Can myofunctional therapy increase tongue tone and reduce symptoms in children with sleep-disordered breathing?

Data in the literature suggest that myofunctional therapy (MT) may be able to play a role in the treatment of children with sleep-disordered breathing (SDB). Our study investigated the effectiveness of MT in reducing respiratory symptoms in children with SDB by modifying tongue tone. Polysomnographic recordings were performed at baseline to assess obstructive sleep apnea (OSA) severity in 54 children (mean age 7.1 +/- 2.5 years, 29 male) with SDB. Patients were randomly assigned to either the MT or no-MT group. Myofunctional evaluation tests, an assessment of tongue strength, tongue peak pressure, and endurance using the Iowa Oral Performance Instrument (IOPI), and nocturnal pulse oximetry were performed before (T0) and after (T1) 2 months of treatment. MT reduced oral breathing (83.3 vs 16.6%, p < 0.0002) and lip hypotonia (78 vs 33.3%, p < 0.003), restored normal tongue resting position (5.6 vs 33.4%, p < 0.04), and significantly increased mean tongue strength (31.9 +/- 10.8 vs 38.8 +/- 8.3, p = 0.000), tongue peak pressure (34.2 +/- 10.2 vs 38.1 +/- 7.0, p = 0.000), and endurance (28.1 +/- 8.9 vs 33.1 +/- 8.7, p = 0.01) in children with SDB. Moreover, mean oxygen saturation increased (96.4 +/- 0.6 vs 97.4 +/- 0.7, p = 0.000) and the oxygen desaturation index decreased (5.9 +/- 2.3 vs 3.6 +/- 1.8, p = 0.001) after MT. Oropharyngeal exercises appear to effectively modify tongue tone, reduce SDB symptoms and oral breathing, and increase oxygen saturation, and may thus play a role in the treatment of SDB.