Train Your Airway: How Myofunctional Therapy Helps Sleep Apnea

Quick takeaways

• Myofunctional therapy targets muscles around your upper airways to improve strength, endurance and position.¹
• Exercising the tongue, palate, throat, lips and jaws can help keep airways open and improve symptoms of OSA.³
• Myofunctional therapy is used as a complement to CPAP and other treatments for OSA.⁴
• Consistent practice is important for optimal results.¹
• Your doctor can guide you through the recommended treatments for your sleep apnea symptoms.

If you’re living with sleep apnea — a condition where breathing stops and restarts many times throughout the night — you may be familiar with the different treatment options. These include continuous positive airway pressure (CPAP) therapy (a device that’s designed to help you breathe consistently throughout the night), oral appliances and surgical implants. Myofunctional therapy uses exercises to strengthen the throat, tongue, face and jaw muscles, and can help support sleep apnea treatments.¹

Learn more about myofunctional therapy and how it may help with obstructive sleep apnea (OSA) symptoms.

Understanding sleep apnea and exercise therapy

Healthy, functional muscles are important for keeping the upper airways open, which can support normal breathing during sleep.² When the tongue, throat and jaw muscles relax, the airways may become narrow. This can cause breathing to become shallow or stop for seconds to minutes at a time while sleeping.

Myofunctional therapy may help reduce the apnea-hypopnea index (AHI) in people living with sleep apnea. AHI measures how many times a person’s breathing slows or stops per hour of sleep. One study shows myofunctional therapy reducing AHI by 34% in adults with sleep apnea.³

What is obstructive sleep apnea (OSA)?

Obstructive sleep apnea (OSA) is a condition where your upper airway becomes blocked repeatedly during sleep, making it harder for air to flow. These blockages can reduce or completely stop the flow of air, causing your breathing to pause throughout the night.

Symptoms of OSA may include:

• Excessive daytime sleepiness
• Morning headaches
• Feeling irritable or moody
• Difficulty concentrating, struggling to feel present during the day
• Snoring or gasping for air while you sleep

If you’re concerned about your sleep, it’s a good idea to talk to a doctor. Over time, untreated sleep apnea is associated with heart disease, stroke, high blood pressure, and type 2 diabetes. Plus, symptoms like excessive daytime sleepiness may increase the risk of workplace injuries and traffic accidents.

What is myofunctional therapy and how does it help with obstructive sleep apnea exercises?

Myofunctional therapy, also known as oropharyngeal therapy, targets muscles in the mouth, tongue, throat and face. These muscles play an important role in keeping the upper airways open. Strengthening them through specialized exercises may help improve the severity and symptoms of moderate OSA.¹ Performed regularly, these exercises may help support sleep apnea treatments like continuous positive airway pressure (CPAP) therapy.⁴

The science behind oropharyngeal therapy

When the upper airway muscles weaken, they’re more likely to relax to the point of collapse, restricting airflow during sleep.² In the same way you exercise other parts of your body to build strength and endurance, consistent myofunctional therapy can help your muscles stay toned and better support the airways. This can lead to fewer nighttime awakenings and better sleep quality.¹

In one study, people with moderate OSA performed exercises involving the tongue, soft palate, and throat walls daily for three months. Overall, the study reported a significant decrease in neck circumference, sleep apnea severity and daytime sleepiness among participants.¹

How effective is myofunctional therapy in helping sleep apnea and snoring?

People living with mild to moderate sleep apnea who practice myofunctional therapy may experience a reduction in snoring.⁵ However, consistency is important. Most people who notice changes perform the exercises for 10 to 20 minutes a day over the course of a few months.⁴

These exercises usually don’t replace prescribed treatments for moderate or severe sleep apnea. Rather, research suggests that myofunctional therapy can be used in addition to CPAP therapy. CPAP therapy uses a mask that fits over your nose and/or mouth, connected to a machine that delivers a steady flow of air. This air is designed to keep your airway open and reduce breathing pauses while you sleep. People who perform exercises for sleep apnea during the day may be more likely to use their CPAP device regularly at night.⁴

Types of myofunctional exercises

Myofunctional exercises can be isotonic (focusing on movement and coordination) or isometric (helping to build endurance and stability).¹ Below are examples of exercises that are intended to help support upper airway muscle function during sleep.¹

These exercises are educational and not a substitute for medical care. Talk to your doctor before starting a new routine, especially if you have moderate to severe obstructive sleep apnea.

Tongue exercises

People with obstructive sleep apnea (OSA) tend to have weaker tongue muscles than those without sleep apnea.⁶ Tongue muscle exercises can build strength and endurance, helping to reposition the tongue and keep airways open while you sleep.¹⁵ These exercises can be repeated for a few minutes each day:¹

• Lift the tongue toward the roof of the mouth with a gentle sucking motion and hold it firmly in place.
• Place the tip of the tongue on the palate and slide it backward to enhance strength.
• Push the tongue against the floor of the mouth, keeping the tip touching the bottom teeth.

Some people may also use tongue resistance devices for exercise to help boost strength.⁶ Professional providers can help ensure you use these devices safely and correctly.

Throat and soft palate exercises

People with OSA tend to have overly long and flexible soft palates.¹ The palate can collapse into the airway during sleep. Speech exercises can elevate the palate by working other upper airway muscles.¹

• Say a series of vowels (A-E-I-O-U), pausing between them, to practice muscle control. Use extra emphasis as you pronounce the vowel.^1,15
• Pronounce a vowel without pausing to build strength and endurance.^1,15
• Perform singing exercises to improve muscle tone in throat tissues.⁷

Facial and jaw exercises

Exercises targeting the lips, cheeks, mouth and jaw can help improve strength and coordination. Improving control of these muscles may help keep the mouth from opening during sleep.⁸

• Open and close your mouth slowly and gently to strengthen the jaw.⁸
• Lift the corners of your mouth as if smiling widely. Hold this position for a few seconds and then relax.¹
• Create a gentle suction with the cheeks with the rest of the facial muscles relaxed. Hold the position to build endurance and repeat the motion to boost strength.¹
• Practice gentle chewing and swallowing to coordinate movement and encourage the tongue and jaw to work together.¹

Building a myofunctional exercise routine for sleep apnea

Myofunctional therapy may help reduce snoring and breathing pauses, but some people find it hard to keep up the exercises consistently. As many as 40% of people skip or stop exercising altogether.³ Getting professional guidance to perform the exercises correctly and tracking your progress can help you create a consistent routine.

Creating a routine that works

Various muscles are used to keep the upper airway open. You may see better results from a series of exercises targeting the tongue, throat, palate, face and jaw, rather than focusing on one area.¹

You can get a sense of whether the exercises are making a difference by monitoring symptoms such as snoring, daytime sleepiness, sleep quality and energy over time. Your doctor can assess your progress based on your apnea-hypopnea index (AHI) score.

Working with professionals

Working with a professional trained in myofunctional therapy may help ensure the exercises fit your needs. Potential providers include certified myofunctional therapists, orofacial myologists, speech pathologists and occupational therapists.⁹

Your provider can customize therapy based on your symptoms and the muscles that need strengthening. A personalized program tends to include instructions on proper techniques and how often and long to do the exercises. A digital or mobile app may be helpful in guiding you through exercises and monitoring consistency.¹⁰

Talk with your doctor before starting myofunctional therapy or making any changes to your existing treatment plan. It’s important to confirm your sleep apnea diagnosis and ensure any exercises for sleep apnea are coordinated with other treatments such as continuous positive airway pressure (CPAP).

Tracking and adjusting treatment over time

Everyone responds differently to sleep apnea treatments. By monitoring your symptoms, you can get a better sense of whether the treatment is working and discuss any changes with your doctor.

Consistency plays an important role in treating sleep apnea. Create a log that tracks how often you perform exercises, as well as symptoms such as snoring (ask your bed partner), headaches, energy level and night awakenings. If you feel like your symptoms are getting worse or you’re not seeing improvements, talk to your doctor. A sleep study is the only way to diagnose sleep apnea and assess changes over time.

Combining exercises with other treatments

Myofunctional therapy is usually used in addition to other sleep apnea treatments and not as a replacement.⁴ By helping to retrain and strengthen muscles that support the upper airways, these exercises may support treatments such as CPAP, oral appliances and lifestyle changes.

Exercises and CPAP therapy

Continuous positive airway pressure (CPAP) is highly effective and is the most used and understood method for treating sleep apnea.¹⁶ Still, some people may find it challenging to use their CPAP consistently.¹¹

By enhancing muscle function and control, myofunctional therapy may improve airway stability and reduce air leakage during CPAP use.¹² Studies suggest a link between consistent myofunctional therapy and lower CPAP pressure requirements, which may lead to improved comfort and greater nighttime CPAP use.¹³

Exercises and oral appliance therapy

Some doctors prescribe oral appliances to treat mild to moderate obstructive sleep apnea. These hard, plastic devices fit over the teeth and hold the jaw in place while sleeping to help support airflow. One study reported improvements in lip strength, tongue strength and endurance when an oral device was used alongside myofunctional therapy.¹⁴

Exercises and lifestyle changes

Doctors may recommend lifestyle adjustments to manage sleep apnea severity. Oropharyngeal exercises can support these healthy habits.

• Excess weight can cause airway blockages during sleep. Your doctor may suggest healthy weight management through physical activity and diet to help treat sleep apnea.
• Smoking can cause inflammation in the throat, making breathing more difficult. Avoid tobacco use to improve airway health.
• Drinking alcohol and taking sedatives can relax the airway and make sleep apnea worse. Try cutting back to improve throat function and breathing.
• Sleep hygiene, or good habits that promote better sleep, can help improve sleep quality and support OSA treatment. Try to wake up and go to bed at consistent times, avoid screens close to bedtime, and keep your room dark to help set your circadian rhythm.

Long-term maintenance

Myofunctional therapy is like any exercise plan. Your muscles may become stronger with consistent practice, but the gains can disappear if you stop exercising. Continuing oropharyngeal exercises may help support the strength and natural positioning of the tongue, throat, palate and jaw. If you’re having trouble sticking to your therapy routine, consider joining a sleep apnea group or online community for support and encouragement.

A good night’s sleep is within reach

Living with sleep apnea can be challenging, but your doctor can help guide you through treatment options.

Want to dive deeper into your sleep? Take an online sleep assessment to learn more.

References:

1. Source: Guimarães, Kátia C., et al. “Effects of Oropharyngeal Exercises on Patients with Moderate Obstructive Sleep Apnea Syndrome.” American Journal of Respiratory and Critical Care Medicine, vol. 179, no. 10, May 2009, pp. 962–66. PubMed. https://doi.org/10.1164/rccm.200806-981OC
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7. Source: Ojay, A., and E. Ernst. “Can Singing Exercises Reduce Snoring? A Pilot Study.” Complementary Therapies in Medicine, vol. 8, no. 3, Sept. 2000, pp. 151–56. ScienceDirect. https://doi.org/10.1054/ctim.2000.0376
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11. Source: Shaukat, Rabia, et al. “Adherence to Positive Airway Pressure Therapy in Patients With Obstructive Sleep Apnea.” Cureus, vol. 14, no. 6, p. e25946. PubMed Central. https://doi.org/10.7759/cureus.25946
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