title: Effects of Oropharyngeal Exercises on Snoring: A Randomized Trial.
abstract: BACKGROUND
  Snoring is extremely common in the general population and may indicate OSA. However, snoring is not objectively measured during polysomnography, and no standard treatment is available for primary snoring or when snoring is associated with mild forms of OSA. This study determined the effects of oropharyngeal exercises on snoring in minimally symptomatic patients with a primary complaint of snoring and diagnosis of primary snoring or mild to moderate OSA.
  
  
  METHODS
  Patients were randomized for 3 months of treatment with nasal dilator strips plus respiratory exercises (control) or daily oropharyngeal exercises (therapy). Patients were evaluated at study entry and end by sleep questionnaires (Epworth Sleepiness Scale, Pittsburgh Sleep Quality Index) and full polysomnography with objective measurements of snoring.
  
  
  RESULTS
  We studied 39 patients (age, 46 ± 13 years; BMI, 28.2 ± 3.1 kg/m2; apnea-hypopnea index (AHI), 15.3 ± 9.3 events/h; Epworth Sleepiness Scale, 9.2 ± 4.9; Pittsburgh Sleep Quality Index, 6.4 ± 3.3). Control (n = 20) and therapy (n = 19) groups were similar at study entry. One patient from each group dropped out. Intention-to-treat analysis was used. No significant changes occurred in the control group. In contrast, patients randomized to therapy experienced a significant decrease in the snore index (snores > 36 dB/h), 99.5 (49.6-221.3) vs 48.2 (25.5-219.2); P = .017 and total snore index (total power of snore/h), 60.4 (21.8-220.6) vs 31.0 (10.1-146.5); P = .033.
  
  
  CONCLUSIONS
  Oropharyngeal exercises are effective in reducing objectively measured snoring and are a possible treatment of a large population suffering from snoring.
  
  
  BACKGROUND
  ClinicalTrials.gov; No.: NCT01636856; URL: www.clinicaltrials.gov.
authors.affiliation: Sleep Laboratory, University of São Paulo Medical School, São Paulo, Brazil.
authors.forename: Vanessa
authors.initials: V
authors.lastname: Ieto
authors.affiliation: Sleep Laboratory, University of São Paulo Medical School, São Paulo, Brazil.
authors.forename: Fabiane
authors.initials: F
authors.lastname: Kayamori
authors.affiliation: Neurology Department, University of Antioquia, Medellín, Colombia.
authors.forename: Maria I
authors.initials: MI
authors.lastname: Montes
authors.affiliation: Sleep Laboratory, University of São Paulo Medical School, São Paulo, Brazil.
authors.forename: Raquel P
authors.initials: RP
authors.lastname: Hirata
authors.affiliation: Sleep Laboratory, University of São Paulo Medical School, São Paulo, Brazil.
authors.forename: Marcelo G
authors.initials: MG
authors.lastname: Gregório
authors.affiliation: Pulmonary Division, Heart Institute (InCor) Physics Institute, University of São Paulo Medical School, São Paulo, Brazil.
authors.forename: Adriano M
authors.initials: AM
authors.lastname: Alencar
authors.affiliation: Sleep Laboratory, University of São Paulo Medical School, São Paulo, Brazil.
authors.forename: Luciano F
authors.initials: LF
authors.lastname: Drager
authors.affiliation: Sleep Laboratory, University of São Paulo Medical School, São Paulo, Brazil.
authors.forename: Pedro R
authors.initials: PR
authors.lastname: Genta
authors.affiliation: Sleep Laboratory, University of São Paulo Medical School, São Paulo, Brazil. Electronic address: geraldo.lorenzi@gmail.com.
authors.forename: Geraldo
authors.initials: G
authors.lastname: Lorenzi-Filho
mesh_terms: D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017286:Polysomnography; D020181:Sleep Apnea, Obstructive / Q000150:complications* / Q000503:physiopathology; D012913:Snoring / Q000209:etiology* / Q000503:physiopathology / Q000517:prevention & control*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome