The effect of tongue strength and endurance in patients with obstructive sleep apnea

Abstract

PURPOSE: This study aimed to evaluate tongue strength and endurance in patients with OSA and identify variables that modify their effects on OSA severity. METHODS: A cross-sectional study included 189 adults with OSA, classified according to the apnea-hypopnea index (AHI) as mild (n = 63), moderate (n = 52), or severe (n = 74). The anterior and posterior tongue strengths, and tongue endurance were measured using the IOPI® Pro device. General linear models were applied to estimate unadjusted and adjusted marginal means. Adjustment was made for age, sex, and body mass index (BMI). RESULTS: The anterior tongue strength did not differ significantly across mild, moderate, and severe OSA (56.11 ± 11.31 vs. 51.32 ± 10.67 vs. 55.55 ± 13.22 kPa, p = 0.07), nor did posterior tongue strength (50.16 ± 16.14 vs. 46.25 ± 12.55 vs. 47.84 ± 13.39 kPa, p = 0.328), or tongue endurance (16.00 (12,22) vs. 14.75 (12,17.5) vs. 17.30 (13,23) seconds, p = 0.744). BMI was a significant effect modifier for anterior and posterior tongue strength. In the non-obese subgroup (BMI < 30 kg/m2) adjusted analyses for age and gender revealed differences in mean anterior (diff = 10.48, p = 0.017) and posterior (diff = 13.26, p = 0.02) tongue strength between patients with mild and severe OSA. CONCLUSION: In an adult cohort, tongue strength did not differ among patients with mild, moderate, and severe OSA. However, in non-obese patients (BMI < 30 kg/m²), tongue strength was lower in those with severe OSA compared to those with mild OSA. Future studies on the impact of tongue strength may be best directed at non-obese patients with OSA.