title: Effects of oropharyngeal exercises on patients with moderate obstructive sleep apnea syndrome.
abstract: BACKGROUND
  Upper airway muscle function plays a major role in maintenance of the upper airway patency and contributes to the genesis of obstructive sleep apnea syndrome (OSAS). Preliminary results suggested that oropharyngeal exercises derived from speech therapy may be an effective treatment option for patients with moderate OSAS.
  
  
  OBJECTIVE
  To determine the impact of oropharyngeal exercises in patients with moderate OSAS.
  
  
  METHODS
  Thirty-one patients with moderate OSAS were randomized to 3 months of daily ( approximately 30 min) sham therapy (n = 15, control) or a set of oropharyngeal exercises (n = 16), consisting of exercises involving the tongue, soft palate, and lateral pharyngeal wall.
  
  
  RESULTS
  Anthropometric measurements, snoring frequency (range 0-4), intensity (1-3), Epworth daytime sleepiness (0-24) and Pittsburgh sleep quality (0-21) questionnaires, and full polysomnography were performed at baseline and at study conclusion. Body mass index and abdominal circumference of the entire group were 30.3 +/- 3.4 kg/m(2) and 101.4 +/- 9.0 cm, respectively, and did not change significantly over the study period. No significant change occurred in the control group in all variables. In contrast, patients randomized to oropharyngeal exercises had a significant decrease (P < 0.05) in neck circumference (39.6 +/- 3.6 vs. 38.5 +/- 4.0 cm), snoring frequency (4 [4-4] vs. 3 [1.5-3.5]), snoring intensity (3 [3-4] vs. 1 [1-2]), daytime sleepiness (14 +/- 5 vs. 8 +/- 6), sleep quality score (10.2 +/- 3.7 vs. 6.9 +/- 2.5), and OSAS severity (apnea-hypopnea index, 22.4 +/- 4.8 vs. 13.7 +/- 8.5 events/h). Changes in neck circumference correlated inversely with changes in apnea-hypopnea index (r = 0.59; P < 0.001).
  
  
  CONCLUSIONS
  Oropharyngeal exercises significantly reduce OSAS severity and symptoms and represent a promising treatment for moderate OSAS. Clinical trial registered with www.clinicaltrials.gov (NCT 00660777).
authors.affiliation: Sleep Laboratory, Pulmonary Division, Heart Institute (InCor), University of São Paulo Medical School, Av Dr Enéas Carvalho de Aguiar, 44, CEP 05403-904, São Paulo, Brazil.
authors.forename: Kátia C
authors.initials: KC
authors.lastname: Guimarães
authors.forename: Luciano F
authors.initials: LF
authors.lastname: Drager
authors.forename: Pedro R
authors.initials: PR
authors.lastname: Genta
authors.forename: Bianca F
authors.initials: BF
authors.lastname: Marcondes
authors.forename: Geraldo
authors.initials: G
authors.lastname: Lorenzi-Filho
mesh_terms: D000368:Aged; D015992:Body Mass Index; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020247:Myofunctional Therapy / Q000379:methods*; D017286:Polysomnography / Q000379:methods; D020181:Sleep Apnea, Obstructive / Q000503:physiopathology / Q000628:therapy*; D012913:Snoring / Q000209:etiology; D016896:Treatment Outcome