Authors (including presenting author) :
Tang TY(1), Ng MC(1), Tang LY1, Liu KY(1), Ko WT(2), Tsui TK(2)
Affiliation :
(1)Occupational Therapy Department, (2)Department of Paediatrics & Adolescent Medicine, Pamela Youde Nethersole Eastern Hospital
Introduction :
Obstructive Sleep Apnea Syndrome(OSAS)is a significant health problem characterized by repetitive episodes of upper airway occlusion during sleep. It may lead to snoring, daytime sleepiness, sleep fragmentation, and affect the sleep quality. The estimated prevalence of OSAS in children and youths is about 1-5%. Apart from having surgery or using Continuous Positive Airway Pressure Ventilator (CPAP), activating the orofacial function and habituating a proper nasal breathing pattern are also imperative to reduce obstruction to the airway during sleeping. To facilitate these processes, OT management program using Orofacial Myofunctional Therapy(OMT), which incorporate neurological re-education exercises in the daily routine, maybe a new way to help.
Objectives :
To evaluate the effects of OT management program for children and youths with mild to moderate OSAS by using OMT.
Methodology :
A total of 15 cases between 4 and 18 years old with diagnosis of mild to moderate OSAS, referred from Sleep Clinic of Department of Paediatrics & Adolescent Medicine, were recruited into a half-year OSAS management program in 2019. The program consisted of 2 phases: the intensive phase (once/week, total 8 sessions) and the generalization phase (once/2 weeks, total 8 sessions). It was carried out in groups of 5 patients. Participants learnt a different set of oropharyngeal home exercises on each session and they were required to repeat the home exercises daily. 7 patients completed the whole program and underwent an evaluation protocol at 3 times: before treatment, after the intensive phase and after the generalization phase. Evaluations included snoring frequency (0-7), snoring intensity (0-4) and Epworth sleepiness scale (0-24).
Result & Outcome :
Compared with before treatment, patients showed significant improvement in ESS scores after both the intensive phase and the generalization phase (p=0.017; p=0.017). Besides, 57% of participants reported a decrease in the snoring frequency and intensity after both the intensive phase and generalization phase although the improvement was not statistically significant (p=0.102; p=0.102). Moreover, 2 out of 7 patients reported a higher chance in nasal breathing and one patient reported reduced frequency of sore throat due to decreased mouth breathing habit after the program.
This preliminary study demonstrated the effect of OT management program in reducing the OSAS symptoms in children and youths with mild to moderate OSAS. More effort could be put to validate the results by recruiting more patients into the program. Moreover, future studies are needed to demonstrate the lasting effects of continued OMT.
