CMT CMT Sleep Disorders & Bruxism 2 — Questions and Answers
Question 1: Which study is frequently cited as landmark evidence for myofunctional therapy's role in reducing OSA severity?
- Smith et al. 2001
- GuimarĂŁes et al. 2009 (Correct answer)
- Proffit et al. 1995
- McNamara et al. 2012
Correct answer: GuimarĂŁes et al. 2009
GuimarĂŁes et al. (2009) published an RCT demonstrating that oropharyngeal exercises significantly reduced AHI by approximately 39% and snoring in adults with moderate OSA.
Question 2: What does polysomnography (PSG) measure and why is it relevant to myofunctional therapists?
- It measures blood pressure and heart rate only
- It is the gold-standard sleep study measuring EEG, airflow, oxygen, and muscle activity to diagnose sleep disorders (Correct answer)
- It measures jaw clenching force during sleep
- It is a daytime test for airway resistance
Correct answer: It is the gold-standard sleep study measuring EEG, airflow, oxygen, and muscle activity to diagnose sleep disorders
Polysomnography is the gold-standard overnight sleep study that diagnoses OSA and bruxism; myofunctional therapists use PSG results from referring providers to guide treatment and measure progress.
Question 3: In children with enlarged tonsils and OSA, myofunctional therapy is typically recommended:
- Instead of adenotonsillectomy
- Before any surgical intervention
- After adenotonsillectomy to address residual muscle dysfunction (Correct answer)
- Only if OSA is severe
Correct answer: After adenotonsillectomy to address residual muscle dysfunction
Myofunctional therapy is most commonly recommended post-adenotonsillectomy to retrain tongue posture, nasal breathing, and swallowing patterns that often persist as habits after the obstruction is removed.
Question 4: Which muscle group's weakness is MOST directly implicated in posterior airway collapse during sleep?
- Masseter and temporalis
- Genioglossus and pharyngeal dilator muscles (Correct answer)
- Orbicularis oris and mentalis
- Buccinator and risorius
Correct answer: Genioglossus and pharyngeal dilator muscles
The genioglossus and pharyngeal dilator muscles are responsible for maintaining airway patency during sleep; their insufficient activation during sleep leads to posterior airway collapse in OSA.
Question 5: What is 'positional OSA' and how does it differ from non-positional OSA in terms of myofunctional therapy candidacy?
- Positional OSA occurs only during REM sleep; non-positional occurs in all sleep stages
- Positional OSA is predominantly worse in supine sleep and may require primarily positional therapy, while non-positional benefits more from oropharyngeal exercise (Correct answer)
- Positional OSA is more severe and always requires CPAP
- There is no clinical difference in myofunctional therapy candidacy
Correct answer: Positional OSA is predominantly worse in supine sleep and may require primarily positional therapy, while non-positional benefits more from oropharyngeal exercise
Positional OSA is predominantly triggered by supine sleeping and may respond to positional therapy alone, while non-positional OSA has greater muscle-based contributions that benefit more from myofunctional intervention.
Question 6: A patient reports tooth wear, jaw pain, and waking with temporal headaches. The dentist has ruled out TMJ pathology. What myofunctional condition should the therapist prioritize assessing?
- Tongue thrust
- Sleep bruxism (Correct answer)
- Lip incompetence
- Low tongue posture
Correct answer: Sleep bruxism
Tooth wear, jaw pain, and morning temporal headaches are the classic clinical triad of sleep bruxism, making it the primary myofunctional assessment priority in this presentation.
CMT CMT Sleep Disorders & Bruxism 2
Which study is frequently cited as landmark evidence for myofunctional therapy's role in reducing OSA severity?