Effects of physical therapy with multilevel upper airway exercise for moderate and severe obstructive sleep apnea- A preliminary randomized controlled trial

Background: Obstructive apnea (OSA) is characterized with complete or partial obstruction of upper airway during sleep. Critically compromised by upper airway anatomical impaired properties, oropharyngeal muscle dysfunction is recognized as one of the primary phenotypic traits. The upper airway exercise was targeted on oropharyngeal muscle dysfunction by re-educating and re-shaping the oropharyngeal muscles to maintain the upper airway patency. Although OSA was thought as multilevel collapsibility of the upper airway, it still lacked clinical evidence to prove an effective model of upper airway exercise. Therefore, the purpose of this study was to exam the clinical effects of physical therapy with multilevel upper airway exercise for moderate and severe OSA. Methods: Fifteen subjects with newly diagnosed moderate or severe OSA (AHI≥15) were randomized into intervention group and control group. The intervention group (N=8) underwent a 12-week-intervention of hospital based rehabilitation program, while the control group (N=7) was kept on waiting for 12 weeks. The multilevel upper airway exercise comprised retropalatal, retroglossal, hypopharynegal, facial and TMJ levels. The primary outcome was Polysomnography (PSG) data, including apnea-hypopnea index (AHI), arousal index, mean SpO2, and oxygen desaturation index (ODI). Additionally, the secondary outcome was oropharyngeal and respiratory muscle function.

Author(s): Hsin-Yu Lin

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