Orofacial Myofunctional Therapy in adults with Obstructive Sleep Apnea: A systematic review with meta-analysis
DOI:
https://doi.org/10.62827/fb.v27i6.1229Keywords:
Sleep Apnea; Myofunctional Therapy; Physical Therapy Modalities; Continuous Positive Airway Pressure.Abstract
Introduction: Obstructive sleep apnea is a prevalent respiratory disorder associated with cardiovascular, metabolic, and neurocognitive consequences that impact quality of life. Although continuous positive airway pressure is the standard treatment, low adherence limits its effectiveness. In this context, orofacial myofunctional therapy is being studied as a complementary strategy. Objective: To describe the effects of orofacial myofunctional therapy on outcomes in adults with obstructive sleep apnea. Methods: A systematic review with meta-analysis was conducted using the PubMed/MEDLINE (Medical Literature Analysis and Retrieval System Online), Embase, Scopus, Cochrane Library (Cochrane Central Register of Controlled Trials), Scientific Electronic Library Online, and Latin American and Caribbean Health Sciences Literature databases. Randomized clinical trials and prospective interventional studies involving adults with polysomnography-confirmed obstructive sleep apnea were included. Risk of bias was assessed using the Risk of Bias 2 and Risk of Bias in Non-randomized Studies of Interventions tools, and the certainty of evidence was evaluated using the Grading of Recommendations Assessment, Development and Evaluation system. Results: Five studies met the eligibility criteria (194 participants). Orofacial myofunctional therapy reduced the apnea-hypopnea index by 7.88 events/hour (mean difference: -7.88; 95% confidence interval: -10.20 to -5.60) and increased adherence to continuous positive airway pressure by 1.2 hours per night. Improvements were observed in daytime sleepiness, sleep quality, and maximal voluntary ventilation. Conclusion: Orofacial myofunctional therapy demonstrated a favorable effect on the treatment of obstructive sleep apnea in adults, supported by moderate-certainty evidence. Further studies are needed.
References
Gottlieb DJ, Punjabi NM. Diagnosis and management of obstructive sleep apnea: a review. JAMA. 2020;323(14):1389-400. doi: 10.1001/jama.2020.3514.
Boers E, Barrett MA, Benjafield AV, Barnet JH, Ravelo LA, Kaye L, et al. Projecting the 30-year burden of obstructive sleep apnoea in the USA: a prospective modelling study. Lancet Respir Med. 2025;13(12):1078-86. doi: 10.1016/S2213-2600(25)00243-7.
Siripajana P, Chalidapongse P, Sanguanwong N, Chaweewannakorn C. Efficacy of oropharyngeal exercises as an adjuvant therapy for obstructive sleep apnea: a randomized controlled trial. J Prosthodont Res. 2024;68(4):540-8. doi: 10.2186/jpr.JPR_D_23_00041.
Çakmakcı S, Alpaydın AÖ, Özalevli S, Öztura İ, İtil BO. The effect of oropharyngeal exercise in patients with moderate and severe obstructive sleep apnea using CPAP: a randomized controlled study. Sleep Breath. 2022;26(2):567-74. doi: 10.1007/s11325-021-02423-y.
Huang P, Tang Q, Yang X, Li M, Li S. Effects of oropharyngeal exercises on CPAP compliance: a prospective intervention study. Am J Otolaryngol. 2024;45(4):104274. doi: 10.1016/j.amjoto.2024.104274.
Prakassajjatham M, Opascharoenkij R, Rojanamungkalporn M. The effect of orofacial myofunctional therapy on biometrics and compliance of positive airway pressure therapy in patients with obstructive sleep apnea. Sleep Breath. 2025;29(2):163. doi: 10.1007/s11325-025-03313-3.
Köster A, Hoang AD, Dashuk A, Vaher H, Sikk K, Jagomägi T. Effects of web-based orofacial myofunctional therapy on hyoid bone position in adults with mild to moderate obstructive sleep apnea: evidence from an Estonian substudy of a randomized controlled trial. J Clin Med. 2026;15(1):257. doi: 10.3390/jcm15010257.
Saccomanno S, Valeri C, Palermiti M, Salvati SE, Inchingolo F, Ferrante L, et al. Myofunctional therapy in sleep disorders: a systematic review. Explor Med. 2026;7:1001396. doi: 10.37349/emed.2026.1001396.
Rueda JR, Mugueta-Aguinaga I, Vilaró J, Rueda-Etxebarria M. Myofunctional therapy (oropharyngeal exercises) for obstructive sleep apnoea. Cochrane Database Syst Rev. 2020;11(11):CD013449. doi: 10.1002/14651858.CD013449.pub2.
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Copyright (c) 2026 Aila Fernandes Oliveira Cardoso, Camila Marciana Costa Silva, Carolina Márcia de Moura Sodré, Lucas de Oliveira Mesquita, Lorena dos Santos Magalhães Silva (Autor)
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