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Methods for increasing upper airway muscle tonus in treating obstructive sleep apnea: systematic review

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Abstract

Objective

Treatment of obstructive sleep apnea (OSA) using methods for increasing upper airway muscle tonus has been controversial and poorly reported. Thus, a review of the evidence is needed to evaluate the effectiveness of these methods.

Design

The design used was a systematic review of randomized controlled trials.

Data sources

Data sources are from the Cochrane Library, Medline, Embase and Scielo, registries of ongoing trials, theses indexed at Biblioteca Regional de Medicina/Pan-American Health Organization of the World Health Organization and the reference lists of all the trials retrieved.

Review methods

This was a review of randomized or quasi-randomized double-blind trials on OSA. Two reviewers independently applied eligibility criteria. One reviewer assessed study quality and extracted data, and these processes were checked by a second reviewer. The primary outcome was a decrease in the apnea/hypopnea index (AHI) of below five episodes per hour. Other outcomes were subjective sleep quality, sleep quality measured by night polysomnography, quality of life measured subjectively and adverse events associated with the treatments.

Data synthesis

Three eligible trials were included. Two studies showed improvements through the objective and subjective analyses, and one study showed improvement of snoring, but not of AHI while the subjective analyses showed no improvement. The adverse events were reported and they were not significant.

Conclusions

There is no accepted scientific evidence that methods aiming to increase muscle tonus of the stomatognathic system are effective in reducing AHI to below five events per hour. Well-designed randomized controlled trials are needed to assess the efficacy of such methods.

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Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Emergency Medicine and Evidence-Based Medicine, Universidade Federal de São Paulo (UNIFESP), Sao Paulo, Sao Paulo, Brazil

    Juliana Spelta Valbuza, Márcio Moysés de Oliveira, Cristiane Fiquene Conti, Lucila Bizari F. Prado, Luciane Bizari Coin de Carvalho & Gilmar Fernandes do Prado

  2. Brazilian Cochrane Center, Universidade Federal de São Paulo (UNIFESP), Sao Paulo, Sao Paulo, Brazil

    Juliana Spelta Valbuza, Márcio Moysés de Oliveira & Cristiane Fiquene Conti

  3. Neuro-Sono - Sao Paulo Hospital Sleep Laboratory, Universidade Federal de São Paulo (UNIFESP), Sao Paulo, Sao Paulo, Brazil

    Juliana Spelta Valbuza, Márcio Moysés de Oliveira, Cristiane Fiquene Conti, Lucila Bizari F. Prado, Luciane Bizari Coin de Carvalho & Gilmar Fernandes do Prado

  4. Rua Claudio Rossi, 394, Sao Paulo, Sao Paulo, CEP 01547-000, Brazil

    Juliana Spelta Valbuza

Authors
  1. Juliana Spelta Valbuza
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  2. Márcio Moysés de Oliveira
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  3. Cristiane Fiquene Conti
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  4. Lucila Bizari F. Prado
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  5. Luciane Bizari Coin de Carvalho
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  6. Gilmar Fernandes do Prado
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Corresponding author

Correspondence to Juliana Spelta Valbuza.

Additional information

Juliana Spelta Valbuza and Márcio Moysés de Oliveira contributed equally to this work.

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Valbuza, J.S., de Oliveira, M.M., Conti, C.F. et al. Methods for increasing upper airway muscle tonus in treating obstructive sleep apnea: systematic review. Sleep Breath 14, 299–305 (2010). https://doi.org/10.1007/s11325-010-0377-9

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  • DOI: https://doi.org/10.1007/s11325-010-0377-9

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