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The effect of oropharyngeal exercise in patients with moderate and severe obstructive sleep apnea using CPAP: a randomized controlled study

  • Sleep Breathing Physiology and Disorders • Original Article
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Abstract

Purpose

Obstructive sleep apnea (OSA) is an important public health problem. Beyond common treatment options, solution-oriented options are needed. Oropharyngeal exercise training may be a research area in this respect. This study aimed to evaluate the effects of oropharyngeal exercise (OPE) in addition to continuous positive airway pressure (CPAP) therapy in patients diagnosed with OSA.

Methods

Patients with moderate and severe OSA were screened from the electronic database of our hospital and 41 patients (20: exercise group; 21: control group) were included in the study. Each patient was assessed with CPAP usage time, maximal voluntary ventilation (MVV), maximum inspiratory and expiratory pressure (MIP-MEP), neck circumference, body mass index (BMI), waist-hip ratio, Epworth sleepiness score, Pittsburgh sleep quality index (PSQI), and short-form health survey (SF-36) in the first visit. The OPE was prescribed in addition to CPAP for the exercise group and performed by the patients for 3 months. At the end of the third month, groups were re-assessed with the same parameters.

Results

Most of the patients were men, and the mean age of the study population was 51.9 ± 7.4; the mean apnea–hypopnea index (AHI) in the last polysomnography report was 53.3 ± 27.4. In the exercise group, MVV (p = 0.003), MIP (p = 0.002), MEP (p = 0.024), and SF-36 energy/fatigue (p = 0.020) were observed to increase while the total PSQI score (p = 0.036) decreased. The neck circumference (p = 0.006) and BMI (p = 0.013) were found to be significantly decreased in the exercise group.

Conclusions

We found that OPE training may have improved respiratory muscle strength as well as sleep quality and health-related quality of life in the exercise group. OPE along with CPAP therapy may be recommended in moderate and severe OSA patients who are willing to participate.

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Acknowledgements

We would like to thank Ahmet Naci Emecen, MD, who is working in the Department of Public Health, Epidemiology, for helping us with the analysis of data.

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Authors and Affiliations

  1. Department of Chest Diseases, Faculty of Medicine, Dokuz Eylül University, Izmir, Turkey

    Selin Çakmakcı, Aylin Özgen Alpaydın & Bahriye Oya İtil

  2. Department of Pulmonary Rehabilitation, School of Physical Therapy and Rehabilitation, Dokuz Eylül University, Izmir, Turkey

    Sevgi Özalevli

  3. Department of Neurology Diseases, Faculty of Medicine, Dokuz Eylül University, Izmir, Turkey

    İbrahim Öztura

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  1. Selin Çakmakcı
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  2. Aylin Özgen Alpaydın
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Contributions

S.Ç. and O.İ. contributed to the concept and design of this study. İ.Ö. contributed to the interpretation of polysomnography data. A.Ö.A. and S.Ö. both equally contributed to the respiratory physiotherapy design. S.Ç. contributed to the data interpretation, writing the manuscript, and preparing figures. O.İ. supervised the project and reviewed the manuscript. All authors approved the final version.

Corresponding author

Correspondence to Selin Çakmakcı.

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Ethics approval

All procedures performed in studies involving human participants were following 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. The local university ethics committee provided ethical approval, with the ethical protocol number 3980-GOA. All eligible patients were informed about the study and those who were willing to participate signed the consent form for participation and publication of data.

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The authors declare no competing interests.

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Çakmakcı, S., Özgen Alpaydın, A., Özalevli, S. et al. The effect of oropharyngeal exercise in patients with moderate and severe obstructive sleep apnea using CPAP: a randomized controlled study. Sleep Breath 26, 567–574 (2022). https://doi.org/10.1007/s11325-021-02423-y

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  • DOI: https://doi.org/10.1007/s11325-021-02423-y

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