treatment to OSA, but compliance was mentioned as an issue. We performed a prospective study on age matched randomized children submitted to myofunctional therapy (MFT) or to a functional device used during sleep (passive MFT).
110 children 4 to 16 were recruited for the study, 54 children were in the MFT group [A] while 56 were in the "nocturnal device" group [B]. Clinical evaluation, polysomnography and cephalometric X-Rays were performed at baseline, 6 months and 12 months, with clinical follow-up at 3 months.
MFT group show very important absence of compliance, at six months only 23 subjects participated and only 10/23 had been compliant with treatment. None came back for research investigation at 12 months. 48/56 of passive MFT children ended the research protocol at 12 months. Comparison of baseline to 6 and 12 months data showed that all children with passive MFT improved (PSG and cephalometrics) and had nasal breathing during sleep at 1 year, and no negative effect of device were noted. The 10 children compliant with MFT showed clear improvement of sleep related breathing with also changes at cephalometric -X-rays.
Compliance is a major problem of MFT, and MFT will have to take into consideration the absolute need to have continuous parental involvement in the procedure. Passive MFT gives many more positive results, but potential negative effects of device on other jaw will have to be continuously evaluated.
肌功能疗法已被报道为 OSA 的有效辅助治疗方法，但依从性是一个问题。我们对接受肌功能疗法（MFT）或睡眠时使用的功能性设备（被动 MFT）的年龄匹配的随机儿童进行了前瞻性研究。
110 名 4 至 16 岁的儿童被招募参加研究，54 名儿童被纳入 MFT 组 [A]，56 名儿童被纳入“夜间设备”组 [B]。基线、6 个月和 12 个月时进行临床评估、多导睡眠图和头影测量 X 光检查，并在 3 个月时进行临床随访。
MFT 组的依从性非常差，6 个月时只有 23 名受试者参与，只有 10/23 名受试者依从治疗。12 个月时没有人回来进行研究调查。48/56 名接受被动 MFT 的儿童在 12 个月时完成了研究方案。与基线相比，6 个月和 12 个月的数据显示，所有接受被动 MFT 的儿童（PSG 和头影测量）均有改善，并且在 1 年内睡眠时均有鼻呼吸，并且未发现器械的负面影响。10 名依从 MFT 的儿童的睡眠相关呼吸明显改善，头影测量 X 光也有变化。
依从性是 MFT 的主要问题，MFT 将不得不考虑到持续获得父母参与该程序的绝对必要性。被动 MFT 带来了更多积极的结果，但设备对其他下颌的潜在负面影响将需要不断评估。
