Table 2.

Strategies and exercises for young and adult patients with OSA recommended in the reviewed studies

	Frequency (times a day)/dose
Nasal lavage with an application of saline in each nostril	Three times/10 mL38,39
Soft palate
Pronounce an oral vowel intermittently (isotonic exercise)/elevate the soft palate and uvula while intermittently saying the vowel “A”	Three times/3 min29,38,52
	Five times/10 repetitions53
	Three times/20 repetitions39,54
Pronounce an oral vowel continuously (isometric exercise)	Three times/3 min29,38
	Five times/10 repetitions53
Elevate the soft palate and uvula without vocalization, after gaining control and coordination of movement (~after 3–5 weeks)	Three times/5 s39,54
Elevate the soft palate with and without a yawn	Three to five times per day50
	Five times/10 repetitions53
Produce lingua-velar sounds by contacting the dorsum of the tongue and the velum several times each	Three to five times per day50
Produce uvular sounds by contraction of the uvula several times each	Three to five times per day50
Tongue
Brush the superior surfaces of the tongue while it is positioned in the floor of the mouth. Also, brush the lateral surfaces of the tongue	Three times/5 repetitions29,38
	Five times/10 repetitions53
Place the tip of the tongue against the front of the palate and slide the tongue backward	A total of 3 min throughout the day
	Three times/20 repetitions29,39,54
	Five times/10 repetitions53
Place the tongue tip as far as possible on the palate	Three to five times per day50
Press the entire tongue upward against the palate	A total of 3 min throughout the day38
	Three to five times per day50
	Three times/20 repetitions29,39,54
	Five times/10 repetitions50
Press the tongue against the palate and apply a counterresistance on both cheeks using the hands	Three to five times per day50
Place the tongue tip in contact with the inferior incisive teeth and force its posterior region of the tongue downward	A total of 3 min throughout the day38
	Three times/20 repetitions29,39,54
Protrude the tongue tip forward just in front of the lips, without touching the teeth or lips,50 and without deviation. Hold, relax, and repeat53	Three to five times per day/30 s50
	Five times/10 repetitions53
Repeatedly stick the tongue in and out as fast as possible	Five times/10 repetitions53
Spread center of the tongue, so the sides of the tongue touch the bottom of the upper teeth	Three to five times per day/30 s50
Protrude the tongue outside the mouth and move the tip (lift and down)	Three to five times per day50
Move the tongue to the right/left corner of the mouth and keep it pointed	Three to five times per day50
Flick the tongue from corner-to-corner as quickly as possible. Move the tongue all around the lips in a circle quickly	Five times/10 repetitions53
Stick out the tongue to reach the chin with the tip. Hold at the farthest extension	Five times/10 repetitions53
Stick out the tongue. Hold a spoon upright against the tip of your extended tongue and try to push it away while your hand holds the spoon in place	Five times/10 repetitions53
Rotate the tongue in the oral vestibule	Three times/10 repetitions starting in the right side and 10 left side29
Facial
Pressure the lips (orbicularis oris muscle) with the mouth closed (isometric exercise)	Three times/30 s38
	Five times/10 repetitions53
Open and close the jaw slowly and widely, keeping the lips in contact (orbicularis oris muscle)	Five times/10 repetitions53
Pucker the lips (as if about to kiss). Hold for a count of 10 and relax	Five times/10 repetitions53
Spread the lips into a big, exaggerated smile. Hold and relax	Five times/10 repetitions53
Pucker lips–hold–smile–hold	Five times/10 repetitions53
Pucker the lips with the mouth wide open, without closing the jaws. Hold and relax	Five times/10 repetitions53
Close the lips firmly, and then make a “slurping” noise, as if sipping a drink	Five times/10 repetitions53
Perform suction movements contracting only the buccinators. These exercises are performed with repetitions (isotonic) and holding position (isometric)	Unclear38
	Five times/10 repetitions53
Suck air from a syringe of 20 mL	Three times a day/5 repetitions29
Recruitment of the buccinator muscle against the finger that is introduced into the oral cavity	Unclear38
	Three times a day/10 repetitions each side29,39,54
	Five times/10 repetitions53
Alternated elevation of the mouth angle muscle (isometric exercise), with repetitions (isotonic exercise)	Three times a day/10 intermittent elevations three times38
Lateral jaw movements with alternating elevation of the mouth angle muscle	Unclear38
	Five times/10 repetitions53
Open and close mouth as quickly as you can, making sure your lips close each time	Five times/10 repetitions53
Say the syllable “Ma” quickly and repeatedly. Do the same with “La” and “Kala”	Five times/10 repetitions53
Sing “A–E–I–O–U” as loud as possible	Five times/10 repetitions53
Stomatognathic functions
Suction
Suck the yogurt with a narrow straw	Unclear38
Breathing and speech
Forced nasal inspiration and oral expiration in conjunction with phonation of open vowels, while sitting	Unclear29,38
	Five times/10 repetitions53
Balloon inflation with prolonged nasal inspiration and then forced blowing	Repeated five times without taking the balloon out of the mouth29,38,53
Swallowing and chewing
Alternate bilateral chewing	The patients were instructed to incorporate this pattern whenever they were eating29,38,39,53,54
Deglutition: swallow with the tongue positioned on the palate, occluded teeth, and without perioral muscle contraction	The patients were instructed to incorporate this pattern whenever they were eating29,38,39,53,54
Holding the tongue tip between teeth anteriorly while trying to swallow	Three to five times per day50

Abbreviation: OSA, obstructive sleep apnea.