When considering treatment options for sleep apnea, nighttime breathing devices are usually top of mind. But did you know physical therapy can help with sleep apnea symptoms?

Working with a physical therapist to strengthen muscles involved in breathing and supporting the airway can support other sleep apnea treatments. With time, people may see improvements in symptoms and overall health.

This article explains how physical therapy can address the underlying causes of sleep apnea and what types of treatments to expect. If you’d like to add physical therapy to your treatment plan, ask your healthcare provider if it’s right for yo

How Physical Therapy Helps Sleep Apnea

OSA develops when the airway is blocked while sleeping. The airway becomes blocked when muscles around the throat relax too much or aren’t strong enough to support the upper airway, causing it to collapse and prevent airflow.

PT can help address muscle weakness and potentially improve OSA symptoms. The main types of exercises given to people with OSA include respiratory muscle training, oropharyngeal exercises, and therapeutic exercise.

Respiratory Muscle Training

Many muscles in your body help with respiration (breathing). The main ones include the:

• Diaphragm — This is the major muscle of respiration, spanning the base of the ribcage. When it contracts, your ribcage and belly expand as you breathe in.
• Intercostal muscles — External intercostals located between the ribs help expand the upper part of the ribcage while breathing in. Internal intercostals push air out of the lungs when you forcefully breathe out.
• Upper airway muscles — Also known as pharyngeal muscles, these stabilize, support, and open the airway.

Physical therapists may have you perform breathing exercises using special devices. The two main methods of training include:

• Inspiratory muscle training — Breathing in against resistance to strengthen muscles.
• Expiratory muscle training — Breathing out against resistance to strengthen muscles.

Current research shows that respiratory muscle training can improve quality of life by helping address heart health issues, like high blood pressure, which often overlap with OSA.

But studies are mixed as to whether it addresses OSA symptoms directly. Some research suggests respiratory muscle training can improve nighttime breathing and daytime fatigue in people with mild to moderate OSA, while others suggest symptoms are better addressed through other methods.

Oropharyngeal Exercises

Oropharyngeal exercises (also known as orofacial myofunctional therapy) target the muscles around the mouth and throat to improve their mobility and coordination. The primary goal is to increase their muscle tone, which can help keep the airway open at night.

Oropharyngeal training involves exercises for the face, mouth, and throat muscles, like sticking out your tongue or puckering your lips. The genioglossus, a muscle that controls the tongue, is one of the main muscles targeted by these exercises. Scientists believe it’s too relaxed in people with OSA, leading to airflow issues.

Oropharyngeal exercises may feel silly at first, but regular training — 15 to 30 minutes per day, three to seven days per week — may make a difference.

Studies suggest that these exercises can improve snoring and breathing during sleep. Combined with other interventions, people may see improved muscle strength around the airway.

Therapeutic Exercise

Physical therapists often prescribe tailored exercise programs to improve general endurance and strength. For reference, the American College of Sports Medicine recommends that adults ages 18 to 65 perform regular endurance and strengthening exercises as follows:

• Thirty minutes of moderate intensity aerobic (heart-pumping) exercise five days per week, or 20 minutes of vigorous aerobic exercise three days per week
• Resistance training targeting major muscle groups two days per week

It’s OK to work your way up to the recommendations above. If you’re not sure where to start or how to change your current exercise regimen safely, ask a physical therapist for help.

These programs can complement respiratory muscle training and oropharyngeal exercises while supporting better sleep quality, weight control, and overall well-being.

When Can Physical Therapy Help?

Ask your doctor if PT can complement your current treatment plan. PT is especially helpful if, like some MySleepApneaTeam members, you struggle to use a CPAP or find comfortable symptom management strategies.

“I’ve tried different devices, including mouth guards from my dentist and CPAP. I don’t want to get surgery or take pills. I want to try other methods,” said one member.

Another member said, “I had no idea there were so many treatment options. I’ve been suffering through using my CPAP, but I’d love to try other ways to control my sleep apnea.”

Targeted exercises — like the ones listed in this article — may help OSA symptoms. But PT can also help other issues that are preventing you from getting comfortable treatment.

For example, if you notice your hip hurts while lying on your side during positional therapy, a physical therapist may be able to show you ways to accommodate it or reduce pain. If an unstable knee is holding you back from your exercise goals, they can help treat that, too.

Join the Conversation

On MySleepApneaTeam, people share their experiences with sleep apnea, get advice, and find support from others who understand.

Have you tried physical therapy for obstructive sleep apnea? What was your experience? Let others know in the comments below.