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Neutral supporting mandibular advancement device with tongue bead for passive myofunctional therapy: a long term

Yu-Shu Huang1, Li-Chuan Chuang2, Michèle Hervy-Auboiron3

  • 1Department of Child Psychiatry and Sleep Center, Chang Gung Memorial Hospital and College of Medicine, Taoyuan, Taiwan; Department of Craniofacial Research Center and Sleep Center, Chang Gung Memorial Hospital and College of Medicine, Chang Gung University, Taoyuan, Taiwan.

Sleep Medicine
|November 19, 2018
PubMed

Insights

Compliance remains a significant challenge for myofunctional therapy (MFT) in children with obstructive sleep apnea (OSA). Passive MFT devices demonstrated better adherence and positive outcomes compared to active MFT.

Area of Science:

  • Pediatric Sleep Medicine
  • Orthodontics
  • Respiratory Medicine

Background:

  • Myofunctional therapy (MFT) is a recognized complementary treatment for obstructive sleep apnea (OSA).
  • Patient compliance with MFT regimens presents a significant challenge in pediatric OSA management.

Purpose of the Study:

  • To compare the efficacy and compliance of traditional myofunctional therapy (MFT) versus a passive MFT device in children with OSA.
  • To evaluate the impact of both MFT approaches on polysomnography (PSG) and cephalometric parameters.

Main Methods:

  • A prospective study involving 110 children aged 4-16 years with OSA.
  • Participants were randomized into two groups: active MFT (n=54) and passive MFT device (n=56).
  • Assessments included clinical evaluation, PSG, and cephalometric X-rays at baseline, 6, and 12 months.

Main Results:

  • The active MFT group exhibited very low compliance, with only 10/23 participants compliant at 6 months and none at 12 months.
  • The passive MFT group showed high compliance (48/56 completing the study) and significant improvements in PSG and cephalometric measures.
  • Children using the passive MFT device achieved nasal breathing during sleep at 1 year with no noted adverse effects.

Conclusions:

  • Compliance is a critical barrier to the effectiveness of traditional MFT for pediatric OSA.
  • Passive MFT devices offer a more promising alternative, demonstrating better adherence and positive clinical outcomes.
  • Continuous parental involvement is essential for active MFT, while potential adverse effects of passive devices require ongoing monitoring.
Abstract

Keywords:
Functional oral applianceMyofunctional therapyPediatric obstructive sleep apnea syndromePolysomnographyProspective study

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