Myofunctional therapy improves adherence to continuous positive airway pressure treatment
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Few studies have investigated myofunctional therapy in patients with obstructive sleep apnea syndrome (OSAS). The objective of this study was to evaluate the effect of myofunctional therapy on continuous positive airway pressure (CPAP) adherence.
The study was registered at ClinicalTrials.gov (NCT01289405). Male patients with OSAS were randomly divided into four treatment groups: placebo, patients undergoing placebo myofunctional therapy (N = 24); myofunctional therapy, undergoing myofunctional therapy (N = 27); CPAP, undergoing treatment with CPAP (N = 27); and combined, undergoing CPAP therapy and myofunctional therapy (N = 22). All patients underwent evaluations before and after 3 months of treatment evaluation and after 3 weeks of washout. Evaluations included Epworth sleepiness scale (ESS), polysomnography, and myofunctional evaluation.
The 100 men had a mean age of 48.1 ± 11.2 years, body mass index of 27.4 ± 4.9 kg/m2, ESS score of 12.7 ± 3.0, and apnea-hypopnea index (AHI) of 30.9 ± 20.6. All treated groups (myofunctional therapy, CPAP, and combined myofunctional therapy with CPAP) showed decreased ESS and snoring, and the myofunctional therapy group maintained this improvement after the “washout” period. AHI reduction occurred in all treated groups and was more significant in CPAP group. The myofunctional therapy and combined groups showed improvement in tongue and soft palate muscle strength when compared with the placebo group. The association of myofunctional therapy to CPAP (combined group) showed an increased adherence to CPAP compared with the CPAP group.
Our results suggest that in patients with OSAS, myofunctional therapy may be considered as an adjuvant treatment and an intervention strategy to support adherence to CPAP.
KeywordsObstructive sleep apnea Treatment Myofunctional therapy Continuous positive airway pressure Polysomnography
The present study received financial support from the Research Incentive Fund Association (Associação Fundo de Incentivo à Pesquisa—AFIP) and the São Paulo Research Foundation (Fundação de Amparo à Pesquisa do Estado de São Paulo—FAPESP) (no. 07/50525-1 for R. Santos-Silva, and CEPID number 98/14303-3 for S. Tufik). S. Tufik and L.R.A. Bittencourt received research grants from the National Council for Scientific and Technological Development (Conselho Nacional de Desenvolvimento Científico e Tecnológico—CNPq).
GD, RS-S, ET, FLMH, RS, SB, LCG, ST, and LB (1) contributed substantially to the conception and design, acquisition of data or analysis and interpretation of data; (2) drafted the article or revised it critically for important intellectual content; and (3) approved the final version for publication.
Compliance with ethical standards
The study was approved by the research ethics committee of the Universidade Federal de São Paulo—UNIFESP (CEP 2002/08) and registered at ClinicalTrials.gov (NCT01289405). All patients gave written informed consent.
Conflict of interest
The authors declare that they have no conflict of interest.
This study was funded by the Associação Fundo de Incentivo à Pesquisa—AFIP Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) and Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq).
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