title: Clinical analysis of pharyngeal musculature and genioglossus exercising to treat obstructive sleep apnea and hypopnea syndrome.
abstract: OBJECTIVE
  To evaluate the effect of pharyngeal musculature and genioglossus exercising on obstructive sleep apnea and hypopnea syndrome (OSAHS).
  
  
  METHODS
  We conducted a non-randomized retrospective clinical trial of 75 patients with OSAHS. Fifty-four patients were managed by exercising of the pharyngeal musculature and genioglossus (exercising group). Twenty-one patients, who refused to undertake any treatment, were defined as the control group. We took the Epworth Sleepiness Scale (ESS), checked patients' polysomnography, and took 320-detector computed tomography (CT) before treatment. Six and twelve months later, we made records of apnea hypopnea index (AHI), lowest arterial oxygen saturation (LSaO2), body mass index (BMI), the shortest sagittal diameter, and transverse diameter, and the effective rates of exercising were calculated and compared with the 21 patients without any treatment (control group) at the same time. SPSS 10.0 was used to analyze the data.
  
  
  RESULTS
  Before treatment, the ESS value was 7.67; 6 and 12 months later, the values were 3.54 and 3.25, respectively in the exercising group. AHI was decreased to 15.36 after 6 months and 13.79 after 12 months from 22.84 at the beginning. LSaO2 values were up to 81.18% after 6 months and 81.93% after 12 months from 74.05% at the beginning. There were significant differences in ESS scores, AHI, and LSaO2 between pre-treatment and post-treatment in the exercising group (P<0.05). However, there was no statistical difference in all the parameters between 6 and 12 months of exercising. The effective rates were 70.37% and 74.07% after 6- and 12-month exercising, respectively. There were significant differences between the exercising and control groups (P<0.0001). There was no statistical difference in the effective rate of the exercising group between 6 and 12 months of exercising (P>0.05). At 12 months of exercising, the compliance of the anteroposterior pharyngeal wall of the retropalatal area was lower (P<0.01) than that before treatment. There was no significant change of BMI in either group.
  
  
  CONCLUSIONS
  Exercising pharyngeal musculature and genioglossus is a kind of non-invasive and cost-effective method to treat some OSAHS patients, especially those who are old, without surgical complications, and especially mild and moderate OSAHS patients who do not want to take surgery and continuous positive airway pressure (CPAP) treatment. In addition, exercising pharyngeal musculature and genioglossus can be considered as remedial treatment of OSAHS to surgery and other therapies.
authors.affiliation: Otolaryngology Department, Ningbo First Hospital, Ningbo 315000, China.
authors.forename: Shi-xiong
authors.initials: SX
authors.lastname: Tang
authors.affiliation: Otolaryngology Department, Ningbo First Hospital, Ningbo 315000, China.
authors.forename: Jing
authors.initials: J
authors.lastname: Qing
authors.affiliation: Otolaryngology Department, Ningbo First Hospital, Ningbo 315000, China.
authors.forename: Yao-wen
authors.initials: YW
authors.lastname: Wang
authors.affiliation: Otolaryngology Department, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, China.
authors.forename: Liang
authors.initials: L
authors.lastname: Chai
authors.affiliation: Otolaryngology Department, Ningbo First Hospital, Ningbo 315000, China.
authors.forename: Wei-min
authors.initials: WM
authors.lastname: Zhang
authors.affiliation: Radiology Department, Ningbo First Hospital, Ningbo 315000, China.
authors.forename: Xian-wang
authors.initials: XW
authors.lastname: Ye
authors.affiliation: Radiology Department, Ningbo First Hospital, Ningbo 315000, China.
authors.forename: Jie
authors.initials: J
authors.lastname: Zhang
authors.affiliation: Sleep Monitoring Center, Ningbo First Hospital, Ningbo 315000, China.
authors.forename: Yi-qin
authors.initials: YQ
authors.lastname: Huang
authors.affiliation: Otolaryngology Department, Ningbo First Hospital, Ningbo 315000, China.
authors.forename: Peng
authors.initials: P
authors.lastname: Cheng
mesh_terms: D000328:Adult; D000368:Aged; D005081:Exercise Therapy; D006801:Humans; D008875:Middle Aged; D010100:Oxygen / Q000097:blood; D010609:Pharyngeal Muscles / Q000502:physiology*; D012189:Retrospective Studies; D012891:Sleep Apnea Syndromes / Q000503:physiopathology / Q000628:therapy*; D020181:Sleep Apnea, Obstructive / Q000503:physiopathology / Q000628:therapy*
chemical_list: D010100:Oxygen
keywords: Exercise; Genioglossus; Non-surgical management; Obstructive sleep apnea and hypopnea syndrome; Pharyngeal musculature; Valsalva maneuver