Snore No More: Oral Exercises for Sleep Apnea

Is consistent snoring disturbing your sleep? Or disturbing your partner’s sleep? This type of unhealthy pattern is likely caused by obstructive sleep apnea, or OSA. OSA involves impaired breathing during sleep due to narrowing of the upper airway. It is primarily caused by muscle weakness and structural changes of the oral anatomy.

Note: The content on Sleepopolis is meant to be informative in nature, but it shouldn’t take the place of advice and supervision from your healthcare provider. If you feel you may be suffering from any sleep disorder or medical condition, please see a trained professional.

The Impact of Obstructive Sleep Apnea

Obstructive sleep apnea is more than just a noisy inconvenience. The disorder has been linked to serious medical and safety risks. OSA increases the likelihood of serious health conditions like heart disease, diabetes, stroke, and depression. Chronic drowsiness caused by sleep apnea also heightens the risk of traffic accidents and workplace injuries. “Untreated severe apnea can take 10 to 15 years off of someone’s life,” says Dr. Joseph Golish, a pulmonologist and sleep medicine expert in Brooklyn Heights, Ohio.

Unfortunately, OSA is becoming more prevalent. Current estimates show that nearly 25 million Americans are afflicted with OSA, and over a quarter of them are adults aged thirty to seventy. Standard care involves oral devices, surgery, and/or CPAP machines, but none of these options address the full scope of the disorder.

Like other musculoskeletal conditions, sleep apnea involves issues related to both structure and function. Though weakness of the oropharyngeal muscles is the most common dysfunction leading to OSA, the upper airway can become partially closed for other reasons, such as:

• Problems with nasal & dental structure
• Excessive alcohol consumption, leading to relaxation of the tongue and throat muscles
• Sleep position, particularly lying on the back
• Excess weight, which can impair neck and jaw posture

OSA Treatment

The most direct route to addressing OSA is to improve the function of the mouth and facial muscles involved in breathing. Although it takes time and dedication, oropharyngeal exercises require no special equipment and can demonstrate long-term sleep benefits.

In a recent study, twenty patients with mild to moderate OSA were given oropharyngeal exercises — also called oral motor exercises — to improve their posture and the strength of their facial and tongue muscles. Each exercise was repeated ten times, five sets per day. After three months, patients demonstrated reduced episodes of snoring and significant improvements in all sleep indices. Many reported less daytime drowsiness and improved postural awareness. (1)

By performing regular exercises to improve tongue and lip motor control, you may be able to reduce snoring and ameliorate mild to moderate sleep apnea. The muscles of the mouth and face are no different than any other muscles. They need to be exercised and conditioned to ward off the detrimental effects of prolonged sitting and forward head postures. The goal of the program is to improve the strength of muscles responsible for maintaining an open upper airway during sleep.

Oral Motor Exercises

Lip Trace

Keeping the lips together, use the tongue to trace the inside of the lips in a circular manner, then reverse the circle. Lip trace video.

Chin Nods

Scoop the chin and lengthen the neck, tucking the chin down towards the neck. Chin nods video.

Cheek Puffs

Keeping the lips together, puff out the cheeks starting with forward first, then to the right, left, up, and down. Cheek puffs video.

Caves

Press the tongue to the roof of the mouth, open the mouth as wide as possible, then bring the tongue back down. Caves video.

Spoon hold

Without letting the handle of the utensil touch the teeth, hold it with the lips and try to keep it as level as possible. Spoon hold video.

Ark / Unc

Repeat saying “Ark” and “Unc.” Ark/Unc video.

Tongue Point

Point the tongue to the roof of the mouth. Tongue point video.

Full video of exercises available on Vimeo.

References

1. Verma R, et al. Oropharyngeal exercises in the treatment of obstructive sleep apnoea: our experience. Sleep Breath. 2016;20(4):1193-1201.

Dr. Keith Poorbaugh

Keith Poorbaugh, PT, ScD, OCS, CSCS, CMTPT, FAAOMPT Physical Therapist, Owner, Northern Edge Physical Therapy, Wasilla, Alaska Dr. Poorbaugh has completed specialty certifications, internships and a residency fellowship to develop mastery of manual therapy skills and clinical expertise. Throughout 20 years of clinical experience, he has discovered that clients consistently heal faster when the provider is both compassionate and skilled. His personal challenge to achieve excellence is never ending, as a lifelong learner and mentor. A few of his career highlights are listed below: Graduate of Masters Physical Therapy program at Mayo Clinic in 1997 Clinical Science Doctorate (ScD) in orthopedics from Texas Tech in 2006 Over 15 yrs experience as lead faculty and national instructor with continuing education organizations: IAOM-US, North American Seminars Fellow of the American Academy of Orthopedic Manual Physical Therapists (AAOMPT) Certified in Dry Needling (Myopain, American Dry Needling Institute and Spinal Manipulation Institute) Board (ABPTS) Certified Orthopedic Clinical Specialist (ABPTS) Certified Strength and Conditioning Specialist