Full Text:   <1215>

Summary:  <786>

CLC number: R766

On-line Access: 2015-11-04

Received: 2015-04-26

Revision Accepted: 2015-07-06

Crosschecked: 2015-10-21

Cited: 0

Clicked: 2396

Citations:  Bibtex RefMan EndNote GB/T7714

 ORCID:

Yao-wen Wang

http://orcid.org/0000-0003-1816-4436

-   Go to

Article info.
Open peer comments

Journal of Zhejiang University SCIENCE B 2015 Vol.16 No.11 P.931-939

http://doi.org/10.1631/jzus.B1500100


Clinical analysis of pharyngeal musculature and genioglossus exercising to treat obstructive sleep apnea and hypopnea syndrome


Author(s):  Shi-xiong Tang, Jing Qing, Yao-wen Wang, Liang Chai, Wei-min Zhang, Xian-wang Ye, Jie Zhang, Yi-qin Huang, Peng Cheng

Affiliation(s):  Otolaryngology Department, Ningbo First Hospital, Ningbo 315000, China; more

Corresponding email(s):   wangyaowennihao@hotmail.com

Key Words:  Obstructive sleep apnea and hypopnea syndrome, Non-surgical management, Exercise, Genioglossus, Valsalva maneuver, Pharyngeal musculature


Shi-xiong Tang, Jing Qing, Yao-wen Wang, Liang Chai, Wei-min Zhang, Xian-wang Ye, Jie Zhang, Yi-qin Huang, Peng Cheng. Clinical analysis of pharyngeal musculature and genioglossus exercising to treat obstructive sleep apnea and hypopnea syndrome[J]. Journal of Zhejiang University Science B, 2015, 16(11): 931-939.

@article{title="Clinical analysis of pharyngeal musculature and genioglossus exercising to treat obstructive sleep apnea and hypopnea syndrome",
author="Shi-xiong Tang, Jing Qing, Yao-wen Wang, Liang Chai, Wei-min Zhang, Xian-wang Ye, Jie Zhang, Yi-qin Huang, Peng Cheng",
journal="Journal of Zhejiang University Science B",
volume="16",
number="11",
pages="931-939",
year="2015",
publisher="Zhejiang University Press & Springer",
doi="10.1631/jzus.B1500100"
}

%0 Journal Article
%T Clinical analysis of pharyngeal musculature and genioglossus exercising to treat obstructive sleep apnea and hypopnea syndrome
%A Shi-xiong Tang
%A Jing Qing
%A Yao-wen Wang
%A Liang Chai
%A Wei-min Zhang
%A Xian-wang Ye
%A Jie Zhang
%A Yi-qin Huang
%A Peng Cheng
%J Journal of Zhejiang University SCIENCE B
%V 16
%N 11
%P 931-939
%@ 1673-1581
%D 2015
%I Zhejiang University Press & Springer
%DOI 10.1631/jzus.B1500100

TY - JOUR
T1 - Clinical analysis of pharyngeal musculature and genioglossus exercising to treat obstructive sleep apnea and hypopnea syndrome
A1 - Shi-xiong Tang
A1 - Jing Qing
A1 - Yao-wen Wang
A1 - Liang Chai
A1 - Wei-min Zhang
A1 - Xian-wang Ye
A1 - Jie Zhang
A1 - Yi-qin Huang
A1 - Peng Cheng
J0 - Journal of Zhejiang University Science B
VL - 16
IS - 11
SP - 931
EP - 939
%@ 1673-1581
Y1 - 2015
PB - Zhejiang University Press & Springer
ER -
DOI - 10.1631/jzus.B1500100


Abstract: 
Objective: To evaluate the effect of pharyngeal musculature and genioglossus exercising on obstructive sleep apnea and hypopnea syndrome (OSAHS). Methods: We conducted a non-randomized retrospective clinical trial of 75 patients with OSAHS. Fifty-four patients were managed by exercising of the pharyngeal musculature and genioglossus (exercising group). Twenty-one patients, who refused to undertake any treatment, were defined as the control group. We took the Epworth Sleepiness Scale (ESS), checked patients’ polysomnography, and took 320-detector computed tomography (CT) before treatment. Six and twelve months later, we made records of apnea hypopnea index (AHI), lowest arterial oxygen saturation (LSaO2), body mass index (BMI), the shortest sagittal diameter, and transverse diameter, and the effective rates of exercising were calculated and compared with the 21 patients without any treatment (control group) at the same time. SPSS 10.0 was used to analyze the data. Results: Before treatment, the ESS value was 7.67; 6 and 12 months later, the values were 3.54 and 3.25, respectively in the exercising group. AHI was decreased to 15.36 after 6 months and 13.79 after 12 months from 22.84 at the beginning. LSaO2 values were up to 81.18% after 6 months and 81.93% after 12 months from 74.05% at the beginning. There were significant differences in ESS scores, AHI, and LSaO2 between pre-treatment and post-treatment in the exercising group (P<0.05). However, there was no statistical difference in all the parameters between 6 and 12 months of exercising. The effective rates were 70.37% and 74.07% after 6- and 12-month exercising, respectively. There were significant differences between the exercising and control groups (P<0.0001). There was no statistical difference in the effective rate of the exercising group between 6 and 12 months of exercising (P>0.05). At 12 months of exercising, the compliance of the anteroposterior pharyngeal wall of the retropalatal area was lower (P<0.01) than that before treatment. There was no significant change of BMI in either group. Conclusions: Exercising pharyngeal musculature and genioglossus is a kind of non-invasive and cost-effective method to treat some OSAHS patients, especially those who are old, without surgical complications, and especially mild and moderate OSAHS patients who do not want to take surgery and continuous positive airway pressure (CPAP) treatment. In addition, exercising pharyngeal musculature and genioglossus can be considered as remedial treatment of OSAHS to surgery and other therapies.

咽肌与颏舌肌治疗阻塞性睡眠呼吸暂停低通气综合征

目的:探讨咽肌及颏舌肌锻炼治疗阻塞性睡眠呼吸暂停低通气综合征(OSAHS)的疗效。
创新点:首次证实咽部及舌部肌肉锻炼是除呼吸机外一种有效治疗OSAHS的非手术疗法。
方法:2010年1月至2012年4月54例OSAHS患者采用咽肌与颏舌肌锻炼法治疗(图1),治疗前及治疗后6月、12月分别行Epworth嗜睡评分、多导睡眠监测(PSG监测)和320排计算机断层扫描(CT)检查上气道,记录其呼吸暂停低通气指数(AHI)、最低血氧饱和度(LSaO2)、体重指数(BMI)、腭后区和舌后区的最小矢径和最小横径,计算各壁的顺应性,比较治疗前后各指标变化情况,并与21例未作任何治疗者(对照组)进行比较。
结论:咽肌与颏舌肌锻炼是一种无创、实用、经济有效的方法,用来治疗部分OSAHS患者。

关键词:睡眠呼吸暂停;阻塞性;非手术治疗;咽肌;颏舌肌

Darkslateblue:Affiliate; Royal Blue:Author; Turquoise:Article

Reference

[1]Bilston, L.E., Gandevia, S.C., 2014. Biomechanical properties of the human upper airway and their effect on its behavior during breathing and in obstructive sleep apnea. J. Appl. Physiol. (1985), 116(3):314-324.

[2]Brown, E.C., Cheng, S., McKenzie, D.K., et al., 2013. Respiratory movement of upper airway tissue in obstructive sleep apnea. Sleep, 36(7):1069-1076.

[3]Carrera, M., Barbe, F., Sauleda, J., et al., 1999. Patients with obstructive sleep apnea exhibit genioglossus dysfunction that is normalized after treatment with continuous positive airway pressure. Am. J. Respir. Crit. Care Med., 159(6):1960-1966.

[4]Chen, L.Y., Ye, J.Y., Cui, J.H., 2005. The study of genioglossus muscle activity on patients with obstructive sleep apnea hypopnea syndrome. Chin. Arch. Otolaryngol.-Head Neck Surg., 12(7):453-457 (in Chinese).

[5]Chouchou, F., Pichot, V., Barthélémy, J.C., et al., 2014. Cardiac sympathetic modulation in response to apneas/hypopneas through heart rate variability analysis. PLoS ONE, 9(1):e86434.

[6]Editorial Board of Chinese Journal of Otorhinolaryngology Head and Neck Surgery, 2009. Guidelines for the diagnosis and surgical treatment of obstructive sleep apnea hypopnea syndrome. Chin. J. Otorhinolaryngol. Head Neck Surg., 44(2):95-96 (in Chinese).

[7]Fregosi, R.F., 2011. Influence of tongue muscle contraction and transmural pressure on nasopharyngeal geometry in the rat. J. Appl. Physiol. (1985), 111(3):766-774.

[8]Kirkness, J.P., Schwartz, A.R., Schneider, H., et al., 2008. Contribution of maleXII, age, and obesity to mechanical instability of the upper airway during sleep. J. Appl. Physiol. (1985), 104(6):1618-1624.

[9]Kuna, S.T., 2001. Effects of pharyngeal muscle activation on airway size and configuration. Am. J. Respir. Crit. Care Med., 164(7):1236-1241.

[10]Mateika, J.H., Syed, Z., 2013. Intermittent hypoxia, respiratory plasticity and sleep apnea in humans: present knowledge and future investigations. Respir. Physiol. Neurobiol., 188(3):289-300.

[11]Mezzanotte, W.S., Tangel, D.J., White, D.P., 1992. Waking genioglossal electromyogram in sleep apnea patients versus normal controls (a neuromuscular compensatory mechanism). J. Clin. Invest., 89(5):1571-1579.

[12]Mezzanotte, W.S., Tangel, D.J., White, D.P., 1996. Influence of sleep onset on upper-airway muscle activity in apnea patients versus normal controls. Am. J. Respir. Crit. Care Med., 153(6):1880-1887.

[13]Mortimore, I., Bennett, S., Douglas, N., 2000. Tongue protrusion strength and fatiguability: relationship to apnoea/hypopnoea index and age. J. Sleep Res., 9(4):389-393.

[14]Philip, P., Gross, C.E., Taillard, J., et al., 2005. An animal model of a spontaneously reversible obstructive sleep apnea syndrome in the monkey. Neurobiol. Dis., 20(2):428-431.

[15]Quinnell, T.G., Bennett, M., Jordan, J., et al., 2014. A crossover randomized controlled trial of oral mandibular advancement devices for obstructive sleep apnoea-hypopnoea (TOMADO). Thorax, 69(10):938-945.

[16]Schwartz, A.R., O'Donnell, C.P., Baron, J., et al., 1998. The hypotonic upper airway in obstructive sleep apnea: role of structures and neuromuscular activity. Am. J. Respir. Crit. Care Med., 157(4):1051-1057.

[17]Sériès, F., Côté, C., Simoneau, J., et al., 1995. Physiologic, metabolic, and muscle fiber type characteristics of musculus uvulae in sleep apnea hypopnea syndrome and in snorers. J. Clin. Invest., 95(1):20-25.

[18]Shortt, C.M., Fredsted, A., Bradford, A., et al., 2013. Diaphragm muscle remodeling in a rat model of chronic intermittent hypoxia. J. Histochem. Cytochem., 61(7):487-499.

[19]Wang, Q., Zhang, C., Jia, P., et al., 2014. The association between the phenotype of excessive daytime sleepiness and blood pressure in patients with obstructive sleep apnea-hypopnea syndrome. Int. J. Med. Sci., 11(7):713-720.

[20]White, D.P., 2005. Pathogenesis of obstructive and central sleep apnea. Am. J. Respir. Crit. Care Med., 172(11):1363-1370.

[21]White, D.P., 2014. New therapies for obstructive sleep apnea. Semin. Respir. Crit. Care Med., 35(5):621-628.

[22]Zhang, Q., Zhang, X., Zhao, M., et al., 2014. Correlation of obstructive sleep apnea hypopnea syndrome with metabolic syndrome in snorers. J. Biomed. Res., 28(3):222-227.

[23]中文摘要

[24]题目:咽肌与颏舌肌治疗阻塞性睡眠呼吸暂停低通气综合征

[25]目的:探讨咽肌及颏舌肌锻炼治疗阻塞性睡眠呼吸暂停低通气综合征(OSAHS)的疗效.

[26]创新点:首次证实咽部及舌部肌肉锻炼是除呼吸机外一种有效治疗OSAHS的非手术疗法.

[27]方法:2010年1月至2012年4月54例OSAHS患者采用咽肌与颏舌肌锻炼法治疗(图1),治疗前及治疗后6月、12月分别行Epworth嗜睡评分、多导睡眠监测(PSG监测)和320排计算机断层扫描(CT)检查上气道,记录其呼吸暂停低通气指数(AHI)、最低血氧饱和度(LSaO2)、体重指数(BMI)、腭后区和舌后区的最小矢径和最小横径,计算各壁的顺应性,比较治疗前后各指标变化情况,并与21例未作任何治疗者(对照组)进行比较.

[28]结论:咽肌与颏舌肌锻炼是一种无创、实用、经济有效的方法,用来治疗部分OSAHS患者.

[29]关键词:睡眠呼吸暂停;阻塞性;非手术治疗;咽肌;颏舌肌

Open peer comments: Debate/Discuss/Question/Opinion

<1>

Please provide your name, email address and a comment





Journal of Zhejiang University-SCIENCE, 38 Zheda Road, Hangzhou 310027, China
Tel: +86-571-87952783; E-mail: cjzhang@zju.edu.cn
Copyright © 2000 - Journal of Zhejiang University-SCIENCE