Department of Otolaryngology Head and Neck Surgery, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, China.
Department of Otolaryngology Head and Neck Surgery, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, China.
Am J Otolaryngol. 2024 Jul-Aug;45(4):104274. doi: 10.1016/j.amjoto.2024.104274. Epub 2024 Apr 3.
To investigate the effects of oropharyngeal exercise on continuous positive airway pressure (CPAP) compliance in patients with moderate to severe obstructive sleep apnea over a period of 6 months.
This study was conducted as a prospective, observational, and interventional investigation. A total of 70 patients with moderate to severe obstructive sleep apnea were randomly assigned to either the oropharyngeal exercise group (n = 44) or the sham-therapy group (n = 26). The compliance of the enrolled patients with CPAP therapy was assessed at baseline, 3-month follow-up and 6-month follow-up. Objective sleep data, questionnaire and CPAP use time were collected over a half-year period (i.e., baseline, 6 months, and 12 months).
The study found that the average use time of CPAP within one month was significantly longer in the oropharyngeal exercises group compared to the sham-therapy group at the 3-month assessment (5.5 ± 1.2 vs 4.8 ± 1.3 h per night; p=0.030), and much significantly longer at 6-months assessment (6.0 ± 1.4 vs 4.9 ± 1.3 h per night; p=0.001). Furthermore, the average use time of CPAP increased over time, with the oropharyngeal exercises group exhibiting a more pronounced growth from baseline to the six-month follow-up (4.8 ± 1.0 h per night to 6.0 ± 1.3 h per night, p < 0.001) compared to the sham-therapy group (4.8 ± 1.3 h per night to 4.9 ± 1.3 h per night, p=0.952). Additionally, the oropharyngeal exercise group demonstrated an improvement in the Epworth sleepiness scale compared to the sham-therapy group at the 3-month follow-up (6.0 ± 2.0 vs 8.8 ± 3.2; p < 0.001), as well as decreased significantly at 6-month follow-up (p = 0.032).
CPAP adherence can be improved with oropharyngeal exercises therapy among moderate to severe OSA patients. Notably, the average duration of CPAP usage and reduction in daytime sleepiness were maintained even after six months of oropharyngeal exercise therapy.
研究口咽运动对中重度阻塞性睡眠呼吸暂停患者持续气道正压通气（CPAP）顺应性的影响，为期 6 个月。
本研究为前瞻性、观察性和干预性研究。共纳入 70 例中重度阻塞性睡眠呼吸暂停患者，随机分为口咽运动组（n=44）和假治疗组（n=26）。在基线、3 个月随访和 6 个月随访时评估纳入患者 CPAP 治疗的顺应性。在半年内（即基线、6 个月和 12 个月）收集客观睡眠数据、问卷调查和 CPAP 使用时间。
研究发现，在 3 个月评估时，口咽运动组患者一个月内 CPAP 的平均使用时间明显长于假治疗组（5.5±1.2 比 4.8±1.3 小时/夜；p=0.030），在 6 个月评估时明显更长（6.0±1.4 比 4.9±1.3 小时/夜；p=0.001）。此外，CPAP 的平均使用时间随时间增加，口咽运动组从基线到 6 个月随访时的增长更为明显（4.8±1.0 小时/夜到 6.0±1.3 小时/夜，p<0.001），而假治疗组无明显变化（4.8±1.3 小时/夜到 4.9±1.3 小时/夜，p=0.952）。此外，与假治疗组相比，口咽运动组在 3 个月随访时Epworth 嗜睡量表评分改善（6.0±2.0 比 8.8±3.2；p<0.001），6 个月随访时评分显著降低（p=0.032）。
中重度 OSA 患者行口咽运动治疗可提高 CPAP 依从性。值得注意的是，即使在 6 个月的口咽运动治疗后，CPAP 的平均使用时间和白天嗜睡的减少仍能维持。
