European Archives of Oto-Rhino-Laryngology

, Volume 275, Issue 4, pp 849–855 | Cite as

Oropharyngeal and tongue exercises (myofunctional therapy) for snoring: a systematic review and meta-analysis

  • Macario CamachoEmail author
  • Christian Guilleminault
  • Justin M. Wei
  • Sungjin A. Song
  • Michael W. Noller
  • Lauren K. Reckley
  • Camilo Fernandez-Salvador
  • Soroush Zaghi
Review Article



Oropharyngeal and tongue exercises (myofunctional therapy) have been shown to improve obstructive sleep apnea. However, to our knowledge, a systematic review has not been performed for snoring. The study objective is to perform a systematic review, with a meta-analysis, dedicated to snoring outcomes after myofunctional therapy.


PubMed/MEDLINE and three other databases were searched through November 25, 2017. Two authors independently searched the literature. Eligibility (1) patients: children or adults with snoring, (2) intervention: oropharyngeal and/or tongue exercises, (3) comparison: pre and post-treatment data for snoring, (4) outcomes: snoring frequency and snoring intensity, (5) study design: publications of all study designs.


A total of 483 articles were screened, 56 were downloaded in their full text form, and nine studies reported outcomes related to snoring. There were a total of 211 patients (all adults) in these studies. The snoring intensity was reduced by 51% in 80 patients from pre-therapy to post-therapy visual analog scale values of 8.2 ± 2.1 (95% CI 7.7, 8.7) to 4.0 ± 3.7 (95% CI 3.2, 4.8). Berlin questionnaire snoring intensity reduced by 36% in 34 patients from 2.5 ± 1.0 (95% CI 2.2, 2.8) to 1.6 ± 0.8 (95% CI 1.3, 1.9). Finally, time spent snoring during sleep was reduced by 31% in 60 patients from 26.3 ± 18.7% (95% CI 21.6, 31.0) to 18.1 ± 20.5% (95% CI 12.9, 23.3) of total sleep time.


This systematic review demonstrated that myofunctional therapy has reduced snoring in adults based on both subjective questionnaires and objective sleep studies.


Snoring Myofunctional therapy Systematic review Meta-analysis 



No funding was received for this research.

Compliance with ethical standards

Conflict of interest

All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria, educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge, or beliefs) in the subject matter or materials discussed in this manuscript.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

For this type of study, formal consent is not required. There is no additional need for informed consent as no identifying information is included in this article.

Supplementary material

405_2017_4848_MOESM1_ESM.tif (991 kb)
Supplementary material 1 (TIF 990 KB)


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Copyright information

© This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply 2017

Authors and Affiliations

  • Macario Camacho
    • 1
    Email author
  • Christian Guilleminault
    • 2
  • Justin M. Wei
    • 1
  • Sungjin A. Song
    • 1
  • Michael W. Noller
    • 3
  • Lauren K. Reckley
    • 1
  • Camilo Fernandez-Salvador
    • 1
  • Soroush Zaghi
    • 4
  1. 1.Division of Otolaryngology-Head and Neck SurgeryTripler Army Medical CenterHonoluluUSA
  2. 2.Sleep Medicine Division, Department of PsychiatryStanford Hospital and ClinicsRedwood CityUSA
  3. 3.School of MedicineUniformed Services University of the Health SciencesBethesdaUSA
  4. 4.UCLA Medical Center, Santa MonicaSanta MonicaUSA

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