Sensorimotor Tongue Evaluation and Rehabilitation in Patients with Sleep-disordered Breathing: a Novel Approach

Study Objectives: To evaluate tone, apraxia and stereognosis dysfunctions in patients with SDB compared with healthy controls, and to monitor the effectiveness of Airway Gym as an easy-to-use myofunctional therapy (MT) modality in terms of the tongue's motor and sensory responses, comparing results before and after therapy.

Methods: This was a prospective, non-randomised pilot study of 25 patients with moderate to severe obstructive sleep apnoea-hypopnoea syndrome (OSAHS), 25 patients with primary snoring (PS) and 20 healthy controls. Qualitative and quantitative instruments-Iowa Oral Performance Instrument (IOPI), lingual apraxia and stereognosis tests were used to assess tongue sensorimotor function.

Results: 22 patients with PS, 21 with OSAHS and all 20 controls ended the therapy. In OSAHS, the Epworth Sleepiness Scale score decreased from 16 ± 7.3 to 12 ± 4.5 after therapy (p = 0.53). In PS and OSAHS groups, the IOPI scores increased significantly. These measures did not change significantly in the controls. Lingual apraxia testing showed that controls performed all the manoeuvres, whereas PS 5.6 ± 1.4 and OSAHS 4.5 ± 1.9 (p = 0.14). In the stereognosis test, the mean number of figures recognised was 2.6 ± 2.2 in OSAHS, 3.3±1.2 in PS and 5.7±0.9 in control group (p < 0.05). Patients with OSAHS recognised circles and ovals less often.

Conclusion: Using the Airway Gym app produced improvements in sensorimotor tongue function in patients with SDB, due to continuous stimulation of the brain based on proprioceptive training required to localise responses when doing the exercises.