Sleep Health
Obstructive sleep apnea in women: What you need to know
If you're living with sleep apnea - a condition where breathing stops and restarts many times throughout the night - you may be familiar with the different treatment options. These include continuous positive airway pressure (CPAP) therapy (a device that's designed to help you breathe consistently throughout the night), oral appliances and surgical implants. Myofunctional therapy uses exercises to strengthen the throat, tongue, face and jaw muscles, and can help support sleep apnea treatments.1
Learn more about myofunctional therapy and how it may help with obstructive sleep apnea (OSA) symptoms.
Healthy, functional muscles are important for keeping the upper airways open, which can support normal breathing during sleep.2 When the tongue, throat and jaw muscles relax, the airways may become narrow. This can cause breathing to become shallow or stop for seconds to minutes at a time while sleeping.
Myofunctional therapy may help reduce the apnea-hypopnea index (AHI) in people living with sleep apnea. AHI measures how many times a person's breathing slows or stops per hour of sleep. One study shows myofunctional therapy reducing AHI by 34% in adults with sleep apnea.3
Obstructive sleep apnea (OSA) is a condition where your upper airway becomes blocked repeatedly during sleep, making it harder for air to flow. These blockages can reduce or completely stop the flow of air, causing your breathing to pause throughout the night.
Symptoms of OSA may include:
Excessive daytime sleepiness
Morning headaches
Feeling irritable or moody
Difficulty concentrating, struggling to feel present during the day
Snoring or gasping for air while you sleep
If you're concerned about your sleep, it's a good idea to talk to a doctor. Over time, untreated sleep apnea is associated with heart disease, stroke, and other health issues. Plus, symptoms like excessive daytime sleepiness may increase the risk of workplace injuries and traffic accidents.
Myofunctional therapy, also known as oropharyngeal therapy, targets muscles in the mouth, tongue, throat, and face. These muscles play an important role in keeping the upper airways open. Strengthening them through specialised exercises may help improve the severity and symptoms of moderate OSA.1 Performed regularly, these exercises may help support sleep apnea treatments like continuous positive airway pressure (CPAP) therapy.4
When the upper airway muscles weaken, they're more likely to relax to the point of collapse, restricting airflow during sleep.2 In the same way you exercise other parts of your body to build strength and endurance, consistent myofunctional therapy can help your muscles stay toned and better support the airways. This can lead to fewer nighttime awakenings and better sleep quality.1
In one study, people with moderate OSA performed exercises involving the tongue, soft palate, and throat walls daily for three months. Overall, the study reported a significant decrease in neck circumference, sleep apnea severity and daytime sleepiness among participants.1
People living with mild to moderate sleep apnea who practise myofunctional therapy may experience a reduction in snoring.5 However, consistency is important. Most people who notice changes perform the exercises for 10 to 20 minutes a day over the course of a few months.4
These exercises usually don't replace prescribed treatments for moderate or severe sleep apnea. Rather, research suggests that myofunctional therapy can be used in addition to CPAP therapy. CPAP therapy uses a mask that fits over your nose and/or mouth, connected to a machine that delivers a steady flow of air. This air is designed to keep your airway open and reduce breathing pauses while you sleep. People who perform exercises for sleep apnea during the day may be more likely to use their CPAP device regularly at night.4
Myofunctional exercises can be isotonic (focusing on movement and coordination) or isometric (helping to build endurance and stability).1 Below are examples of exercises that are intended to help support upper airway muscle function during sleep.1
These exercises are educational and not a substitute for medical care. Talk to your doctor before starting a new routine, especially if you have moderate to severe obstructive sleep apnea.
People with obstructive sleep apnea (OSA) tend to have weaker tongue muscles than those without sleep apnea.6 Tongue muscle exercises can build strength and endurance, helping to reposition the tongue and keep airways open while you sleep.15 These exercises can be repeated for a few minutes each day:1
Some people may also use tongue resistance devices for exercise to help boost strength.6 Professional providers can help ensure you use these devices safely and correctly.
People with OSA tend to have overly long and flexible soft palates.1 The palate can collapse into the airway during sleep. Speech exercises can elevate the palate by working other upper airway muscles.1
Exercises targeting the lips, cheeks, mouth and jaw can help improve strength and coordination. Improving control of these muscles may help keep the mouth from opening during sleep.8
Myofunctional therapy may help reduce snoring and breathing pauses, but some people find it hard to keep up the exercises consistently. As many as 40% of people skip or stop exercising altogether.3 Getting professional guidance to perform the exercises correctly and tracking your progress can help you create a consistent routine.
Various muscles are used to keep the upper airway open. You may see better results from a series of exercises targeting the tongue, throat, palate, face and jaw, rather than focusing on one area.1
You can get a sense of whether the exercises are making a difference by monitoring symptoms such as snoring, daytime sleepiness, sleep quality and energy over time. Your doctor can assess your progress based on your apnea-hypopnea index (AHI) score.
Working with a professional trained in myofunctional therapy may help ensure the exercises fit your needs. Potential providers include certified myofunctional therapists, orofacial myologists, speech pathologists and occupational therapists.9
Your provider can customise therapy based on your symptoms and the muscles that need strengthening. A personalised programme tends to include instructions on proper techniques and how often and long to do the exercises. A digital or mobile app may be helpful in guiding you through exercises and monitoring consistency.10
Talk with your doctor before starting myofunctional therapy or making any changes to your existing treatment plan. It's important to confirm your sleep apnea diagnosis and ensure any exercises for sleep apnea are coordinated with other treatments such as continuous positive airway pressure (CPAP).
Everyone responds differently to sleep apnea treatments. By monitoring your symptoms, you can get a better sense of whether the treatment is working and discuss any changes with your doctor.
Consistency plays an important role in treating sleep apnea. Create a log that tracks how often you perform exercises, as well as symptoms such as snoring (ask your bed partner), headaches, energy level and night awakenings. If you feel like your symptoms are getting worse or you're not seeing improvements, talk to your doctor. A sleep study is the only way to diagnose sleep apnea and assess changes over time.
Myofunctional therapy is usually used in addition to other sleep apnea treatments and not as a replacement.4 By helping to retrain and strengthen muscles that support the upper airways, these exercises may support treatments such as CPAP, oral appliances and lifestyle changes.
Continuous positive airway pressure (CPAP) is highly effective and is the most used and understood method for treating sleep apnea.16 Still, some people may find it challenging to use their CPAP consistently.11
By enhancing muscle function and control, myofunctional therapy may improve airway stability and reduce air leakage during CPAP use.12 Studies suggest a link between consistent myofunctional therapy and lower CPAP pressure requirements, which may lead to improved comfort and greater nighttime CPAP use.13
Some doctors prescribe oral appliances to treat mild to moderate obstructive sleep apnea. These hard, plastic devices fit over the teeth and hold the jaw in place while sleeping to help support airflow. One study reported improvements in lip strength, tongue strength and endurance when an oral device was used alongside myofunctional therapy.14
Doctors may recommend lifestyle adjustments to manage sleep apnea severity. Oropharyngeal exercises can support these healthy habits.
Myofunctional therapy is like any exercise plan. Your muscles may become stronger with consistent practice, but the gains can disappear if you stop exercising. Continuing oropharyngeal exercises may help support the strength and natural positioning of the tongue, throat, palate and jaw. If you're having trouble sticking to your therapy routine, consider joining a sleep apnea group or online community for support and encouragement.
Living with sleep apnea can be challenging, but your doctor can help guide you through treatment options. Take the Resmed Online Sleep Quiz to learn more about your sleep health and find out if you might benefit from speaking with a doctor about sleep apnea.
This article is intended for educational purposes only and is not a substitute for medical advice. Please consult your doctor for medical advice.
ResMed is a global leader in sleep technology that has its origins right here in Australia. Our goal is to provide people with the means to awaken their best and enjoy healthier lives by promoting good sleep habits and creating awareness for sleep disorders such as sleep apnea.
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