Could oral exercises improve obstructive sleep apnea in adults?

When your patients receive sleep apnea diagnoses, their primary care physicians will often urge them to exercise more. Since obesity correlates with sleep apnea, and exercise is good for obese patients, it should also be good for sleep apnea, right?

Many patients ignore this advice. They’re used to being scolded by doctors about their weight, and it often seems as if the moment they step on the scale, the conversation shifts to diet and exercise as a cure for everything. It’s disheartening for patients because they feel as if their health is about a number on the scale, and it’s exhausting for doctors since patients rarely end up putting this advice into practice.

However, one class of exercise has been shown to improve sleep apnea symptoms like snoring and AHI quickly and noticeably. These are the exercises associated with oral-myofunctional therapy.

How does OMT improve sleep apnea symptoms?

In adults and some children with OSA, the obstruction is a result of low tone in the tongue and throat muscles, especially when sleeping or lying on their backs. The muscles flop over the entrance to the windpipe, blocking it and preventing air from reaching the lungs. 

As the body’s oxygen level drops, the sleeper’s brain wakes them slightly, they gasp and begin to breathe again, and then they settle back into sleep. These frequent microarousals to maintain oxygen saturation leave the sleeper feeling exhausted, disrupt normal biological processes that must occur during sleep, and lead to life-long health problems.

OMT can help strengthen and tone these muscles so they’re less likely to block the windpipe.  If the sleeper gets more air, they’re less likely to see oxygen saturation levels drop, they’ll experience fewer microarousals, and their symptoms will improve. OMT is especially powerful when used in combination with another intervention like a CPAP machine or an oral appliance.

What does the research say about OMT?

Meta-studies have found some evidence to support the use of OMT in conjunction with other interventions for OSA. In a 2018 study published in The Nature and Science of Sleep, researchers found that certain exercises could improve snoring and AHI scores. Plus, they made patients more likely to use their BPAP and CPAP machines as directed.

A 2020 study published in the Journal of Clinical Sleep Medicine found that muscle therapy could improve AHI by 40%. While the authors of both studies say that more research needs to be done, their work suggests that adding OMT to your patients’ sleep apnea treatment plans can significantly improve outcomes.

Are there exercises I should recommend to my patients?

The National Sleep Foundation recommends three simple tongue exercises to strengthen the tongue and throat muscles. Patients should spend 30 minutes a day exercising their tongue in short bursts. By learning and practicing the exercises, they can strengthen their tongue and throat while they’re working, watching television, or even sitting at stoplights.

Have your patients work these into their daily routines. You may want to demonstrate and have them practice with a mirror in the office:

Do each exercise in groups of 20 repetitions:

1. Push the tip of the tongue against the roof of the mouth and slide backward.
2. Suck the tongue upward so it lies against the palate.
3. Force the back of the tongue downward against the floor of the mouth while touching the tip of the tongue to the bottom front teeth. (This is more difficult and may take more direction.)

Are you curious about how your dental practice can support OMT for patients with sleep apnea? Check out the Academy of Orofacial Myofunctional Therapy’s site for more information.

Dr. Meghna Dassani has practiced dentistry for over two decades and is passionate about the role dentists play in whole-body health. You can learn more at her website: MeghnaDassani.com.