Navarro Andrés, Bosco Gabriela, Serrano Bárbara, Baptista Peter, O'Connor-Reina Carlos, Plaza Guillermo
Department of Otorhinolaryngology, Hospital Universitario de Fuenlabrada, Universidad Rey Juan Carlos, C.P. 28042 Madrid, Spain.
Department of Otorhinolaryngology, Hospital Universitario Sanitas La Zarzuela, C.P. 28023 Madrid, Spain.
J Clin Med. 2025 Jul 7;14(13):4781. doi: 10.3390/jcm14134781.
: Myofunctional therapy has emerged as a treatment option for obstructive sleep apnea (OSA). The Iowa Oral Performance Instrument (IOPI) enables objective measurement of lingual and orofacial muscle strength, although it was originally designed for evaluating dysphagia. OSA is frequently associated with a hypotonic phenotype characterized by reduced strength in upper airway muscles, but its identification remains unclear. : We evaluated the usefulness of IOPI measurements in identifying hypotonic phenotypes among patients with obstructive sleep apnea (OSA). : We carried out a cross-sectional study analyzing the relationship between IOPI scores, sleep polygraphy metrics-such as the apnea-hypopnea index (AHI)-and findings from physical examination. In addition to the standard IOPI protocol, we introduced novel maneuvers aimed at providing a more comprehensive assessment of oropharyngeal muscle function. : Although IOPI conventional maneuvers showed no clear association with AHI or ODI, the inferior tongue maneuver showed higher awake tongue strength, with a statistically significant correlation to both AHI (r = 0.2873; = 0.008) and ODI (r = 0.2495; = 0.032). Performing each exercise three times yielded highly consistent results across trials (r > 0.94), but did not significantly alter the overall outcome. Interestingly, lower tongue strength values were observed in patients with a high-arched palate ( < 0.05), whereas no relevant associations were found with the presence of a restricted lingual frenulum or CPAP use. : Incorporating specific IOPI maneuvers, especially the inferior tongue exercise, may provide additional insight into muscle function in OSA. Selective repetition is advisable for borderline values.
肌功能治疗已成为阻塞性睡眠呼吸暂停（OSA）的一种治疗选择。爱荷华口腔功能仪器（IOPI）能够客观测量舌部和口面部肌肉力量，尽管它最初是为评估吞咽困难而设计的。OSA常与一种以气道上部肌肉力量减弱为特征的低张表型相关，但对其识别仍不明确。
我们评估了IOPI测量在识别阻塞性睡眠呼吸暂停（OSA）患者低张表型方面的有用性。
我们进行了一项横断面研究，分析IOPI评分、睡眠多导监测指标（如呼吸暂停低通气指数（AHI））与体格检查结果之间的关系。除了标准的IOPI方案外，我们还引入了旨在更全面评估口咽肌肉功能的新操作。
尽管IOPI传统操作与AHI或氧减指数（ODI）无明显关联，但舌下部操作显示清醒时舌部力量更高，与AHI（r = 0.287³；P = 0.008）和ODI（r = 0.2495；P = 0.032）均有统计学意义的相关性。每项练习重复三次在各试验中产生了高度一致的结果（r > 0.⁹⁴），但未显著改变总体结果。有趣的是，高拱腭患者的舌部力量值较低（P < 0.05），而未发现与舌系带过短或使用持续气道正压通气（CPAP）存在相关关联。
纳入特定的IOPI操作，尤其是舌下部练习，可能会为OSA患者的肌肉功能提供更多见解。对于临界值，建议选择性重复测量。
