Bethesda, MD 20894, Web Policies A tongue stabilizing device should not be used by: People who cannot stick their Your session will last about an hour, and youll likely begin by lying down on your back on the massage table. Certified in Craniosacral (CST) and trained in Rhythmic Movements (RMT) to help develop coordination, emotional stability, mental wellbeing, muscle tone and primitive reflexes. (https://pubmed.ncbi.nlm.nih.gov/26340656/). The main limitations were that the total number of patients in most studies was low, the studies were at single institutions (except one that was multicentered) and most studies did not explicitly state that patients were consecutive. When physical trauma and/or emotional trauma adversely tighten this freely moving system, tremendous pressure can be exerted on associated nerves, muscles, organs, blood vessels, lymph vessels and bones. Myofunctional therapy to treat obstructive sleep apnea: a systematic review and meta-analysis. SLEEP2015;38(5):669675. Review Manager (RevMan) [Computer program] Version 5.3 (Copenhagen: The Nordic Cochrane Centre, The Cochrane Collaboration, 2014) was used for meta-analysis. Influence of craniosacral therapy on anxiety, depression and quality of life in patients with fibromyalgia. WebMany Ways To Reach Us. This is known as a strain pattern. The Fascia has to be Free. Quantitative synthesis in systematic reviews. ResMed's AirView data storage and management system is the world's The basic principle of CFT is that the body knows best how to heal itself. The searches were performed through June 18, 2014. "Dr. Barry Gillespie discovered the Craniosacral Fascial System, which consists of a slight motion of the brain and spinal cord pumping cerebrospinal fluid into the fascial web that connects every structural cell of the body. Full texts were reviewed and any referenced articles that were not already obtained were ordered and obtained. What You Should Know, 7 Heating Pads for Aches and Pains, Big and Small, Femoroacetabular (Hip) Impingement: What You Need to Know, Finkelstein Test for de Quervains Tenosynovitis, recurrent ear infections or colic in infants, trauma recovery, including trauma from whiplash, mood disorders like anxiety or depression, a history of recent traumatic head injuries, which may include cranial bleeding or skull fractures, falling asleep, and later recalling memories or seeing colors, having a pins and needles (numbing) sensation. The mean difference for the remaining studies was 10.49 26 [95% CI 12.67, 8.31]. While theres no guarantee that it will work for everyone who tries it, theres evidence that CST can help decrease common ailments, including anxiety, depression, fibromyalgia symptoms, headaches, neck pain, back pain and even symptoms of colic or discomfort in infants and babies. What Is Craniosacral Therapy? Sauer C, Schluter B, Hinz R, Gesch D. Childhood obstructive sleep apnea syndrome: an interdisciplinary approach A prospective epidemiological study of 4,318 five-and-a-half-year-old children. The instrument consists of eight items that are assessed for each individual study. Craniosacral Fascial Therapy I The Gillespie Approach. Gillespie ApproachCraniosacral Fascial Therapy Articles, Gillespie ApproachCraniosacral Fascial Therapy and Dr. Barry Gillespie. ? Rogers AP. Wardrop PJ, Ravichandran S, Hair M, Robertson SM, Sword D. Do wind and brass players snore less? Several medical and surgical treatment modalities exist as treatment for obstructive sleep apnea (OSA).13 Four patho-physiological traits seen in patients with OSA are: the passive critical closing pressure of the upper airway (Pcrit), arousal threshold, loop gain, and muscle responsiveness (PALM) with categories of 1, 2, 2a, 2b, and 3.4 It has been demonstrated that patients in four of five PALM categories will benefit from anatomic interventions.4 Because the dilator muscles of the upper airway play a critical role in maintaining an open airway during sleep, researchers have explored exercises and other airway training (singing, didgeridoo, instrument playing) that target oral cavity and oropharyngeal structures as a method to treat OSA.57 Myofunctional therapy (MT) and proper tongue positioning in the oral cavity have been described since 1918 to improve mandibular growth, nasal breathing, and facial appearance.8 Guimaraes has proposed MT as a treatment for OSA since the 1990s.9 MT is composed of isotonic and isometric exercises that target oral (lip, tongue) and oropharyngeal structures (soft palate, lateral pharyngeal wall).7,10 There have been an increasing number of studies evaluating the effect of MT in the form of case studies, case series, and most recently, two randomized controlled trials.7,1013, The most comprehensive MT exercises are described by Guimaraes et al.7 and involve the soft palate, tongue, and facial muscles and address stomatognathic functions. What Is Myofascial Release and Does It Work? For the best results, book an appointment with a licensed health professional, such as an osteopath or a physical therapist. One 2012 study found that it was effective at reducing symptoms in those with severe migraines. Guimaraes9 has also published thorough instructions for performing the exercises that involve the soft palate, tongue, facial muscles, and stomatognathic functions to be performed 30 min a day.7. Categories. I was having a pretty anxious morning and my back was like painfully tensed, but I feel so much more grounded now and my back is honestly a million times better. Select search type The power of the Gillespie ApproachCraniosacral Fascial Therapy revolves around hands-on procedures that facilitate healing without drugs, vitamins, supplements, technology or surgery. Also the pauses result in daytime. Except the study by Guilleminault et al,10 which followed patients for 4 y, all of the other studies spanned 2 to 6 mo. CFT techniques are gentle and Sleep apnea is far more common than we think, because most of the time it goes undiagnosed. WebDo you want to transform your family's health or patients' lives in a professional setting? It is a holistic and gentle method of treatment that promotes balance and harmony in the body, making it an excellent choice for people of all ages and health conditions. Accessibility For each of the searches, the titles and abstracts were screened and the full text versions of articles that met criteria were downloaded. Craniosacral therapy (or CST) is a non-invasive, manual therapy performed on the head, skull and sacrum. Guimaraes KC. A total of two pediatric studies (25 patients, age 8.4 3.1 y) reported polysomnography and/or sleepiness outcomes. Methods for increasing upper airway muscle tonus in treating obstructive sleep apnea: systematic review. WebManagement of Obstructive Sleep Apnea - Ki Beom Kim 2021-01-04 This book provides comprehensive information on the etiology, pathophysiology, medical implications, diagnosis, and surgical and nonsurgical treatment of obstructive sleep apnea (OSA). Oral Appliance Therapy for Obstructive Sleep Apnea. Sullivan CE, Issa FG, Berthon-Jones M, Eves L. Reversal of obstructive sleep apnoea by continuous positive airway pressure applied through the nares. Because of the potential global magnitude of the discoveries he made, Dr. Barry Gillespie left his periodontal practice in 1997 after 22 years to devote himself full time to this work. You can also visit his website at gillespieapproach.com. The Gillespie Approach is designed to help the body release tension and restrictions in the fascia, which is the connective tissue that surrounds and supports the muscles, bones, and organs in the body. Castro-Sanchez AM, Mataran-Penarrocha GA, Granero-Molina J, Aguilera-Manrique G, Quesada-Rubio JM, Moreno-Lorenzo C. Benefits of massage-myofascial release therapy on pain, anxiety, quality of sleep, depression, and quality of life in patients with fibromyalgia. It can be hypothesized that the exercises improve oral and/or oropharyngeal muscle tone and also may decrease the amount of fatty deposition of the tongue, but this has not been proven. Evid Based Complement Alternat Med. As a library, NLM provides access to scientific literature. DOI: 10.1186/1472-6882-12-S1-P111. Thanks for reaching out! The study by Guilleminault et al.10 demonstrates a long-term (4 y) maintenance of reduction in AHI and alleviation of OSA symptoms in patients who continued to perform MT exercises, compared to the control group that had recurrence of symptoms and recurrence of an elevated AHI at 4-y follow-up.10 Because this is the only study that has reported outcomes longer than 6 mo after initiation of MT exercises, additional long-term studies are needed to demonstrate the lasting effects of continued MT. John is a Gillespie Approach Craniosacral Fascial Therapy (CFT) practitioner in the Midcoast Maine area. WebAnatomically, the craniosacral system (CSS) is the deepest layer of the fascial system, a continuous network surrounding every structure of the body. There was heterogeneity, and the studies by Suzuki et al.12 and Berreto et al.18 were shown to be the sources. This cycle is always my baseline starting point because it gives me an idea how well the craniosacral fascial system is initially functioning. Dr. Barry Gillespie believes that the effects of fetal trauma and birth trauma can be mitigated at the beginning of life to create optimal brain function, prevent many diseases and avert a lifetime of suffering. Healthline has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. The human body has layers of fascial tension strain patterns and can be compared to the layers of an onion. Myofunctional therapy helps to reposition the tongue, improve nasal breathing, and increase muscle tone in pediatric and adult OSA patients. The importance of clearing the strain from the craniosacral fascial system before orthodontics cannot be overstated. The case study by de Paula Silva et al.23 demonstrated a decrease in snoring intensity after 8 sessions. What is oral myofunctional therapy for sleep apnea? The CFT Global Team --- Kim Sherlock and Holly Steflik --- provides Craniosacral Fascial Therapy workshops and services around the world. You might consider using a tongue stabilizing device if you: Have been unable to tolerate standard treatments for sleep apnea, such as continuous positive airway pressure (CPAP). WebBest Businesses for Postoperative Care in Buford. He was ready to start orthodontics with an ALF appliance. St. Paul: (651) 332-7474 Fax: (651) 332 Craniosacral Therapy Sleep Apnea - When this happen 5-30 times in a single hour! WebOur practitioners are licensed physical therapists with certification in alternative treatment methods like myofascial release, Graston Technique, Matrix Repatterning, craniosacral therapy, visceral manipulation, neural manipulation and Pilates-based exercise. The polysomnography demonstrated a 72.4% reduction in snoring pre- versus post-MT (14.05 4.89% to 3.87 4.12%, before and after, respectively), P < 0.001.17 With regard to subjective improvement in snoring intensity, the three studies quantifying the outcomes reported that during posttreatment there was a decrease in snoring to either light snoring, or the sound was similar to normal breathing. Up to 80% of OSA (Obstructive Sleep Apnea) sufferers are undiagnosed. Nourish it. Effectiveness of circumoral muscle exercises in the developing dentofacial morphology in adenotonsillectomized children: an ultrasonographic evaluation. I followed that pattern, allowed it to manifest, and waited for a deep tissue release. The therapist uses gentle pressure techniques to assess the existence of possible disruptions and/or restrictions in your fascial system. Your session needs to wait if you have experienced any of the following and have NOT been released for treatment by your physician: CST is not covered by insurance. Other patients often report feeling a sense of deep relaxation. The craniosacral mechanism pumps vital fluid called "Current literature demonstrates that myofunctional therapy decreases apnea-hypopnea index by approximately 50% in adults and 62% in children. WebSleep Apnea Therapy: CranioSacral Fascial Therapy: Our entire body is connected by fascia, a sophisticated tissue that maintains the integrity of our neuromuscular and It can be recommended that future researchers consider using the standardized exercises, which have been developed and used over a period of several years by Guimaraes et al.7 because they have the most experience with the therapy. Craniosacral Therapy for chronic pain: a systematic review and meta-analysis of randomized controlled trials. 2 OSA is characterized by repetitive episodes of upper airway occlusion during sleep, 3 which decrease blood oxygen levels and cause fragmented sleep. Cranial osteopathy is a form of osteopathic therapy. Later in life, this person may develop headaches and focus on the symptoms in the head verses the original point of strain, at the lower leg. The Gillespie Approach is an effective treatment for a wide range of conditions, including chronic pain, headaches, stress-related conditions, and other issues that can be caused by tension in the fascia. This allows optimal mobility and better brain function. He seems more easy going and joyful! Craniosacral therapy (CST) is a gentle hands-on technique that uses a light touch to examine membranes and movement of the fluids in and around the central nervous system. The preand post-MT AHI for adults decreased from 24.5 14.3/h to 12.3 11.8/h, MD of 14.26 [95% CI 20.98, 7.54] (P < 0.0001). If they detect its needed, they may gently press or reposition you to normalize the flow of the cerebrospinal fluids. A search was performed on Web of Science, Scopus, MED-LINE, and The Cochrane Library, initially January 18, 2014, with an update on June 18, 2014. WebCraniosacral Fascial Therapy can optimize brain function and release fascial strain patterns, which can correct the following conditions: ADULTS: Decreased cognitive abilities, Migraine, Sinus Headache, Concussion, Jaw Pain, Neck Pain, Sleep Issues, Back Pain, Whiplash, TMJ, Depression, Anxiety, Pelvic Pain CHILDREN: St. Paul: (651) 332-7474 Fax: (651) 332 The pre- and post-MT AHI mean standard deviation (M SD; 82 patients) decreased from 24.5 14.3/h to 12.3 11.8/h, with a mean difference (MD) of 14.26 [95% CI 20.98, 7.54], Z score of 4.16 (P < 0.0001) (Figure 2). Additionally, the study by Guilleminault et al.10 reported that 11 children remained cured of OSA (AHI of 0.5 0.4/h) after continuing MT for 4 y. Learn more about Cleveland Clinic initiatives to prevent illness and foster health. WebThe AirCurve 10 ST comes with a pressure range of 3-25 cm H20, which is a wider pressure range than in a standard CPAP device. As the body healed, there was scarring of the fascial web, creating a downward pull through the pelvis, spinal column, and up into the cranial bones. CRANIOSACRAL FASCIAL THERAPY (CFT) This modality is a brilliant merging of the foundations of Craniosacral Therapy and Fascial Release work. If individual patient data were reported and patients lost 10% or more of their body weight, then those patients were excluded. myo/craniosacral/buteyko all are NOT proven for the treatment of obstructive sleep apnea. WebStill Point Induction. She had tongue, lip, and cheek ties revised twice and also had craniosacral therapy (CST). Questions that have not been addressed that could be studied in the future include whether there is a relationship with the tongue exercises and changes in the tongue and palatal muscle tone and/ or strength, tongue size (tongue fat), and overall upper airway volume changes pretreatment and posttreatment. When untreated, traumas can lead to chronic conditions that many people too readily accept as their status quo. Cooper A. Orofacial myology and myofunctional therapy for sleep telated breathing disorders. They may use tissue-release methods while supporting one of your limbs. WebCFT can also help adults unwind tight fascia and release years of strain. (2012). Additionally, long-term follow-up for more than 6 mo is limited. Received 2014 Jul; Revised 2014 Aug; Accepted 2014 Aug. GUID:24E4D178-9348-40D1-A78B-AD0E7BE8E1CB, exercise therapy/methods, myofunctional therapy/methods, obstructive sleep apnea, sleep apnea syndromes. Guimaraes KC, Protetti HM. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Craniosacral therapy (CST) is a gentle manual therapeutic procedure that applies light touch over the body (such as feet, back, and head) to evaluate the delicate craniosacral rhythm. Barry Gillespie, Gillespie ApproachThe King of Prussia Medical Center, Suite 203491 Allendale RoadKing of Prussia, PA 19406 Guimaraes KC, Drager LF, Marcondes BF, Lorenzi Filho G. Treatment of obstructive sleep apnea with oro-pharyngeal exercises: a randomized study [abstract]. Dr. Barry Gillespie discovered the Craniosacral Fascial System, which consists of a slight motion of the brain and spinal cord pumping cerebrospinal fluid into the fascial web that connects every structural cell of the body. Both the I2 statistic (0%) and the Q statistic (value of 0.8) demonstrated no heterogeneity. Torticollis and Sleep Issues - Craniosacral Fascial Therapy We avoid using tertiary references. Before Its based on the Third, subjective sleepiness also improves post-MT as demonstrated by a clear reduction in ESS score for the 93 patients in which it was administered, with a reduction from 14.8 3.5 to 8.2 4.1 (in 75 patients in whom M SDs were reported).7,13,17,18,26,29 The posttreatment ESS is below the threshold for hypersomnia, which is generally considered to be 11 or higher on the scale.39 Additionally, the 1999 study by Guimaraes9 reported a subjective reduction in sleepiness; however, the use of a validated sleepiness scale was not specified.9, Fourth, despite the heterogeneity in oral and oropharyngeal exercises, overall the improvements in polysomnographic outcomes and sleepiness were consistent. A total of nine adult studies (120 patients, age 44.5 11.6 y, BMI 28.9 6.2 kg/m2) reported polysomnography and/or sleepiness outcomes (Table 1). Reduce snoring and sleep apnea. P02.55. With so many heating pads on the market, our writer, who has a chronic pain condition, lists the products she loves. If you have ever had an injury, your fascial system (which is wrapped around every single structure inside your body) can become restricted and locked into a pattern of dysfunction. Web of Science, Scopus, MEDLINE, and The Cochrane Library. The oxygen desaturation index (ODI) was only reported by Baz et al.,17 demonstrating a 36% reduction, but the article did not specify whether the ODI in the study was based on 3% or 4% desaturation. Its a type of alternative therapy that can be used together with conventional medical treatments for best results. The craniosacral (CS) system comprises the meningeal, fascial, and bony structures of the cranium and spinal column [17]. Your email address will not be published. Removing fascial strain from childbirth, vaccinations, and other early traumas has been demonstrated to help with issues of tongue ties, colic, digestive discomfort, hyperactivity, attention deficit, autism, allergies, asthma, earaches, learning disorders, bedwetting, and other childhood ailments. In adult studies in which MT was performed for at least 3 mo, the mean AHI reduced from 25.2 14.6/h to 12.6 12.2/h, which is a 50% reduction. The most common side effect of cranial sacral therapy with a licensed practitioner is mild discomfort following the treatment. Watch your life transform and be healthy. Although there were nine adult studies, a significant limitation for pediatric studies is that currently only two articles have been published. Soft music and low lighting are often used to increase your state of relaxation. Das UM, Beena JP. 8600 Rockville Pike Locations. He also had Sandifer syndrome and torticollis as an infant and now has focus, attention and concentration issues. Debra Rose Wilson, Ph.D., MSN, R.N., IBCLC, AHN-BC, CHT, What You Need to Know About Muscle Aches and Pains, How Do Trigger Point Injections Work? The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines were downloaded and followed during this review.16. Craniosacral therapy is known to treat a myriad of problems including sleep disturbances. CFT is best described by its founder Barry Gillespie, this is a snippet from his website. sharing sensitive information, make sure youre on a federal To systematically review the literature for articles evaluating myofunctional therapy (MT) as treatment for obstructive sleep apnea (OSA) in children and adults and to perform a meta-analysis on the polysomnographic, snoring, and sleepiness data. Baz et al.17 reported using American Academy of Sleep Medicine (AASM) scoring criteria but did not specify which year, Diaferia et al.13 and Guimaraes et al.7 reported using 1999 AASM scoring criteria, Suzuki et al.12 scored based on the 2005 update to AASM scoring criteria, and the remaining five studies did not specify which polysomnography scoring criteria were used.9,18,23,26,29. CI, confidence interval; MT, myofunctional therapy; SD, standard deviation; Tx, treatment. Facial Nerve Pain. The decision to include the articles was made by consensus, and if necessary the final decision was made by author MC. WebBest Businesses for Post-Traumatic Stress Disorder (PTSD) in Buford. Berreto e Silva Pitta D, Farias Pessoa A, Sampaio AL, Nonato Rodrigues R, Guiot Tavares M, Tavares P. Oral myofunctional therapy applied on two cases of severe obstructive sleep apnea. Fascia is the bodys connective tissue. Craniosacral Therapy (CST) is a method focusing on the link between the cranium (head) and sacrum (the second to last bone at the base of your spine), scientifically proven to work in unison to pump fluid throughout the body, an unknown disruption of which can cause many health issues. It can, as a result, help to treat a number of conditions. To eliminate snoring and prevent sleep apnea, your doctor may recommend a device called a continuous positive airway pressure (CPAP) machine. CI, confidence interval; MT, myofunctional therapy; SD, standard deviation; Tx, treatment. Clients often find lasting relief from migraines, sinus conditions, neck and back pain, sleep issues, and other conditions. Our website services, content, and products are for informational purposes only. You may also email us if you have any additional questions that this website did not answer, or if youd like to make preliminary appointment time inquiries.. Online Booking. The VPAP ST is intended for users with central sleep apnea, who generally need more air pressure than users with obstructive sleep apnea. In some cases, self-care might be a way for you to deal with obstructive sleep apnea and possibly central sleep apnea. Adult premyofunctional and postmyofunctional therapy outcomes for lowest oxygen saturation (percent). This can create a pressure onto the brain. Learn what to expect during and after your procedure, including recovery time and pain relief. Techniques used in the Gillespie Approach are intended to address strain patterns in the body, but more importantly, it addresses directly the effect a strain pattern has on the craniosacral system. Johns M, Hocking B. Daytime sleepiness and sleep habits of Australian workers. Removing fascial strain from childbirth, vaccinations, and other early traumas has been demonstrated to help with issues of tongue ties, colic, digestive discomfort, hyperactivity, attention deficit, autism, allergies, asthma, earaches, learning disorders, bedwetting, and other childhood ailments. Profound effects on body function may result as a major cause of health conditions. Kumar TV, Kuriakose S. Ultrasonographic evaluation of effectiveness of circumoral muscle exercises in adenotonsillectomized children. Craniosacral therapy (CST) is a gentle hands-on treatment that may provide relief from a variety of symptoms including headaches, neck pain and side effects of cancer treatment among many others. 2023 Healthline Media LLC. It mainly occurs in males over 50, but females can get it. It offers a number of health benefits, in addition to relieving muscle tension and pain. Diaferia G, Badke L, Santos-Silva R, Bommarito S, Tufik S, Bittencourt L. Effect of speech therapy as adjunct treatment to continuous positive airway pressure on the quality of life of patients with obstructive sleep apnea. WebSleep apnea is a serious sleep disorder that occurs when a person's breathing is interrupted during sleep. Releasing the fascial restrictions of the craniosacral system and total body allow for a freely moving brain and body parts, which has tremendous health benefits. Steele CM. This releases tightness and pain in your myofascial tissues. Nine adult studies (120 patients) reported polysomnography, snoring, and/or sleepiness outcomes. Studies have shown that Figure 1 summarizes the flow for study selection. The views herein are the private views of the authors and do not reflect the official views of the Department of the Army or the Department of Defense. Check out these videos from Dr. Gillespie to learn more. CFT may contribute to excellent infant neurological development. In his asthmatic clinical research, which spanned 20 years through the 1980s and 1990s, he also discovered that many other childhood diseases such as chronic earaches, headaches, learning disorders, ADHD, rhinitis, colic, reflux, scoliosis and strabismus stemmed from dysfunction of the craniosacral fascial system. Matarn-Pearrocha GA, et al. Zane T. (2011). Trigger point injections target tight, painful muscles. [Speech therapy proposals to the snoring patient]. A 6-year-old boy from a sleep doctor referral presented with sleep apnea. The study by Villa et al.35 was a prospective randomized controlled trial in which postadenotonsillectomy patients were randomized to either oropharyngeal exercises or control group. CST uses a light touch to examine membranes and movement of fluids in and around the central nervous system. Two pediatric studies (25 patients) reported outcomes. 2023 THE GILLESPIE APPROACH - CFT | All rights reserved. Design by EPOH LLC, Renaissance Integrative Therapy, Inc. | 1158 Professional Drive, Suite D | Williamsburg, Virginia 23185. Measuring inconsistency in meta-analyses. Required fields are marked *, Stay updated on major news and Gillespie Approach Training opportunities with the free weekly newsletterplus get the free e-book "How Your Fussy Baby Can Become A Happy Baby". Traumas can include: * difficult birth * concussion * surgery * emotional trauma * auto accidents * dental/orthodontics * falls * toxic exposure *. Learn about causes. CRANIOSACRAL FASCIAL THERAPY (CFT)facilitates the release of accumulated strain to improve physical mobility and cognitive function. For combining data, a two-tailed, paired t test was performed (P < 0.05 was the cutoff for significance). 9500 Euclid Avenue, Cleveland, Ohio 44195 |, Important Updates + Notice of Vendor Data Event. Studies providing raw patient data without means and standard deviations were manually input into SPSS for calculation; or if individual scatterplots with pretreatment and posttreatment data were available, the estimated data point values were used to calculate the means and standard deviations. Cranial sacral therapy may be able to provide relief for certain conditions, with the strongest evidence supporting it as a treatment for conditions like headaches. This neuropathy usually starts in the toes (in the most distal peripheral nerves) then progresses to the foot, then up the ankle and so on. This systematic review and meta-analysis of nine adult and two pediatric studies evaluating the effect of MT on OSA has five main findings. What Are the Health Benefits of a Hot Stone Massage? Make sure you ask your healthcare provider if theyre licensed for CST before making the appointment, and if theyre not, look for a provider who is. The studies included in this review included one abstract,26 one retrospective case report,23 three retrospective case series,9,10,18 three prospective case series,12,17,29 one randomized trial,35 and two randomized controlled trials.7,13 Most of the studies satisfied four to six of the eight NICE quality assessment tool items (presented in Table S1 of supplemental material). Guimaraes KC, Drager LF, Genta PR, Marcondes BF, Lorenzi-Filho G. Effects of oropharyngeal exercises on patients with moderate obstructive sleep apnea syndrome. The third cranial technique Amy recommends for insomnia is called the "Rock and Glide." Craniosacral therapy for migraine: A feasibility study. For soft palate exercises, patients pronounce oral vowel sounds either continuously (isometric exercises) or intermittently (isotonic exercises).7 Tongue exercises include moving the tongue along the superior and lateral surfaces of the teeth, positioning the tongue tip against the anterior aspect of the hard palate, pressing the entire tongue against the hard and soft palate, and forcing the tongue onto the floor of the mouth.7 Facial exercises address the lip (i.e., contraction and relaxation of the orbicularis oris), buccinators (i.e., suction movements and application of intraoral finger pressure against the buccinator muscles), and jaw muscles (i.e., lateral jaw movements).7 In addition, stomatognathic functions are addressed by instructing patients to inhale nasally and exhale orally without and then with balloon inflation, and performing specific swallowing and chewing exercises (i.e., swallowing with the teeth clenched together, tongue positioned in the palate and without contraction of perioral muscles; alternating chewing sides).7 A newer study describes a device that conditions and strengthens oral and tongue muscles.12.
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