【論文摘要】Efficacy of Combined Treatment With Mandibular Advancement Device and Oropharyngeal Exercises for Patients With Obstructive Sleep Apnea

【論文摘要】合併下顎推進裝置配戴與口咽肌肉訓練對阻塞性睡眠呼吸中止症患者的治療成效

Huang-Kang Ku(顧桓綱) ； Ching-Hsia Hung(洪菁霞)

《物理治療》 48卷2期 (2023/06) Pp. 139-139

https://doi.org/10.6215/FJPT.202306.P17

摘要

Background and Purpose: Obstructive Sleep Apnea (OSA) is a sleeping disorder with recurrent upper airway obstruction during sleeping. A mandibular advancement device (MAD) is one of the treatment options to resolve the anatomical etiology causes of OSA. Oropharyngeal exercise (OE) is a novel intervention which is targeted at internal/external tongue muscle training with significant improvements in oropharyngeal muscle tension. At the current stage, the efficacy of combined treatment between MAD and OE has not been investigated. Therefore, the present study aimed at evaluating the effect of combination of MAD and OE on the improvement of the OSA severity and tongue muscle power in OSA patients. Methods: Eleven OSA patients who are currently using the MAD treatment were recruited. Participants were divided into the OE group and the control group. The participants in control group were received only MAD treatment. The program of OE mainly involved tongue, oropharyngeal, and lips exercises. The OE was performed 1-3 sessions/day with each session being 30-minute, 3 to 5 days per week for 12 weeks. The participants in OE group were requested to visit a rehabilitation clinic once a week for progressing their training protocols based on the tongue muscle strength and endurance measurement. The polysomnography and tongue muscle strength and endurance were measured at baseline and 12-week post-intervention. Effects of training were examined with an independent t test and paired t test. Results: The values of Apnea- Hypopnea Index, tongue muscle strength and endurance showed significant improvements in the OE group compared with the control group. AHI decreased from 34.8 ± 24.4 to 22.4 ± 19.3 events/hour. The maximum tongue protrusion strength increased from 45.5 ± 11.2 to 66.0 ± 8.9 kpa and endurance from 20.1 ± 9.2 to 50.9 ± 19.9 s. Conclusions: The combination of MAD and OE can significantly improve muscle strength and endurance of the tongue, and reduce the severity of sleep apnea in individuals with OSA. Clinical Relevance: It is the first study that reports combining MAD and OE in OSA patients. Our results suggested that combination of MAD and OE could be applied to rehabilitation clinics to provide better treatment effects for OSA patients.