Table 2.
Summary of eligible RCT studies.
| Study | Country, Study Type, Sample Size | Interventions and Sample Size per Group | Inclusion Criteria | Sex and Age | Number of Visits | Trained/Supervised By |
|---|---|---|---|---|---|---|
| Diaferia et al, 201325 | Brazil, Non blinded RCT n = 140 | 1. Myofunctional therapy (MT; speech therapy) n = 27 | 1. Patients diagnosed with OSA based on clinical and polysomnographic criteria independently of severity 2. All men between the ages of 25 to 65 years 3. Body mass index (BMI) < 35 kg/m2 |
140M/0F 48.1 ± 11.2 years |
3 (first week, first month, third month) | Supervised by trained staff of CPAP service |
| 2. CPAP group n = 27 | ||||||
| 3. Speech therapy + CPAP n = 22 | ||||||
| 4. Controls (sham speech therapy) n = 24 | ||||||
| Diaferia et al, 201722 | Brazil, Non blinded RCT n = 140 | 1. MT (speech therapy) n = 27 | 1. Consecutive men age 25 to 65 years 2. BMI < 35 kg/ m2 3. OSA diagnosis confirmed by clinical and polysomnographic criteria |
140M/0F 48.1 ± 11.2 years |
3 (first week, first month, third month) | Trained by speech pathologist and supervised by trained staff of CPAP service |
| 2. CPAP n = 27 | ||||||
| 3. CPAP + MT n = 22 | ||||||
| 4. Controls (Sham MT: exercises without therapeutic function, relaxation and stretching of the neck muscles), n = 24 | ||||||
| Guimaraes et al, 200914 | Brazil, Single blinded RCT n = 31 | 1. Oropharyngeal exercises n = 16 2. Controls (deep breathing) n = 15 |
1. Eligible patients between 25 and 65 years of age with a recent diagnosis of moderate OSAS evaluated in the sleep laboratory | 21M/10F Intervention group: 51.5 ± 6.8 years Controls: 47.7 ± 9.8 years |
Weekly visits for 3 months | Trained by speech pathologist |
| Ieto et al, 201521 | Brazil, Single blinded RCT n = 39 | 1. Oropharyngeal exercise Group n = 19 2. Controls (nasal dilator strips plus nasal lavage with deep breathing) n =20 |
1. Between 20 and 65 years of age 2. Primary complaint of snoring 3. Recent diagnosis of primary snoring or mild to moderate OSA. |
22M/17F 6.0 ± 13.0 years |
Weekly visits for 3 months | Supervised by the investigator who performed the sleep study |
| Kuo et al, 201716 | Taiwan, Non blinded RCT n = 25 | 1. Expiratory muscle strength training (EMST): Resistance pressure at 75% of each participant’s PE max n = 13. Controls 2. (Resistance pressure at 0% of each participant’s PE max) n = 12 | 1. Age 20–60 years 2. Current OSA (AHI > 5 events/h) |
21M/4F Intervention group: 44.3 ± 2.9 Controls: 48.0 ± 3.1 |
Not mentioned | EMST trainer |
| Puhan et al, 200627 | Switzerland, Single Blinded RCT n = 25 | 1. Didgeridoo n = 14 2. Controls (Waiting list – no treatment) n = 11 |
1. German speaking participants aged > 18 years 2. Self-reported snoring 3. AHI of 15–30 events/h. |
21M/4F Intervention group: 49.9 ± 6.7 Controls: 47 ± 8.9 |
3 visits | Didgeridoo instructor |
| Villa et al, 201526 | Italy, Single Blinded RCT n = 27 | 1. Oropharyngeal exercises plus nasal washing n = 14 2. Controls (nasal washing) n = 13 |
1. Children with clinical cutoff value of AHI > 5 events/h for moderate-severe OSA while residual OSA was defined as an AHI index > 1 events/h after AT 2. Persistence of respiratory symptoms (snoring, oral breathing, and sleep apnea). | 24M/3F 4.82 ± 1.36 years |
3 monthly meetings for 2 months | Myofunctional Therapist |
| Villa et al, 201724 | Italy, Non Blinded RCT n = 54 | 1. MT + nasal washing n = 36 2. Controls (nasal washing group) n = 18 |
1. Children referred to a pediatric sleep center for SDB 2. Diagnosis of OSA confirmed by the presence of SDB symptoms 3. PSG yielding an obstructive AHI > 1 event/h. |
22M/32F7 1 ± 2.5 years |
2 monthly meetings for 2 months | Myofunctional Therapist |
| Vranish & Bailey et al, 201628 | US, Single Blinded RCT n = 24 | 1. Inspiratory muscle strength training (75% of PI max) n = 12 2. Controls (15% of PI max) n = 12 |
1. Adults with mild, moderate, and severe OSA, who did not use or had discontinued using CPAP, dental devices, or other OSA-related therapies for at least 6 months prior to the study intake | 16M/8F Intervention group: 61.5 ± 3.9 years Controls:69.1 ± 3.4 years |
Not mentioned | Trained using inspiratory threshold training device |
AHI = apnea-hypopnea index, AT = adeno tonsillectomy, CPAP = continuous positive airway pressure, EMST = expiratory muscle strength training, F = female, M = male, OSA = obstructive sleep apnea, PE max = expiratory pressure, PI max = inspiratory pressure, RCT = randomized controlled trials, SDB = sleep-disordered breathing.