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Effect of a 1-week intense myofunctional training on obstructive sleep apnoea in children with Down syndrome
  1. Magnus von Lukowicz1,
  2. Nina Herzog1,
  3. Sebastian Ruthardt2,
  4. Mirja Quante1,
  5. Gabriele Iven2,
  6. Christian F Poets1
  1. 1 Sleep Medicine, Department of Neonatology, University of Tuebingen, Tuebingen, Germany
  2. 2 Therapiezentrum Iven, Baiersbronn, Germany
  1. Correspondence to Professor Christian F Poets, Department of Neonatology, University Children’s Hospital, Tübingen 72076, Germany; christian-f.poets{at}


Background Obstructive sleep apnoea (OSA) is common in children with Down syndrome (DS), yet difficult to treat. As muscular hypotonia of the upper airway may cause OSA and is also common in DS, we tested whether intense myofunctional therapy improves OSA in children with DS.

Patients and methods Forty-two children underwent cardiorespiratory sleep studies immediately before and after a 1-week intensive training camp consisting of three daily 45 min sessions of myofunctional exercises according to Padovan. Primary outcome was the mixed-obstructive-apnoea/hypopnoea index (MOAHI), secondary outcomes the ≤3% oxygen desaturation index (DI3), the ≤90% desaturation index (DI90) and the lowest pulse oximeter saturation (SpO2nadir).

Results Eighteen recordings had ≥3 hours of artefact-free recording in both the pretreatment and post-treatment sleep study and were therefore included in the analysis. Mean age was 6.3 years (SD 2.5); 83% had OSA prior to intervention. Mean MOAHI was 6.4 (SD 8.6) before and 6.4 (SD 10.8) after the intervention (p>0.05); the DI3 and SpO2nadir also did not change. Only the DI90 decreased significantly from 2.7 (SD 4.5) to 2.1 (SD 3.7) (p<0.05).

Conclusion The 1-week intense myofunctional training camp evaluated here in children with DS had only a marginal effect on OSA. Whether a longer follow-up period or duration of intervention would yield stronger effects remains to be determined.

  • trisomy 21
  • obstructive sleep apnoea
  • myofunctional exercises
  • functional treatment

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  • Contributors ML designed the study, performed the analyses, drafted the initial manuscript and revised the manuscript. NH analysed the recordings and contributed to patient recruitment. SR set up the recordings. MQ supervised the analysis of the recordings. GI supervised the myofunctional treatment. CFP initiated and supervised the study. SR, MQ, GI and CFP reviewed and revised the manuscript making important intellectual contributions.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Not required.

  • Ethics approval Ethics Committee of Tuebingen University Hospital.

  • Provenance and peer review Not commissioned; externally peer reviewed.