Myofunctional therapy for OSA: a meta-analysis
Sanket Meghpara, Moeed Chohan, Anuja Bandyopadhyay, Conrad Kozlowski, Jameson Casinas, Clete A. Kushida, Macario Camacho
Abstract
INTRODUCTION: Myofunctional therapy (MT) improves obstructive sleep apnea (OSA) in patients. AREAS COVERED: We systematically reviewed publications to evaluate MT as a treatment for OSA. We identified relevant articles and performed a meta-analysis on apnea-hypopnea index (AHI) scores, lowest oxygen saturation (LSAT), and Epworth Sleepiness Scale (ESS). Search databases were retained as primary data sources with the search performed through 18 June 2021. EXPERT OPINION: Fifteen studies with 237 patients provided OSA outcomes before and after MT, which were analyzed for this meta-analysis. The mean AHI scores decreased from 28.0 ± 16.2/h to 18.6 ± 13.1/h. The AHI standard mean difference (SMD) is -1.34 (large effect) [95% CI -0.84, -1.85], (P < 0.00001). LSAT (197 patients) improved from 83.18 ± 6.10% to 85.13 ± 7.01%. The LSAT SMD is 0.44 [95% CI 0.75, 0.12], (P < 0.007). Sleepiness measured via ESS (156 patients) demonstrated a decrease from 12.71 ± 5.73 to 8.78 ± 5.80. The ESS SMD is -1.0 [95% CI -0.50, -1.50], (P < 0.0001).