A Retrospective Review of Oromyofunctional Therapy in the Treatment of Pediatric Sleep-Disordered Breathing: A Local Single-Center Study

Background and objectivesPediatric sleep-disordered breathing (SDB) ranges from primary snoring to obstructive sleep apnea (OSA).Oromyofunctional therapy (OMT) aims to improve upper airway function through targeted muscle training.This study reviewed the observed clinical and polysomnography (PSG) outcomes in children with SDB receiving OMT and explored associations between treatment compliance and observed outcomes. MethodsThis single-center retrospective observational study reviewed medical records of children aged three to 18 years who received OMT for SDB between January 2018 and December 2024.Outcomes included caregiverreported changes in snoring and daytime sleepiness, modified Epworth Sleepiness Scale (mESS) scores, and pre-and post-intervention PSG parameters as follows: obstructive apnea-hypopnea index (OAHI), nadir oxygen saturation (SpO 2 ), and arousal index.A sensitivity analysis was performed in an isolated OMT subgroup, excluding patients with concurrent weight reduction, improvement in allergic rhinitis, adenotonsillectomy, or nocturnal non-invasive ventilation.Acceptable compliance was defined as completion of at least 50% of the prescribed treatment components. ResultsAmong 48 patients (median age nine years {IQR: 7-12}; 70.8% male), snoring improved in 46/48 (95.8%) and daytime sleepiness in 26/27 (96.2%).Median mESS scores decreased from 4 (IQR: 2-7) to 1 (IQR: 0-3; p<0.001).In the isolated OMT subgroup (n=32), snoring improved in 30/32 (93.8%) and daytime sleepiness in 12/13 (92.3%); median mESS scores decreased from 4.5 (IQR: 2-7) to 1 (IQR: 0-3; p<0.001).Among the 17 patients with paired PSG data in the overall study group, median time between baseline and post-OMT PSG was 20 months (IQR: 17-27.5).COVID pandemic-induced healthcare disruptions and patient-led deferrals contributed to the extended timeline between the paired PSG evaluations.In the whole study group, median OAHI decreased from 8.7 to 2.8 events/h (p=0.015),SpO 2 nadir increased from 89% to 91% (p=0.003), and median arousal index decreased from 9.6 to 6.4 events/h (p=0.006).In the isolated OMT subgroup (n=11), changes in median OAHI (8.7 to 4.9 events/h; p=0.213),SpO 2 nadir (89% to 91%; p=0.050), and median arousal index (7.3 to 6.4 events/h; p=0.075) were not statistically significant.Acceptable compliance was achieved by 35/48 patients (72.9%).No significant associations were found between compliance and age, sex, or comorbidities.Significant improvement in clinical symptoms and mESS scores was observed in both compliance groups.No significant changes in PSG parameters were observed in either compliance group. ConclusionImprovement in symptoms of snoring and daytime sleepiness and reduced mESS scores were observed following OMT intervention in both the whole study group and the isolated OMT subgroup.Although PSG parameters improved significantly in the overall study group, these findings were not consistently demonstrated in the isolated OMT subgroup.Given the retrospective design, small sample size, relatively long interval between pre-and post-intervention PSGs, and potential confounding from concurrent interventions, the independent efficacy of OMT could not be established from this study.Larger prospective controlled studies are needed to evaluate the efficacy of OMT in pediatric SDB.