Myofunctional therapy improves adherence to continuous positive airway pressure treatment.
Giovana Diaféria, Rogerio Santos-Silva, Eveli Truksinas, Fernanda L M Haddad, Renata Santos, Silvana Bommarito, Luiz C Gregório, Sergio Tufik, Lia Bittencourt
Author Information
Giovana Diaféria: Disciplina de Medicina e Biologia do Sono, Departamento de Psicobiologia, Universidade Federal de São Paulo, Rua Napoleao de Barros 925, São Paulo, SP, 04024-002, Brazil. gidiaferia@hotmail.com. ORCID
Rogerio Santos-Silva: Disciplina de Medicina e Biologia do Sono, Departamento de Psicobiologia, Universidade Federal de São Paulo, Rua Napoleao de Barros 925, São Paulo, SP, 04024-002, Brazil.
Eveli Truksinas: Disciplina de Medicina e Biologia do Sono, Departamento de Psicobiologia, Universidade Federal de São Paulo, Rua Napoleao de Barros 925, São Paulo, SP, 04024-002, Brazil.
Fernanda L M Haddad: Disciplina de Medicina e Biologia do Sono, Departamento de Psicobiologia, Universidade Federal de São Paulo, Rua Napoleao de Barros 925, São Paulo, SP, 04024-002, Brazil.
Renata Santos: Disciplina de Medicina e Biologia do Sono, Departamento de Psicobiologia, Universidade Federal de São Paulo, Rua Napoleao de Barros 925, São Paulo, SP, 04024-002, Brazil.
Silvana Bommarito: Departamento de Fonoaudiologia, Universidade Federal de São Paulo, São Paulo, Brazil.
Luiz C Gregório: Departamento de Otorrinolaringologia e Cirurgia de Cabeça e Pescoço, Universidade Federal de São Paulo, São Paulo, Brazil.
Sergio Tufik: Disciplina de Medicina e Biologia do Sono, Departamento de Psicobiologia, Universidade Federal de São Paulo, Rua Napoleao de Barros 925, São Paulo, SP, 04024-002, Brazil.
Lia Bittencourt: Disciplina de Medicina e Biologia do Sono, Departamento de Psicobiologia, Universidade Federal de São Paulo, Rua Napoleao de Barros 925, São Paulo, SP, 04024-002, Brazil.
PURPOSE: Few studies have investigated myofunctional therapy in patients with obstructive sleep apnea syndrome (OSAS). The objective of this study was to evaluate the effect of myofunctional therapy on continuous positive airway pressure (CPAP) adherence. METHODS: The study was registered at ClinicalTrials.gov (NCT01289405). Male patients with OSAS were randomly divided into four treatment groups: placebo, patients undergoing placebo myofunctional therapy (N = 24); myofunctional therapy, undergoing myofunctional therapy (N = 27); CPAP, undergoing treatment with CPAP (N = 27); and combined, undergoing CPAP therapy and myofunctional therapy (N = 22). All patients underwent evaluations before and after 3 months of treatment evaluation and after 3 weeks of washout. Evaluations included Epworth sleepiness scale (ESS), polysomnography, and myofunctional evaluation. RESULTS: The 100 men had a mean age of 48.1 ± 11.2 years, body mass index of 27.4 ± 4.9 kg/m, ESS score of 12.7 ± 3.0, and apnea-hypopnea index (AHI) of 30.9 ± 20.6. All treated groups (myofunctional therapy, CPAP, and combined myofunctional therapy with CPAP) showed decreased ESS and snoring, and the myofunctional therapy group maintained this improvement after the "washout" period. AHI reduction occurred in all treated groups and was more significant in CPAP group. The myofunctional therapy and combined groups showed improvement in tongue and soft palate muscle strength when compared with the placebo group. The association of myofunctional therapy to CPAP (combined group) showed an increased adherence to CPAP compared with the CPAP group. CONCLUSIONS: Our results suggest that in patients with OSAS, myofunctional therapy may be considered as an adjuvant treatment and an intervention strategy to support adherence to CPAP.
