Sleep apnoea: Can’t tolerate CPAP? Try throat exercises


May 24, 2010 from the New York Times

Throat Exercises Can Relieve Sleep Apnea

By ANAHAD O’CONNOR

THE FACTS

For people suffering from sleep apnea, specialized breathing machines are the standard treatment.

The machines use a method called continuous positive airway pressure, or CPAP, which keeps the airway open and relieves potentially dangerous pauses in breathing during the night. But the machines are expensive, and some people complain that the mask and headgear cause uncomfortable side effects, like congestion.

One free and fairly simple alternative may be exercises that strengthen the throat. While they aren’t as established or as well studied as breathing machines, some research suggests they may reduce the severity of sleep apnea by building up muscles around the airway, making them less likely to collapse at night.

In a study published last year in The American Journal of Respiratory and Critical Care Medicine, scientists recruited a group of people with obstructive sleep apnea and split them into two groups. One was trained to do breathing exercises daily, while the other did 30 minutes of throat exercises, including swallowing and chewing motions, placing the tip of the tongue against the front of the palate and sliding it back, and pronouncing certain vowels quickly and continuously.

After three months, subjects who did the throat exercises snored less, slept better and reduced the severity of their condition by 39 percent. They also showed reductions in neck circumference, a known risk factor for apnea. The control group showed almost no improvement.

Other randomized studies have found similar effects. One even showed that playing instruments that strengthen the airways, like the didgeridoo, can ease sleep apnea.

THE BOTTOM LINE

For people with sleep apnea, throat exercises may be a cheap and useful therapy.

Am J Respir Crit Care Med. 2009 May 15;179(10):962-6. Epub 2009 Feb 20.

Effects of oropharyngeal exercises on patients with moderate obstructive sleep apnea syndrome.

Guimarães KC, Drager LF, Genta PR, Marcondes BF, Lorenzi-Filho G.

Sleep Laboratory, Pulmonary Division, Heart Institute (InCor), University of São Paulo Medical School, Av Dr Enéas Carvalho de Aguiar, 44, CEP 05403-904, São Paulo, Brazil.

Abstract

RATIONALE: Upper airway muscle function plays a major role in maintenance of the upper airway patency and contributes to the genesis of obstructive sleep apnea syndrome (OSAS). Preliminary results suggested that oropharyngeal exercises derived from speech therapy may be an effective treatment option for patients with moderate OSAS. OBJECTIVES: To determine the impact of oropharyngeal exercises in patients with moderate OSAS. METHODS: Thirty-one patients with moderate OSAS were randomized to 3 months of daily ( approximately 30 min) sham therapy (n = 15, control) or a set of oropharyngeal exercises (n = 16), consisting of exercises involving the tongue, soft palate, and lateral pharyngeal wall. MEASUREMENTS AND MAIN RESULTS: Anthropometric measurements, snoring frequency (range 0-4), intensity (1-3), Epworth daytime sleepiness (0-24) and Pittsburgh sleep quality (0-21) questionnaires, and full polysomnography were performed at baseline and at study conclusion. Body mass index and abdominal circumference of the entire group were 30.3 +/- 3.4 kg/m(2) and 101.4 +/- 9.0 cm, respectively, and did not change significantly over the study period. No significant change occurred in the control group in all variables. In contrast, patients randomized to oropharyngeal exercises had a significant decrease (P < 0.05) in neck circumference (39.6 +/- 3.6 vs. 38.5 +/- 4.0 cm), snoring frequency (4 [4-4] vs. 3 [1.5-3.5]), snoring intensity (3 [3-4] vs. 1 [1-2]), daytime sleepiness (14 +/- 5 vs. 8 +/- 6), sleep quality score (10.2 +/- 3.7 vs. 6.9 +/- 2.5), and OSAS severity (apnea-hypopnea index, 22.4 +/- 4.8 vs. 13.7 +/- 8.5 events/h). Changes in neck circumference correlated inversely with changes in apnea-hypopnea index (r = 0.59; P < 0.001). CONCLUSIONS: Oropharyngeal exercises significantly reduce OSAS severity and symptoms and represent a promising treatment for moderate OSAS. Clinical trial registered with www.clinicaltrials.gov (NCT 00660777).



Sleep apnea tied to increased risk of stroke; Even mild sleep apnea puts men in danger, study finds

ScienceDaily (Apr. 10, 2010) — Obstructive sleep apnea is associated with an increased risk of stroke in middle-aged and older adults, especially men, according to new results from a landmark study supported by the National Heart, Lung, and Blood Institute (NHLBI) of the National Institutes of Health.

Overall, sleep apnea more than doubles the risk of stroke in men. Obstructive sleep apnea is a common disorder in which the upper airway is intermittently narrowed or blocked, disrupting sleep and breathing during sleep.