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Journal of Zhejiang University SCIENCE B

ISSN 1673-1581(Print), 1862-1783(Online), Monthly

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.

Key words: Obstructive sleep apnea and hypopnea syndrome, Non-surgical management, Exercise, Genioglossus, Valsalva maneuver, Pharyngeal musculature

Chinese Summary  <23> 咽肌与颏舌肌治疗阻塞性睡眠呼吸暂停低通气综合征

目的:探讨咽肌及颏舌肌锻炼治疗阻塞性睡眠呼吸暂停低通气综合征(OSAHS)的疗效。
创新点:首次证实咽部及舌部肌肉锻炼是除呼吸机外一种有效治疗OSAHS的非手术疗法。
方法:2010年1月至2012年4月54例OSAHS患者采用咽肌与颏舌肌锻炼法治疗(图1),治疗前及治疗后6月、12月分别行Epworth嗜睡评分、多导睡眠监测(PSG监测)和320排计算机断层扫描(CT)检查上气道,记录其呼吸暂停低通气指数(AHI)、最低血氧饱和度(LSaO2)、体重指数(BMI)、腭后区和舌后区的最小矢径和最小横径,计算各壁的顺应性,比较治疗前后各指标变化情况,并与21例未作任何治疗者(对照组)进行比较。
结论:咽肌与颏舌肌锻炼是一种无创、实用、经济有效的方法,用来治疗部分OSAHS患者。

关键词组:睡眠呼吸暂停;阻塞性;非手术治疗;咽肌;颏舌肌


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DOI:

10.1631/jzus.B1500100

CLC number:

R766

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On-line Access:

2015-11-04

Received:

2015-04-26

Revision Accepted:

2015-07-06

Crosschecked:

2015-10-21

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