Sleep disordered breathing (SDB) is an upper airway dysfunction that occurs during sleep and is characterised by snoring and/or a greater respiratory effort caused by increased upper airway resistance and pharyngeal collapsibility. Obstructive sleep apnea (OSA) is the most severe clinical type of SDB and the most common cause of OSA is adenotonsillar hypertrophy, though other anatomical and neuromuscular factors such as craniofacial dysmorphism, obesity and hypotonic neuromuscular disease are also involved. Adenotonsillectomy (AT) remains the first-line treatment in children with adenotonsillar hypertrophy even if recent evidence suggests that the outcome of this surgical procedure may not be as favorable as expected
and that residual OSA persists in some cases. Alternative treatments for OSA include orthodontic treatment, mandibular advancement, and weight loss. These treatments correct the oropharyngeal structure but may have no effect on either functionality or neuromuscular disorders. Oropharyngeal exercises may improve stomatognathic function and reduce neuromuscular impairment and may be considered as complementary therapy to adenotonsillectomy to effectively treat pediatric OSA. It may therefore be possible to supplement
medical and surgical treatment with oropharyngeal exercises in order to re-establish nasal breathing, normal lip posture, and restore the correct swallowing pattern. The literature contains few studies designed specifically to investigate the effectiveness of orofacial re-education in OSA and we propose a standardized simplified protocol that could be more easily incorporated into daily activities of children and their family.
1) Integrate medical and surgical treatments for OSA in children with Myofunctional Therapy.
2) Promote restoration of a normal resting posture of the tongue; appropriate oral, lingual and facial muscle patterns; nasal breathing; normal lip posture and a correct swallowing pattern.
3) Promote standardized simplified protocols for myofunctional Treatment