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Strengthen your tongue to breathe better.

You don’t have to go to the gym to strengthen your tongue muscles. These have a fundamental role in obtaining restorative sleep, especially in the presence of sleep apnea. Physiotherapist Thierry Gouzland, an expert in this field, explains why it is essential to exercise at home several times a week. However, prior specialist assessment is required to assess future management.

What is the main goal of lingual physiotherapy?

“Obviously, lingual muscle training (or rather myofunctional therapy) is one aspect of OSAS management. However, even if the tongue represents one of the main buccopharyngeal elements, it is not the only representative. It is really necessary to be concerned about the ventilation problem as well. Some patients have normal tongue function but have difficulty breathing. Remember it must be nasal and not oral. The mobility of the soft palate is also to be assessed. With all these elements, the oro-maxillo-facial reeducator will decide on the best therapeutic position to adopt, whether or not the appliance or orthosis will accompany the mandibular displacement, depending on the case “remembers Thierry Gouzland

Initial assessment

First, a warning is in order. Too often people engage in exercises that are not tailored to their problems and that do not exactly suit them. As our expert reminds us in the introduction, the exercises apply on a case-by-case basis. ” For this reason, a preliminary evaluation phase is essential. There’s no doubt that you’d go through the motions seen on social media tutorials yourself. Only a physiotherapist experienced in OSAS can then determine the exact procedure to follow in order to achieve good nasal breathing and the correct placement of the “sucked” tongue on the palate. Then it’s a matter of placing the structures we’ll have to work on. On the other hand, this first-line assessment makes it possible to specify whether the rehabilitation will bring real improvement to the patient, then it is a question of implementing exercises to be performed daily in the morning and evening at home.”

Toning and acquiring automaticitywith

It is ideal for the patient if daily exercises last 3-4 minutes in the morning and evening. A monthly progress assessment by the reeducator is then scheduled. Movements are thus gradually adapted according to clinical development. Then it is possible to achieve sufficient muscle tone and change the behavior of the tissues“.

Along with this, the patient must acquire certain automatisms during the day. It monitors the position of the tongue stuck to the palate and maintains contact between the two lips to promote nasal breathing. If these two criteria are not achieved, physiotherapy does not have the expected effect. It is therefore necessary, in a certain way, to accustom a person to breathing only through the nose. This warms the air, humidifies it, and captures nasal nitric oxide. For good management, the three axes are complemented by action on the:

Side of ENT and pharyngeal muscle

Vent page explaining diaphragm mobility etc..

– Nasal hygiene and the rediscovery of the concept of air flow through the nose and not through mouth breathing”.

Are the exercises the same for adults or children?

This rehabilitation applies to both adults and children (aged 3 1/2 to 4 years), but with certain differences. Indeed, in adulthood, facial growth is complete. Thierry Gouzland explains that in the Nouvelle-Aquitaine region, screening in schools appeared as part of the Isidore program

As for children, with hypertrophy of the tonsils, tonsillectomy in OSAS is now an indication for ENT surgery. However, as T. Gouzland points out, ” postoperatively, some improved, others did not, with a return to mouth breathing when there are no longer any obstructions. Here, too, maxillofacial physiotherapy takes on its full significance in cooperation with ENT specialists. As for the Anglo-Saxon fashion of frenotomy or frenectomy, it should be moderated“. Also with this in mind, the Academy of Medicine published a warning in July 2022.

Is it necessary to complete specific training to perform this specialization?

Our expert explains it

As part of the initial study of a physiotherapist, the subject is of course dealt with. However, it is still better to take training that is truly tailored to OSAS. Thus, a university diploma issued in Bordeaux and recognized by the Council of the Order has been offered for several years. There is also the possibility of private training.

In connection with sleep apnea syndrome, we have introduced cardio sleep, a specific training (Somnoreab) for the therapy and rehabilitation of children and adults. During this course, a large number of health professionals with CPD validation (doctors, speech therapists, physiotherapists, dentists, etc.) will learn a better understanding of the management of this pathology. In fact, according to their way of practicing, they can practice this specific discipline or at least know good indications. At the same time, this second time enables the creation of interdisciplinary links, the imitation of knowledge and a professional network of interest to all..

Illustration DCSstudio for Freepik

References

1- Somnorehab https://www.cardiosleep.fr/cible/formation-therapeutes-myo-fonctionnels/

Program 2-URPS Isidort https://www.isidort.fr

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