The effect of tongue strength and endurance in patients with obstructive sleep apnea

This study aimed to evaluate tongue strength and endurance in patients with OSA and identify variables that modify their effects on OSA severity.

A cross-sectional study included 189 adults with OSA, classified according to the apnea-hypopnea index (AHI) as mild (n = 63), moderate (n = 52), or severe (n = 74). The anterior and posterior tongue strengths, and tongue endurance were measured using the IOPI^® Pro device. General linear models were applied to estimate unadjusted and adjusted marginal means. Adjustment was made for age, sex, and body mass index (BMI).

The anterior tongue strength did not differ significantly across mild, moderate, and severe OSA (56.11 ± 11.31 vs. 51.32 ± 10.67 vs. 55.55 ± 13.22 kPa, p = 0.07), nor did posterior tongue strength (50.16 ± 16.14 vs. 46.25 ± 12.55 vs. 47.84 ± 13.39 kPa, p = 0.328), or tongue endurance (16.00 (12,22) vs. 14.75 (12,17.5) vs. 17.30 (13,23) seconds, p = 0.744). BMI was a significant effect modifier for anterior and posterior tongue strength. In the non-obese subgroup (BMI < 30 kg/m²) adjusted analyses for age and gender revealed differences in mean anterior (diff = 10.48, p = 0.017) and posterior (diff = 13.26, p = 0.02) tongue strength between patients with mild and severe OSA.

In an adult cohort, tongue strength did not differ among patients with mild, moderate, and severe OSA. However, in non-obese patients (BMI < 30 kg/m²), tongue strength was lower in those with severe OSA compared to those with mild OSA. Future studies on the impact of tongue strength may be best directed at non-obese patients with OSA.