Telemedicine-delivered myofunctional therapy remodels upper airway anatomy in obstructive sleep apnea: a prospective controlled study

STUDY OBJECTIVES: To evaluate whether telemedicine-delivered myofunctional therapy (MT) produces measurable structural changes in the upper airway (UA) of patients with obstructive sleep apnea (OSA). METHODS: This prospective, nonrandomized, blinded study included 60 adults with moderate-to-severe OSA, assigned to three groups: moderate OSA + MT (n = 19), severe OSA + MT + CPAP (n = 20), and OSA + CPAP without MT (control, n = 18). MT consisted of daily oropharyngeal exercises for 3 months, monitored through telemedicine. Pre- and postintervention assessments included sleep studies, submental ultrasound (interarterial distance, tongue thickness, and tongue volume), Iowa Oral Performance Instrument (IOPI) scores, and drug-induced sleep endoscopy (DISE; VOTE classification). Ultrasound measurements were performed by a single blinded examiner. RESULTS: After 3 months, the moderate OSA + MT group showed significant reductions in tongue volume (-8 cm³; P = .002), tongue thickness (-4 mm; P