Myofunctional therapy in sleep disorders: a systematic review

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Abstract
Background: Obstructive sleep apnea (OSA) is a syndrome characterized by episodes of complete cessation of breathing (apnea) or inadequate breathing (hypopnea) during sleep. Methods: A systematic search of PubMed, Cochrane Library, Embase, Scopus, Web of Science, and Lilacs databases was conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We identified 1,532 records; after screening, 9 randomized controlled trials (RCTs), published between 2009 and 2020, met the inclusion criteria. These studies included 698 participants aged 5–75 years. Results: Nine randomized trials (n = 698; 2009–2020) showed that myofunctional therapy (MFT), alone or as an adjunct, for example, continuous positive airway pressure (CPAP) and nasal washing, reduced apnea-hypopnea index (AHI) versus control in adults and children. Snoring intensity improved in trials that measured it; several studies reported gains in oxygen saturation and mouth-breathing reduction. Protocols targeted the soft palate, tongue, and facial muscles with daily home exercises. Discussion: MFT appears to be a promising non-invasive treatment for reducing AHI, especially in pediatric patients. Its benefits extend beyond AHI reduction, supporting orofacial function and nasal breathing. However, its clinical integration remains limited due to a lack of standardized protocols and inconsistent reporting of patient adherence. Most studies also have short follow-up periods, which makes it difficult to assess long-term efficacy. To advance evidence-based use of MFT, future research should adopt standardized outcomes, monitor adherence systematically, and include long-term follow-up.

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