Myofunctional Therapy for Geriatric Sleep Apnea: A Narrative Review

DOI 10.66715/jsccr/2026.v3.i3.99108 | Review Article | 2026 | Volume 3 | Issue 3 | Page 99-108

1. Suhana Banu S, Department of Physiotherapy, Narayana Hrudayalaya Institute of Physiotherapy, Bengaluru, India, shaiksuhana028@gmail.com

2. Dr. Simi Simon, Associate Professor, Department of Physiotherapy, Narayana Hrudayalaya Institute of Physiotherapy, Bengaluru, India, drsimisimon@gmail.com

Myofunctional Therapy for Geriatric Sleep Apnea: A Narrative Review.

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Abstract

Obstructive sleep apnea (OSA) is highly prevalent among older adults and is associated with cardiovascular disease, cognitive decline, daytime sleepiness, falls, and reduced quality of life. Although continuous positive airway pressure remains the standard treatment, adherence is frequently limited by discomfort, cognitive impairment, nasal symptoms, and difficulty handling equipment. Myofunctional therapy (MT), consisting of targeted exercises for the tongue, soft palate, lips, cheeks, and oropharyngeal muscles, has emerged as a noninvasive adjunctive approach. This narrative review examines the rationale, therapeutic protocols, clinical benefits, limitations, and applicability of MT in geriatric patients with OSA. Available evidence suggests that regular exercises may improve upper-airway muscle tone, tongue posture, nasal breathing, lip seal, swallowing coordination, and airway stability during sleep. Studies in adults have reported reductions in apnea–hypopnea index, snoring intensity, daytime sleepiness, and neck circumference, together with improvements in sleep quality and treatment adherence. However, geriatric-specific evidence remains limited, with variability in exercise regimens, supervision, duration, outcome measures, and participant characteristics. Age-related sarcopenia, frailty, dental status, neurological disease, and cognitive impairment may influence feasibility and response. MT appears safest and most effective when individualized, professionally supervised, and combined with established therapies such as positive airway pressure, oral appliances, weight management, and positional therapy. Larger controlled trials focused on older populations are required to determine optimal protocols, long-term adherence, functional outcomes, and cost-effectiveness.