Can Mouth Exercises Improve Sleep Apnea?

Continuous positive airway pressure (CPAP) is the first-line therapy for treating obstructive sleep apnea (OSA). But some people who struggle to tolerate CPAP may benefit from incorporating mouth exercises into their treatment plan.

Also known as orofacial myofunctional therapy (OMT), or simply myofunctional therapy, mouth exercises help strengthen the muscles that impact OSA. With consistent practice, OMT may reduce OSA severity and lower the amount of air pressure the CPAP machine needs to keep your airway open.

What Is Orofacial Myofunctional Therapy?

The therapy involves performing specific exercises with your cheeks, tongue, and lips to improve muscle tone and retrain how the muscles function both during movement and rest, Goldfarb says. But it doesn’t always work in isolation.

"Myofunctional therapy is often part of a larger treatment plan," she explains. Therapists work alongside otolaryngologists, airway-focused dentists, and sleep medicine physicians to address the medical, structural, and muscular factors that contribute to airway obstruction.

Why Muscle Tone Matters for OSA

In people with OSA, the main tongue muscle (the genioglossus) has less muscle tone and is weaker and less coordinated than in people without OSA, Goldfarb says. This impacts how the tongue interacts with other structures in the mouth during sleep, particularly the roof of the mouth.

What Does the Research Say?

"There is evidence that orofacial myofunctional therapy can be helpful in reducing the severity of sleep apnea and associated symptoms of sleepiness and snoring," says Jordan Weiner, MD, a board-certified otolaryngologist and surgeon in private practice in Scottsdale, Arizona, who specializes in treating OSA.

And in a study involving 60 adults with moderate to severe OSA, those who practiced OMT exercises daily for three months saw significant structural changes in their upper airway.

“Larger multicenter studies are needed to evaluate the effectiveness of myofunctional therapy in specific populations as well as its potential use in conjunction with other therapies,” says Dr. Weiner.

Who Is a Good Candidate?

While CPAP is still the first-line therapy for treating OSA, combining CPAP with myofunctional therapy can be helpful for people across the spectrum of OSA severity, Goldfarb says.

CPAP users who struggle with compliance are especially good candidates, she says. When your tongue rests low and your lips don't stay closed, air leaks out of your mouth when you use a CPAP, forcing the device to work harder. Myofunctional therapy addresses this by training your tongue higher and strengthening your lip seal, which can allow the device to work at a lower, more comfortable pressure.

Talk to an otolaryngologist or sleep medicine physician if you can’t tolerate CPAP or if you’re interested in exploring myofunctional therapy. Ultimately, myofunctional therapy has no side effects, so there’s little harm in trying it, Goldfarb says.

What Do Mouth Exercises for Sleep Apnea Look Like?

There’s no one-size-fits-all set of mouth exercises that can help improve OSA, says Goldfarb. “We have to perform a detailed evaluation to see what type of treatment the person needs.”

Goldfarb recommends practicing mouth exercises for at least 10 minutes every day. “It’s kind of like if you want toned abs or biceps — you’re going to have to do it consistently,” she says.

When working with patients, Goldfarb sees them once weekly for roughly two months before cutting down to monthly visits, with patients continuing daily home practice for about a year. Whether exercises are needed long-term varies. “There's a point where they might never need to do the exercises again,” Goldfarb says, though others may need to return to them if symptoms worsen.

How to Find a Qualified Therapist

You can find DIY exercise programs online, but you’ll see better results by working with a qualified myofunctional therapist. A therapist tailors the exercise program to fit your needs, and shows you how to perform the exercises correctly, Goldfarb says.

To identify a qualified myofunctional therapist, look for a speech-language pathologist or registered dental hygienist who’s also received advanced training in myofunctional therapy. "Not all speech-language pathologists or dental hygienists have it — this is advanced training on top of the initial license, so you really have to ask about it," Goldfarb notes.

While certification isn’t required for a practitioner to offer myofunctional therapy, she recommends finding a therapist who’s certified by the International Association of Orofacial Myology or the American Academy of Orofacial Myofunctional Therapy. Both organizations offer a therapist directory. This credential signals that the therapist has completed additional exams and been observed in practice.