{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T20:19:22Z","timestamp":1792268362734,"version":"4.4.0"},"reference-count":48,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2023,8,22]],"date-time":"2023-08-22T00:00:00Z","timestamp":1692662400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Orofacial myofunctional therapy (OMT) is an alternative form of treatment of obstructive sleep apnea (OSA), that incorporates various exercises to optimize tongue placement and increase oropharyngeal tone. The objective of this systematic review and meta\u2010analysis is to determine the efficacy of OMT in OSA patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data Sources<\/jats:title>\n                    <jats:p>PubMed\/Medline, EMBASE, Cochrane, Web of Science.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Review Methods<\/jats:title>\n                    <jats:p>Using PRISMA guidelines, a directed search strategy was performed for randomized control trials (RCTs) published prior to March 24, 2023, featuring 10+ patients with OSA undergoing mono\u2010therapeutic OMT. The primary outcome of interest was apnea\u2010hypopnea index (AHI). Secondary outcomes included subjective sleepiness, sleep\u2010related quality\u2010of\u2010life, and snoring frequency.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of the 1244 abstracts that were identified, 7 RCTs involving 310 patients met inclusion criteria. Adult OMT patients had a statistically significant improvement in AHI (MD \u221210.2; 95% CI, \u221215.6, \u22124.8,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05), subjective sleepiness (Epworth Sleepiness Scale; MD \u22125.66; 95% CI, \u22126.82, \u22124.5,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05), sleep\u2010related quality\u2010of\u2010life (Pittsburgh Sleep Quality Index; MD \u22123.00; 95% CI, \u22124.52, \u22121.49,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05), and minimum oxygen saturation (MD 2.71; 95% CI, 0.23, 5.18,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05) when compared with sham OMT or no therapy. Within the single RCT featuring pediatric OMT patients, patients had poor compliance (&lt;50%) and did not show any improvements in AHI, minimum oxygen saturation, or snoring frequency.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>OMT may provide a reasonable alternative for OSA patients who cannot tolerate CPAP or other more established treatment options. OMT benefits appear limited in children due to poor compliance. More studies are required to evaluate compliance and the long\u2010term effects of OMT on OSA outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>\n                      1\n                      <jats:italic>Laryngoscope<\/jats:italic>\n                      , 134:480\u2013495, 2024\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/lary.30974","type":"journal-article","created":{"date-parts":[[2023,8,22]],"date-time":"2023-08-22T08:47:45Z","timestamp":1692694065000},"page":"480-495","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":60,"title":["Orofacial Myofunctional Therapy for Obstructive Sleep Apnea: A Systematic Review and\n                    <scp>Meta\u2010Analysis<\/scp>"],"prefix":"10.1002","volume":"134","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6186-9912","authenticated-orcid":false,"given":"Elias S.","family":"Saba","sequence":"first","affiliation":[{"name":"Department of Head and Neck Surgery, Kaiser Permanente Oakland Medical Center  Oakland California U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hannah","family":"Kim","sequence":"additional","affiliation":[{"name":"Drexel University College of Medicine  Philadelphia Pennsylvania U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5878-1442","authenticated-orcid":false,"given":"Pauline","family":"Huynh","sequence":"additional","affiliation":[{"name":"Department of Head and Neck Surgery, Kaiser Permanente Oakland Medical Center  Oakland California U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nancy","family":"Jiang","sequence":"additional","affiliation":[{"name":"Department of Head and Neck Surgery, Kaiser Permanente Oakland Medical Center  Oakland California U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,8,22]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kws342"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.0000236560.15735.0f"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.109.901801"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2011.1115"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1080\/17476348.2022.2030225"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.sleep.2009.10.005"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm.152.5.7582313"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.122.3.840"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12931-022-02141-3"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(13)60734-5"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40463-016-0156-0"},{"key":"e_1_2_7_13_1","first-page":"245","article-title":"Adherence to continuous positive airway pressure treatment for obstructive sleep apnea: implications for future interventions","volume":"131","author":"Weaver TE","year":"2010","journal-title":"Indian J Med Res"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD013449.pub2"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.5665\/sleep.4652"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/joor.13325"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/0165-1781(89)90047-4"},{"key":"e_1_2_7_18_1","unstructured":"Sch\u00fcnemannH Bro\u017cekJ GuyattG OxmanA.GRADE handbook for grading quality of evidence and strength of recommendations.2023. 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