The effect of orofacial myofunctional therapy on biometrics and compliance of positive airway pressure therapy in patients with obstructive sleep apnea.

BACKGROUND

Obstructive sleep apnea (OSA) is a common sleep disorder associated with significant health risks. Positive airway pressure (PAP) therapy is the primary treatment for OSA but often presents challenges for patients due to varying patient phenotypes and adherence difficulties. Orofacial myofunctional therapy (OMT) is a potential adjunctive treatment that enhances muscle tone and coordination, which may reduce PAP pressure requirements and improve adherence. This study aimed to investigate the effects of a 3-month OMT intervention on auto-adjusting positive airway pressure (APAP) parameters (maximum, 95th percentile, and mean) and compliance in OSA patients.

METHODS

A prospective cohort intervention study was conducted at Naresuan University Hospital involving 70 OSA patients aged 18-80 years on APAP therapy. Participants underwent a 3-month OMT program, performing twice-daily exercises targeting the palate, tongue, and facial muscles. APAP pressure data and compliance were collected before and after the intervention. Statistical analysis was performed using a multivariate multilevel Gaussian regression model to assess changes in pressure over time. APAP compliance was analyzed using student's t-test and the signed-rank test, with statistical significance set at P < 0.05.

RESULTS

Statistically significant reductions in all APAP parameters were observed subsequent to OMT: mean pressure (-0.50 cmH2O, 95% CI: -0.66, -0.32), 95th percentile pressure (-0.68 cmH2O, 95% CI: -0.89, -0.47), and maximum pressure (-1.14 cmH2O, 95% CI: -1.47, -0.80). Additionally, APAP adherence significantly improved, with average nightly usage increasing from 5.86 ± 1.27 h to 6.42 ± 1.23 h.

CONCLUSION

A 3-month OMT program effectively reduced APAP pressure requirements and improved adherence in OSA patients. While pre-OMT data suggested a gradual increase in APAP pressure needs over time, OMT counteracted this trend by addressing both anatomical and non-anatomical factors. These findings support OMT as a valuable adjunctive therapy for enhancing PAP therapy outcomes.