閉塞性睡眠時無呼吸における閉塞性睡眠時無呼吸に対するビデオ会議を介した遠隔嚥下機能再建術の効果：舌機能および無呼吸重症度に対する効果：準実験的研究

Obstructive sleep apnea (OSA) is marked by recurrent upper airway collapse during sleep and is associated with upper airway muscle dysfunction. Oropharyngeal rehabilitation (OPR) targets this dysfunction through structured muscle training. While supervised OPR improves adherence, its time and logistical demands may hinder access and increase dropout.

This study evaluated the effectiveness of a multilevel OPR program delivered via video conferencing on muscle function and the apnea-hypopnea index (AHI) in individuals with OSA.

This quasi-experimental study included 40 participants with OSA who were pair-matched by age, body mass index, and AHI and assigned to either the intervention or control group. The intervention group underwent 12 weeks of a supervised group-based OPR program delivered via video conferencing. Outcomes measured included polysomnographic parameters, tongue muscle strength and endurance, and sleep-related questionnaires, assessed at baseline and post-intervention.

The intervention group demonstrated significantly greater reductions in AHI, hypopnea index, and AHI in the supine position compared to controls, with decreases of 25%, 28%, and 29%, respectively, versus 10%, 2%, and a 16% increase in the control group. Significant gains in tongue depression, protrusion, and lateralization strength and endurance were observed. Improvements in tongue protrusion endurance showed a weak, negative correlation (ρ=-0.32) with AHI reduction, and adherence to telerehabilitation reached 90%.

Supervised group-based multilevel OPR delivered via video conferencing effectively improved tongue muscle strength and endurance and significantly reduced AHI in individuals with OSA. These findings suggest that remotely supervised OPR may represent a feasible and non-invasive approach for OSA management.