{"title":"口面肌功能治疗对阻塞性睡眠呼吸暂停患者生物特征及气道正压治疗依从性的影响。","authors":"Mantana Prakassajjatham, Ravisara Opascharoenkij, Manita Rojanamungkalporn","doi":"10.1007/s11325-025-03313-3","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Obstructive sleep apnea (OSA) is a common sleep disorder associated with significant health risks. Positive airway pressure (PAP) therapy is the primary treatment for OSA but often presents challenges for patients due to varying patient phenotypes and adherence difficulties. Orofacial myofunctional therapy (OMT) is a potential adjunctive treatment that enhances muscle tone and coordination, which may reduce PAP pressure requirements and improve adherence. This study aimed to investigate the effects of a 3-month OMT intervention on auto-adjusting positive airway pressure (APAP) parameters (maximum, 95th percentile, and mean) and compliance in OSA patients.</p><p><strong>Methods: </strong>A prospective cohort intervention study was conducted at Naresuan University Hospital involving 70 OSA patients aged 18-80 years on APAP therapy. Participants underwent a 3-month OMT program, performing twice-daily exercises targeting the palate, tongue, and facial muscles. APAP pressure data and compliance were collected before and after the intervention. Statistical analysis was performed using a multivariate multilevel Gaussian regression model to assess changes in pressure over time. APAP compliance was analyzed using student's t-test and the signed-rank test, with statistical significance set at P < 0.05.</p><p><strong>Results: </strong>Statistically significant reductions in all APAP parameters were observed subsequent to OMT: mean pressure (-0.50 cmH2O, 95% CI: -0.66, -0.32), 95th percentile pressure (-0.68 cmH2O, 95% CI: -0.89, -0.47), and maximum pressure (-1.14 cmH2O, 95% CI: -1.47, -0.80). Additionally, APAP adherence significantly improved, with average nightly usage increasing from 5.86 ± 1.27 h to 6.42 ± 1.23 h.</p><p><strong>Conclusion: </strong>A 3-month OMT program effectively reduced APAP pressure requirements and improved adherence in OSA patients. While pre-OMT data suggested a gradual increase in APAP pressure needs over time, OMT counteracted this trend by addressing both anatomical and non-anatomical factors. These findings support OMT as a valuable adjunctive therapy for enhancing PAP therapy outcomes.</p>","PeriodicalId":21862,"journal":{"name":"Sleep and Breathing","volume":"29 2","pages":"163"},"PeriodicalIF":2.0000,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"The effect of orofacial myofunctional therapy on biometrics and compliance of positive airway pressure therapy in patients with obstructive sleep apnea.\",\"authors\":\"Mantana Prakassajjatham, Ravisara Opascharoenkij, Manita Rojanamungkalporn\",\"doi\":\"10.1007/s11325-025-03313-3\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Obstructive sleep apnea (OSA) is a common sleep disorder associated with significant health risks. Positive airway pressure (PAP) therapy is the primary treatment for OSA but often presents challenges for patients due to varying patient phenotypes and adherence difficulties. Orofacial myofunctional therapy (OMT) is a potential adjunctive treatment that enhances muscle tone and coordination, which may reduce PAP pressure requirements and improve adherence. This study aimed to investigate the effects of a 3-month OMT intervention on auto-adjusting positive airway pressure (APAP) parameters (maximum, 95th percentile, and mean) and compliance in OSA patients.</p><p><strong>Methods: </strong>A prospective cohort intervention study was conducted at Naresuan University Hospital involving 70 OSA patients aged 18-80 years on APAP therapy. Participants underwent a 3-month OMT program, performing twice-daily exercises targeting the palate, tongue, and facial muscles. APAP pressure data and compliance were collected before and after the intervention. Statistical analysis was performed using a multivariate multilevel Gaussian regression model to assess changes in pressure over time. APAP compliance was analyzed using student's t-test and the signed-rank test, with statistical significance set at P < 0.05.</p><p><strong>Results: </strong>Statistically significant reductions in all APAP parameters were observed subsequent to OMT: mean pressure (-0.50 cmH2O, 95% CI: -0.66, -0.32), 95th percentile pressure (-0.68 cmH2O, 95% CI: -0.89, -0.47), and maximum pressure (-1.14 cmH2O, 95% CI: -1.47, -0.80). Additionally, APAP adherence significantly improved, with average nightly usage increasing from 5.86 ± 1.27 h to 6.42 ± 1.23 h.</p><p><strong>Conclusion: </strong>A 3-month OMT program effectively reduced APAP pressure requirements and improved adherence in OSA patients. While pre-OMT data suggested a gradual increase in APAP pressure needs over time, OMT counteracted this trend by addressing both anatomical and non-anatomical factors. These findings support OMT as a valuable adjunctive therapy for enhancing PAP therapy outcomes.</p>\",\"PeriodicalId\":21862,\"journal\":{\"name\":\"Sleep and Breathing\",\"volume\":\"29 2\",\"pages\":\"163\"},\"PeriodicalIF\":2.0000,\"publicationDate\":\"2025-04-21\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Sleep and Breathing\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s11325-025-03313-3\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Sleep and Breathing","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s11325-025-03313-3","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
The effect of orofacial myofunctional therapy on biometrics and compliance of positive airway pressure therapy in patients with obstructive sleep apnea.
Background: Obstructive sleep apnea (OSA) is a common sleep disorder associated with significant health risks. Positive airway pressure (PAP) therapy is the primary treatment for OSA but often presents challenges for patients due to varying patient phenotypes and adherence difficulties. Orofacial myofunctional therapy (OMT) is a potential adjunctive treatment that enhances muscle tone and coordination, which may reduce PAP pressure requirements and improve adherence. This study aimed to investigate the effects of a 3-month OMT intervention on auto-adjusting positive airway pressure (APAP) parameters (maximum, 95th percentile, and mean) and compliance in OSA patients.
Methods: A prospective cohort intervention study was conducted at Naresuan University Hospital involving 70 OSA patients aged 18-80 years on APAP therapy. Participants underwent a 3-month OMT program, performing twice-daily exercises targeting the palate, tongue, and facial muscles. APAP pressure data and compliance were collected before and after the intervention. Statistical analysis was performed using a multivariate multilevel Gaussian regression model to assess changes in pressure over time. APAP compliance was analyzed using student's t-test and the signed-rank test, with statistical significance set at P < 0.05.
Results: Statistically significant reductions in all APAP parameters were observed subsequent to OMT: mean pressure (-0.50 cmH2O, 95% CI: -0.66, -0.32), 95th percentile pressure (-0.68 cmH2O, 95% CI: -0.89, -0.47), and maximum pressure (-1.14 cmH2O, 95% CI: -1.47, -0.80). Additionally, APAP adherence significantly improved, with average nightly usage increasing from 5.86 ± 1.27 h to 6.42 ± 1.23 h.
Conclusion: A 3-month OMT program effectively reduced APAP pressure requirements and improved adherence in OSA patients. While pre-OMT data suggested a gradual increase in APAP pressure needs over time, OMT counteracted this trend by addressing both anatomical and non-anatomical factors. These findings support OMT as a valuable adjunctive therapy for enhancing PAP therapy outcomes.
期刊介绍：
The journal Sleep and Breathing aims to reflect the state of the art in the international science and practice of sleep medicine. The journal is based on the recognition that management of sleep disorders requires a multi-disciplinary approach and diverse perspectives. The initial focus of Sleep and Breathing is on timely and original studies that collect, intervene, or otherwise inform all clinicians and scientists in medicine, dentistry and oral surgery, otolaryngology, and epidemiology on the management of the upper airway during sleep.
Furthermore, Sleep and Breathing endeavors to bring readers cutting edge information about all evolving aspects of common sleep disorders or disruptions, such as insomnia and shift work. The journal includes not only patient studies, but also studies that emphasize the principles of physiology and pathophysiology or illustrate potentially novel approaches to diagnosis and treatment. In addition, the journal features articles that describe patient-oriented and cost-benefit health outcomes research. Thus, with peer review by an international Editorial Board and prompt English-language publication, Sleep and Breathing provides rapid dissemination of clinical and clinically related scientific information. But it also does more: it is dedicated to making the most important developments in sleep disordered breathing easily accessible to clinicians who are treating sleep apnea by presenting well-chosen, well-written, and highly organized information that is useful for patient care.
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