Department of Chest Diseases, Faculty of Medicine, Dokuz Eylül University, Izmir, Turkey.
Department of Pulmonary Rehabilitation, School of Physical Therapy and Rehabilitation, Dokuz Eylül University, Izmir, Turkey.
Sleep Breath. 2022 Jun;26(2):567-574. doi: 10.1007/s11325-021-02423-y. Epub 2021 Jun 24.
Obstructive sleep apnea (OSA) is an important public health problem. Beyond common treatment options, solution-oriented options are needed. Oropharyngeal exercise training may be a research area in this respect. This study aimed to evaluate the effects of oropharyngeal exercise (OPE) in addition to continuous positive airway pressure (CPAP) therapy in patients diagnosed with OSA.
Patients with moderate and severe OSA were screened from the electronic database of our hospital and 41 patients (20: exercise group; 21: control group) were included in the study. Each patient was assessed with CPAP usage time, maximal voluntary ventilation (MVV), maximum inspiratory and expiratory pressure (MIP-MEP), neck circumference, body mass index (BMI), waist-hip ratio, Epworth sleepiness score, Pittsburgh sleep quality index (PSQI), and short-form health survey (SF-36) in the first visit. The OPE was prescribed in addition to CPAP for the exercise group and performed by the patients for 3 months. At the end of the third month, groups were re-assessed with the same parameters.
Most of the patients were men, and the mean age of the study population was 51.9 ± 7.4; the mean apnea-hypopnea index (AHI) in the last polysomnography report was 53.3 ± 27.4. In the exercise group, MVV (p = 0.003), MIP (p = 0.002), MEP (p = 0.024), and SF-36 energy/fatigue (p = 0.020) were observed to increase while the total PSQI score (p = 0.036) decreased. The neck circumference (p = 0.006) and BMI (p = 0.013) were found to be significantly decreased in the exercise group.
We found that OPE training may have improved respiratory muscle strength as well as sleep quality and health-related quality of life in the exercise group. OPE along with CPAP therapy may be recommended in moderate and severe OSA patients who are willing to participate.
阻塞性睡眠呼吸暂停（OSA）是一个重要的公共卫生问题。除了常见的治疗方法外，还需要有针对性的解决方案。口咽运动训练可能是这方面的一个研究领域。本研究旨在评估口咽运动（OPE）在中重度 OSA 患者中除 CPAP 治疗之外的疗效。
从我院电子数据库中筛选出中重度 OSA 患者，共纳入 41 例患者（20 例：运动组；21 例：对照组）。每位患者在首次就诊时评估 CPAP 使用时间、最大自主通气量（MVV）、最大吸气和呼气压力（MIP-MEP）、颈围、体重指数（BMI）、腰臀比、Epworth 嗜睡评分、匹兹堡睡眠质量指数（PSQI）和简明健康调查问卷（SF-36）。运动组在 CPAP 治疗的基础上增加 OPE，患者自行进行 3 个月的 OPE。在第三个月结束时，两组均重新评估上述参数。
大多数患者为男性，研究人群的平均年龄为 51.9±7.4 岁；最后一次多导睡眠图报告中的平均呼吸暂停低通气指数（AHI）为 53.3±27.4。在运动组中，MVV（p=0.003）、MIP（p=0.002）、MEP（p=0.024）和 SF-36 能量/疲劳（p=0.020）增加，而总的 PSQI 评分（p=0.036）降低。运动组的颈围（p=0.006）和 BMI（p=0.013）明显降低。
我们发现 OPE 训练可能改善了运动组的呼吸肌力量以及睡眠质量和健康相关生活质量。对于愿意参与的中重度 OSA 患者，建议将 OPE 与 CPAP 治疗联合应用。
