Breathing Exercises, Myofunctional Therapy and Sleep Apnea: What Is Known

See a clinician first

Sleep apnea means breathing repeatedly stops and starts during sleep. The NHS says it needs to be treated because it can lead to more serious problems. [1] See a doctor if you stop breathing in your sleep, make gasping, snorting or choking noises, or always feel very tired in the daytime. [1] Exercises should never be your only response to those signs. For the goal-level overview, see sleep apnea.

The NHS also says that if sleep apnea with excessive sleepiness is confirmed, a person must not drive until symptoms like feeling very tired are under control. [1] That is a UK rule; check the rules where you live.

What the exercises are

Myofunctional therapy (also called oropharyngeal or orofacial exercises) is a set of mouth and throat exercises. Cochrane describes combinations of isotonic and isometric exercises for the mouth, pharynx and upper airway, working on functions such as speaking, breathing, blowing, sucking, chewing and swallowing. [2] The NHS lists exercises for the mouth and facial muscles among other treatments sometimes used. [1]

This is different from the calm breathing practices on other pages. We do not give an exercise routine here, because the sources we read do not give one standard protocol and exercises are best taught by a trained clinician.

Where standard care stands

Cochrane states that CPAP (continuous positive airway pressure) is considered the first treatment option for most people with obstructive sleep apnea. [2] The NHS says many people need a CPAP machine, and that lifestyle changes such as losing weight, quitting smoking and drinking less alcohol can sometimes help. [1] MedlinePlus says CPAP devices work well in most people and that other treatments have less evidence. [3]

What research shows

The NHS describes the severity score, the apnea-hypopnea index (AHI), as based on how often your breathing stops while you sleep. [1]

1. Myofunctional therapy vs sham, adults (Cochrane, 9 trials, 347 people)

   Promising but limited

   Probably reduces daytime sleepiness and may improve sleep quality in the short term. [2] AHI fell by about 13 points in two small studies, rated low-certainty. [2]

2. Myofunctional therapy vs CPAP

   Exercises are not equal to CPAP

   Little to no difference in sleepiness, but AHI may be higher with exercises alone (one study of 54 people). [2]

3. Safety and long-term outcomes

   Proper evidence not found

   Safety was not reported: none of the included studies reported adverse events, and none assessed accidents, heart disease or death. [2]

4. Earlier pooled analysis

   Promising but limited

   Nine adult studies reported lower AHI, snoring and sleepiness after therapy, using before-and-after measures. [4]

5. 2024 meta-analysis of 7 trials

   Promising but limited

   Adults had a statistically significant AHI improvement when compared with sham or no therapy, and the authors suggest it may be a reasonable alternative for people who cannot tolerate CPAP. [5]

6. Children

   Insufficient evidence

   A single trial showed poor adherence (under 50%) and no improvement in AHI. [5]

7. Exercises added to a dental device

   No good evidence of benefit

   In 23 people, no added benefit on residual apnea after a mandibular advancement device. [6]

The Cochrane authors rated certainty moderate to very low, mainly because assessors of subjective outcomes were not blinded, data were incomplete and samples were small. [2] Trials lasted two to four months. [2] The 2024 authors say more studies are needed on adherence and long-term effects. [5]

Other breathing and breath-related ideas

• Breathing exercises and respiratory muscle training. A meta-analysis of six studies in adults with mild to moderate sleep apnea found expiratory exercises lowered AHI compared with baseline. [7] A separate review of 13 trials found all had high risk of bias and that inspiratory muscle training may not beat sham for AHI, though it probably improved systolic blood pressure and sleepiness. [8] See inspiratory muscle training.
• Singing and wind instruments. A review of six studies (five cross-sectional and one randomized) found hints of benefit, including from the didgeridoo, but the effect could not be confirmed in the meta-analysis and the certainty of the evidence was graded low. [9] Didgeridoo playing showed a positive effect on AHI and daytime sleepiness in the studies reviewed. [9]
• Mouth taping and gadgets. See mouth taping and other breathing trends.

Snoring

Snoring on its own is a different question from sleep apnea. In a single-center trial of 125 people, six weeks of tongue and mouth exercises were compared with finger coordination exercises. [10] The treated group's snoring score was 2.3 points lower, and the authors tied this to the bed partner's rating, while secondary measures did not differ significantly. [10] The NHS says snoring treatment depends on the cause and recommends seeing a doctor if lifestyle changes are not helping. [11] It also warns that snoring with daytime sleepiness, stopped breathing or gasping may be sleep apnea. [11]

Related pages

• Sleep apnea (Wellness)
• Consumer sleep apnea features: capabilities and limits
• Nasal and mouth breathing: what research shows