Myofunctional Therapy for Sleep Apnea

When you have obstructive sleep apnea (OSA), a sleep disorder in which the upper airway repeatedly collapses during sleep, exercising the muscles in your throat and face can work alongside other treatments like CPAP and oral appliances to help improve symptoms. These muscles help control the position of your tongue and other tissues surrounding your upper airway. Strengthening and retraining them through orofacial myofunctional therapy may help reduce the likelihood of the airway collapsing during sleep.

While more research is needed to know how well myofunctional therapy for sleep apnea works, your doctor may suggest it in addition to your current treatment. Below, we’ll cover how myofunctional therapy works, what the exercises involve, and what research says about its effectiveness can help you decide whether it may be a useful addition to your sleep apnea treatment plan.

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What Is Myofunctional Therapy?

Orofacial myofunctional therapy helps strengthen your throat and facial muscles so that they hold their shape better and don't collapse during sleep. This treatment exercises all the different muscles in a person's airway, including those in the lips, tongue, and back of the throat.

Sometimes called oropharyngeal exercises or simply throat and mouth exercises, this therapy works to improve other important functions controlled by these muscles, including chewing, swallowing and being able to breath through one's nose.

How Does Myofunctional Therapy Help With Sleep Apnea?

During the day, muscles around your throat keep it open, allowing air to move in and out. When you fall asleep, these muscles relax but normally stay active enough to keep your airways clear. But when you have OSA, factors like large tonsils or tongue or excess neck tissue leads to airway collapse, causing snoring and breathing pauses.

Myofunctional exercises work to build up strength and endurance in the muscles around your airway to help keep them open, even when you relax in sleep. This treatment is applicable to OSA but not central sleep apnea (CSA), which happens because of faulty brain signals, not a blocked airway.

Can Myofunctional Therapy Cure Sleep Apnea?

Doctors and experts in the field consider myofunctional therapy to be a potentially helpful addition to typical OSA treatments but not a cure in itself. However, there hasn't been a lot of research in this area to date.

Myofunctional therapy may help improve your sleep apnea symptoms, and some studies show this treatment may improve the apnea-hypopnea index (AHI). AHI is an important metric used to assess sleep apnea severity and measures how many times your breathing pauses or oxygen level drops during each hour of sleep.

These exercises work best alongside other OSA treatments, like CPAP therapy or an oral appliance. If you want to try myofunctional therapy, ask your doctor, but don’t stop your current treatment without medical guidance.

How Effective Is Myofunctional Therapy for Sleep Apnea?

Few studies have been done on myofunctional therapy as a treatment for sleep apnea, and they show mixed results. Two reviews found that myofunctional therapy lowered AHI, improved nighttime oxygen levels, and reduced snoring and daytime sleepiness. People who did the therapy at least 30 minutes a day had the best results.

What Does Myofunctional Therapy Involve?

Myofunctional therapy involves specific exercises you can do at home. These exercises focus on tongue positioning, as well as strengthening and improving the coordination of the muscles that keep the airway open during sleep.

Your oropharyngeal exercises need to be individualized for you by a medical professional with training in this therapy. They’ll base exercise selection on the specific risk factors and craniofacial anatomy contributing to your OSA. Practitioners who offer myofunctional therapy include:

• Speech-language pathologists
• Occupational therapists
• Dental hygienists

Your healthcare provider will teach you exercises and tell you how often to do them. If you do them consistently, you may see better results.

Examples of Myofunctional Therapy Exercises

Myofunctional therapy exercises can include tongue and lip movements, speaking specific sounds, cheek and jaw motions, and breathing techniques. Here are some examples:

• Soft palate: Speaking vowel sounds in short bursts or longer stretches
• Tongue: Moving the tip of the tongue against your teeth, pushing the tongue against the roof of the mouth, or pressing the tongue against the bottom of your mouth
• Lips: Pursing and relaxing your lips
• Cheeks: Sucking in your cheeks or pushing out against resistance from a finger
• Jaw: Sliding your jaw from side to side
• Breathing: Inhaling through your nose and then blowing up a balloon

You may also do swallowing and chewing exercises to strengthen multiple areas at once.

Who May Benefit From Myofunctional Therapy?

Myofunctional therapy can improve symptoms of sleep apnea when paired with other treatments. You may benefit from this therapy if you have these conditions or symptoms:

• Obstructive sleep apnea
• Loud snoring
• Daytime sleepiness
• A large tongue or other oral tissue that blocks your airway

If you want to know how myofunctional therapy may benefit you, ask your doctor. They can help you decide if this therapy option could supplement your current treatments for even better results.

Myofunctional Therapy for Children

A few studies have also researched myofunctional therapy in children with OSA. Research suggests this therapy may result in a lower AHI and better average oxygen levels for some children. But more studies are needed to confirm these results.

Pediatric OSA can have different causes and treatments compared to adult OSA. The most common causes of OSA in a child are obesity and large tonsils. That’s why tonsil removal (tonsilectomy) is often the first recommended treatment for childhood OSA.

No matter the cause, children who may have OSA need an evaluation from a pediatric healthcare provider or sleep specialist. They may recommend oral and throat exercises along with other therapies, but they can help you find the best treatment combination for your child’s specific needs.

Children may also receive myofunctional therapy to help orthodontic treatment work better and to support growth and development, like issues with upper jaw growth.

When to Talk to a Doctor

Always talk to a doctor if you have new or worsening signs of sleep apnea. Your bed partner or roommate may be the first to notice symptoms like loud snoring, choking, or gasping during sleep. But severe daytime sleepiness, difficulty concentrating, and trouble staying asleep can also point to sleep apnea.

When sleep apnea goes untreated, or treatment doesn’t work well, you can have a higher risk for health complications, like:

• Hypertension (high blood pressure)
• Type 2 diabetes
• Heart failure
• Atrial fibrillation (AFib) and other heart rhythm problems
• Coronary artery disease
• Liver disease
• Stroke

With treatment, however, the risk of these complications goes down. If you feel your current therapy isn’t working well enough, or you have new symptoms related to sleep apnea, you can ask your doctor about additional treatment options, including myofunctional therapy.

Written by

Abby McCoy, RN, Contributing Writer

Abby McCoy is an experienced RN who has worked with adults and pediatric patients encompassing trauma, orthopedics, home care, transplant, and case management. She holds a Bachelor’s of Science in Nursing from St. Louis Univeristy and has practiced nursing all over the world from San Francisco, CA, to Tharaka, Kenya. She now writes health content for trusted health outlets like Everyday Health and Next Avenue.

Reviewed by

Dustin Cotliar, MD, MPH, Medical Reviewer

Dr. Dustin Cotliar is a board-certified emergency medicine physician with more than eight years of clinical experience across emergency departments and urgent care settings. He earned his medical degree from the State University of New York (SUNY) Downstate College of Medicine and a Master of Public Health from Columbia University.