None listed
Conditions
Brief summary
Obstructive sleep apnoea (OSA) is a sleep and breathing disorder characterised by repetitive closure or narrowing of the airway during sleep. The upper airway muscles play an important role in keeping the upper airway open. In addition to the non-respiratory functional tasks of speech and swallowing, they serve an important role in tongue protrusion, airway stiffening/support and dilation during breathing. Conversely, poor upper airway muscle function plays a key role in the pathophysiology of OSA. Indeed, more than 30% of patients with OSA have minimal activation of the upper airway muscles during airway narrowing and closure during sleep. Although recent studies highlight the potential of oropharyngeal muscle training as a non-invasive approach to therapy a major unresolved question is: how does oropharyngeal exercise training improve upper airway muscle function to reduce OSA severity? To answer this question, the current study will evaluate changes in OSA severity and upper airway physiology following an upper airway muscle training protocol.
Interventions
12 weeks of targeted upper airway muscle training to improve obstructive sleep apnoea. The training will commence the day after the participants first PSG study.
Exercises will target the soft palate, tongue and sub-mental muscles. Training will involve the use of an Expiratory Muscle Strength Trainer (EMST) and an IOPI medical device.
Participants will instructed on the exercises on day one, week 1, during a face-face consultation. Participants will have bi-weekly sessions with a speech path
12 weeks of targeted upper airway muscle training to improve obstructive sleep apnoea. The training will commence the day after the participants first PSG study. Exercises will target the soft palate, tongue and sub-mental muscles. Training will involve the use of an Expiratory Muscle Strength Trainer (EMST) and an IOPI medical device. Participants will instructed on the exercises on day one, week 1, during a face-face consultation. Participants will have bi-weekly sessions with a speech pathologist by video consultation. Training will be completed daily (~30 mins) at home for 12 weeks. Participants will be asked to complete a daily training diary to monitor adherence to the training protocol. Training will involve (1) prolonged holds and (2) pulses on an air-filled tongue bulb. The number of repetitions will be tailored to participants' baseline performance. For example, during baseline testing, participants maximum repetitions and durations will be determined. Participants will perform the hold at 50% of max effort (as they get "stronger" this value will increase, but it will always remain at 50% max effort). The repetitions will increase by 5% bi-weekly. This will be done during bi-weekly consultations with the speech-pathologist. Similarly, the EMST starting resistance will be tailored to participants' baseline peak expiratory flow. During baseline testing, participants max peak expiratory effort will be determined. Each week, the EMST will be increased by a quarter turn (as per EMST protocol). Participants will complete 5 sets of EMST comprising 5 repetitions per set. This will be completed 5 times per week (as per EMST protocol).
Sponsors
Flinders University
Study design
Allocation
Non-randomised trial
Primary purpose
Treatment
Eligibility
Sex/Gender
All
Age
18 Years to 70 Years
Healthy volunteers
No
Inclusion criteria
Male or female Otherwise healthy with a confirmed diagnosis of OSA. AHI greater than 5 events/h on pre-training PSG night. Currently not on treatment, or have previously failed treatment for OSA
Exclusion criteria
Clinically significant craniofacial malformation. Clinically significant cardiac disease (e.g., rhythm disturbances, coronary artery disease or cardiac failure) or hypertension requiring more than 2 medications for control. Clinically significant neurological disorder, including epilepsy/convulsions. Clinically significant cognitive dysfunction Participants who have had upper airway surgery < 1 year prior to participation
Outcome results
None listed