SchnarchFrei (SnoreFree) Pilot Study 2023

Two separate randomized controlled studies were conducted: one only for diagnosed OSAS (Obstructive Sleep Apnea Syndrome), the other for snoring (Rhonchopathie) and UARS (Upper Airway Resistance Syndrome). Each study included 95 participants. The total dropout rate was less than 10%. The observation period for both studies was 3 months starting with April 2023.

Report of the SnoreFree Pilotstudies 2023

The research

Dario has already 2007 in his diploma thesis at the Vienna General Hospital proven, that this treatment method of logopaedic anti-snoring training has a positive impact.

diploma thesis 2007

The result of the basic research can be viewed here: The diploma thesis “Logopedic-myofunctional therapy for ronchopathy (snoring)” as PDF Download (in german).

In practice

Conclusion: The orofacial myofunctional therapy from speech therapy effectively helps to reduce objectively measured snoring production and intensity after only three months. It can help a large part of the population to sleep better and more relaxed.

Worldwide clinical studies

Clinical studies around the world, which dealt with the training-related influence of snoring and nocturnal respiratory flow disorders and showed a positive effect of oral exercises on sleep-related breathing sounds and breathing stops (sleep apnea).

SnoreFree Pilot study 2007

2007, AKH Wien, Austria, Pilot study / Diploma thesis, SnoreFree Pilot study 2007, Dario Lindes, Speech trainer, -Source-

Dario Lindes has already carried out a pilot study at the Vienna General Hospital in 2007, in cooperation with the ENT department and the pulmonological sleep laboratory, in which his treatment method of logopaedic anti-snoring training was positively evaluated.

Conclusion: The orofacial myofunctional therapy from speech therapy effectively helps to reduce objectively measured snoring production and intensity after only three months. It can help a large part of the population to sleep better and more relaxed.

PMID: 19234106

2009, São Paulo, Brazil, Randomized Controlled Trial, PMID: 19234106, Kátia C Guimarães, Luciano F Drager, Pedro R Genta, Bianca F Marcondes, Geraldo Lorenzi-Filho, -Source-

Upper airway muscle function plays a major role in maintenance of the upper airway patency and contributes to the genesis of obstructive sleep apnea syndrome (OSAS). Preliminary results suggested that oropharyngeal exercises derived from speech therapy may be an effective treatment option for patients with moderate OSAS.

Oropharyngeal exercises significantly reduce OSAS severity and symptoms and represent a promising treatment for moderate OSAS.

PMID: 23702236

2013, São Paulo, Brazil, Randomized Controlled Trial, PMID: 23702236, Giovana Diaferia, Luciana Badke, Rogerio Santos-Silva, Silvana Bommarito, Sergio Tufik, Lia Bittencourt, -Source-

Background: Patients with obstructive sleep apnea (OSA) exhibit reduced quality of life (QoL) due to their daytime symptoms that restricted their social activities. The available data for QoL after treatment with continuous positive airway pressure (CPAP) are inconclusive, and few studies have assessed QoL after treatment with speech therapy or other methods that increase the tonus of the upper airway muscles or with a combination of these therapies. The aim of our study was to assess the effect of speech therapy alone or combined with CPAP on QoL in patients with OSA using three different questionnaires.

Our results suggest that speech therapy alone as well as in association with CPAP might be an alternative treatment for the improvement of QoL in patients with OSA.

PMID: 25950418

2015, São Paulo, Brazil, Randomized Controlled Trial, PMID: 25950418, Vanessa Ieto, Fabiane Kayamori, Maria I Montes, Raquel P Hirata, Marcelo G Gregório, Adriano M Alencar, Luciano F Drager, Pedro R Genta, Geraldo Lorenzi-Filho, -Source-

Background: Snoring is extremely common in the general population and may indicate OSA. However, snoring is not objectively measured during polysomnography, and no standard treatment is available for primary snoring or when snoring is associated with mild forms of OSA. This study determined the effects of oropharyngeal exercises on snoring in minimally symptomatic patients with a primary complaint of snoring and diagnosis of primary snoring or mild to moderate OSA.

Oropharyngeal exercises are effective in reducing objectively measured snoring and are a possible treatment of a large population suffering from snoring.

PMID: 30233265

2018, São Paulo, Brazil, Review, PMID: 30233265, Cláudia Maria de Felício, Franciele Voltarelli da Silva Dias, Luciana Vitaliano Voi Trawitzki, -Source-

Purpose: Orofacial myofunctional therapy (OMT) is a modality of treatment for children and adults with obstructive sleep apnea (OSA) to promote changes in the musculature of the upper airways. This review summarizes and discusses the effects of OMT on OSA, the therapeutic programs employed, and their possible mechanisms of action.

Conclusion: The present review showed that OMT is effective for the treatment of adults in reducing the severity of OSA and snoring, and improving the quality of life. OMT is also successful for the treatment of children with residual apnea. In addition, OMT favors the adherence to continuous positive airway pressure. However, randomized and high-quality studies are still rare, and the effects of treatment should also be analyzed on a long-term basis, including measures showing if changes occurred in the musculature.

PMID: 32045849

2020, São Paulo, Brazil, Meta-Analysis, PMID: 32045849, Ozeas L Lins-Filho, Rodrigo Pinto Pedrosa, Jessica M L Gomes, Sandra L Dantas Moraes, Belmiro Cavalcanti Egito Vasconcelos, Cleidiel Aparecido Araujo Lemos, Eduardo Piza Pellizzer, -Source-

Obstructive sleep apnea (OSA) has many effects on subjective parameters of the disease, such as reduction in quality of life (QoL), sleep quality (SQ), and increases in daytime sleepiness. Studies have reported the beneficial effect of exercise training on OSA severity; however, whether it improves subjective parameters remains unclear. The purpose of the present review was to investigate the effect of exercise training on QoL, daytime sleepiness, and SQ in adults with OSA by summarizing the results of clinical trials.

Exercise training significantly improved QoL (mean difference, 12.9 [95% confidence interval (CI) 6.4 to 19.5]) and SQ (mean difference, -2.0 [95% CI -3.6 to -0.5]), and reduced daytime sleepiness (mean difference, -3.7 [95% CI -6.1 to -1.2]), and OSA severity (mean difference, -11.4 [95% CI -13.4 to -9.4 events/h]). Thus, physical exercise training was effective in improving subjective parameters and reducing the severity of OSA. Additional randomized clinical trials, however, should be performed to confirm these findings.

PMID: 33080062

2021, Tokyo, Japan, Interventional study, PMID: 33080062, Mayumi Suzuki, Toshihiro Okamoto, Yuichi Akagi, Kentaro Matsui, Haruki Sekiguchi, Natsumi Satoya, Yuji Inoue, Akihisa Tatsuta, Nobuhisa Hagiwara, -Source-

Objective: We conducted an interventional study using MFT to evaluate the effect of MFT on middle-to-senior-aged patients with moderate or severe OSA and compared changes in apnoea-hypopnea index (AHI) and tongue pressure.

Conclusions: MFT can be a useful intervention even among middle-aged to elderly patients with OSA. Increased tongue pressure may have contributed to the AHI improvement.

PMID: 26993338

2016, Chandigarh, India, Study, PMID: 26993338, Roshan K Verma, Jai Richo Johnson J, Manoj Goyal, N Banumathy, Upendra Goswami, Naresh K Panda, -Source-

Introduction: Oropharyngeal exercises are new, non-invasive, cost effective treatment modality for the treatment of mild to moderate obstructive sleep apnoea. It acts by increasing the tone of pharyngeal muscles, is more physiological, and effects are long lasting. Aim of the study: The aim of our present study was to evaluate the effect of oropharyngeal exercises in the treatment of mild to moderate obstructive sleep apnoea.

Conclusion: Graded oropharyngeal exercise therapy increases the compliance and also reduces the severity of mild to moderate OSAS.


2018, Pune, India, Paper, ISSN:2347-6567, Nilesh Maharudra Andhare, Tilak Maharashtra Vidyapeeth; Ujwal Yeole, Tilak Maharashtra Vidyapeeth, -Source-

Background: Obstructive Sleep apnea is increasing health problem seen in developed as well as developing countries. CPAP is a gold standard treatment protocol used in all over the countries. Because of its cost effectiveness and device related discomfort it is necessary to find alternative treatment regimen. Oropharyngeal exercises are the treatment which involves the correct use of the physiological structures and functions by means of functional exercises and muscular exercises with the aim of increasing the tonus and mobility of oral structures in upper airway obstruction.

There was significant decrease in severity of apnea on STOP-BANG sleep apnea questionnaire, after Oropharyngeal exercises (p<0.0001). Also there were significant increase in oxygen saturation and PEFR values after Oropharyngeal exercises (p<0.0001 and p<0.0044). Conclusion: It is concluded that Oropharyngeal exercise can achieve improvement in Obstructive sleep apnea syndrome.

ISSN: 2249-9571

2019, University Mullana, India, Research Article, ISSN: 2249-9571, Jaspreet Kaur, Ms. Kanika Rai, Ms. Vinay Kumari, Dr. (Mrs) Jyoti Sarin, -Source-

The field of “oropharyngeal” exercises is a new treatment but it‟s a field that causes good prognosis for snoring, daytime sleepiness and obstructive sleep apnea (OSA) sufferers. Quasi experimental study using non equivalent control group pretest-posttest design was used. Pretest was taken of comparison group by anthropometric parameter, Epworth sleepiness scale, Snoring scale and STOP BANG sleep apnea questionnaire and no intervention was given.

Oropharyngeal exercises are effective in reducing the daytime sleepiness, snoring and risk of obstructive sleep apnea among adults having snoring. The nurses along with the pharmacological therapy they can teach oropharyngeal exercises as an adjuvant therapy in improving sleep quality of patient. Also as a nurse educator teach students about assessment of sleep related problems like snoring, obstructive sleep apnea among patients admitted in hospital. The protocol should be made in the ward to identify the patients having snoring and to teach the oropharyngeal exercises to them. Researches can be conducted regarding different modalities on pharmacological therapy and non-pharmacological treatment also to reduce daytime sleepiness, snoring and risk of obstructive sleep apnea.

PMID: 25370601

2015, Rasht, Iran, Paper, PMID: 25370601, Shadman Nemati, Hooshang Gerami, Soheil Soltanipour, Alia Saberi, Solmaz Khorasani Moghadam, Fatemeh Setva, -Source-

Primary snoring (PS) is one of the sleep breathing disorders with suboptimal results of treatment. It is recommended that Oropharyngeal exercises can be a therapeutic choice for the patients with mild to moderate degrees of PS. We assessed the effects of oropharyngeal-lingual (OPL) exercises on patients with primary snoring (PS) referred to Amiralmomenin University Hospital, Rasht, Iran in 2012. Fifty-three patients with PS underwent the sets of OPL exercises for 3 months, 5 days a week, and 30 min a day under the supervision of a speech therapist. Severity of the snoring was assessed by use of Visual Analogue Scale (VAS) and Snoring Scale Score (SSS) criteria before and after the exercises, and data were analyzed using SPSS version 17. Mean SSS before the study was 7.01 ± 1.72, while it was 3.09 ± 2.7 after the study; and the mean VAS scores were 8.54 ± 1.89 and 4.69 ± 2.94 before and after the study, respectively (P = 0.0001).

There was a significant relationship between having conflicts with roommates (P = 0.0001), duration of snoring occurrence (P = 0.0001), severity of snoring (P = 0.0001) before and after the intervention. In conclusion, doing the OPL exercises significantly decreases the severity of PS.


2012, Mansoura University, Iran, Paper, 269099483, Hemmat Baz, Mohsen Elshafey, Shawky Elmorsy, Mohamed Abu-Samra, -Source-

Introduction: Oral Myofunctional therapy could be considered as a new therapy for snoring and obstructive sleep apnea syndrome (OSAS), because of its direct action on oral motility. Aim of this work: to evaluate the effect of Oral Myofunctional therapy as a simple method for treatment of patients with mild to moderate Obstructive Sleep Apnea Syndrome (OSAS). Materials and methods: 30 patients with mild to moderate OSAS were subjected to the following: 1-Thorough history taking with stress on symptoms of OSAS (snoring, fragmented sleep, witnessed apneas, morning headache and daytime sleepiness) and calculation of Epworth sleepiness scale.

Results: There was significant decrease of apnea hypopnea index (AHI), arousal index after myofunctional therapy as compared to before myofunctional therapy (p < 0.001 for all). Also there were significant decrease in desaturation parameters (desaturation index, average duration SaO2 < 90%, % total sleep time SaO2 < 90%) after myofunctional therapy (p < 0.001). Conclusion: myofunctional therapy can achieve subjective improvement in OSAS symptoms, as well as polysomonographic abnormalities in patients with mild to moderate OSAS and so can be considered as an alternative method of treatment.


2017, Tanta University, Egypt, Paper, 0422-7638, Ahmed Sh.Mohameda, Ragia S. Sharshar, Reham M. Elkolaly, Shaimaa M. Serageldinb, -Source-

Obstructive sleep apnea syndrome (OSAS) is an important disease that represent a challenge for both patients and physicians to reach optimum choice for treatment mostly because genesis of OSAS is multifactorial. Upper airway muscle function plays a major role in maintenance of the upper airway patency especially during sleep. Oropharyngeal exercises may be an effective treatment option for OSAS.

Results: After end of study, daytime sleepiness and AHI improved significantly in group I (moderate OSA) 13 out of 15 patients shifted from moderate to mild OSAS. There was significant decrease in oxygen desaturation and snoring index. As for group II, there was decrease but not significant change in same parameters. Only for moderate OSAS, there was, significant decrease in neck circumference, which inversely correlated with changes in AHI (r = 0.582; P < 0.001). Conclusion: Upper airways exercises can be a novel easy non invasive technique to improve AHI, O2 saturation and snoring thus used in treatment of OSAS patients mainly moderate type.

PMID: 30420832

2018, Dalian, China, Paper, PMID: 30420832, Dongmei Ye, Chen Chen, Dongdong Song, Mei Shen, Hongwei Liu, Surui Zhang, Hong Zhang, Jingya Li, Wenfei Yu and Qiwen Wang, -Source-

The primary aim of the current study was to assess the effects of oropharingeal muscle exercises in obstruction severity on stroke patients with OSAS. The secondary aims were to evaluate the effects of the exercises on rehabilitation of neurological function, sleeping, and morphology change of upper airway. An open-label, single-blind, parallel-group, randomized, controlled trial was designed.

After 6 weeks of treatment, no significant changes were observed in the control group; however, significant changes were observed in the therapy group.

doi: 10.1590/1982-0216201719613317

2017, Sao Paulo, Brasil, Meta-Analysis, doi: 10.1590/1982-0216201719613317, Fabiane Kayamori, Esther Mandelbaum Gonçalves Bianchini, -Source-

Recently, the orofacial myofunctional therapy (OMT) has appeared as a possible alternative treatment for obstructive sleep apnea (OSA). Systematic reviews are required to achieve scientific evidence, seeking to direct the decision on therapeutic issues. The aim of this study was to systematically review the literature about the OMT proposals in adults with OSA related to symptoms and physiological parameters.

Six studies showed a decrease in the Apnea and Hypopnea Index (AHI), five studies showed improvement in the minimum SpO2, decrease in the Epworth Sleepiness Scale (ESS) and in snoring. OMT proposals refer to a three-month program changing the parameters related to partial reduction of AHI, ESS index, snoring, and partial increase of SpO2. There are few randomized studies.

PMID: 25348130

2015, Redwood City, CA, Meta-Analysis, PMID: 25348130, Macario Camacho MD, Victor Certal MD, Jose Abdullatif MD, Soroush Zaghi MD, Chad M. Ruoff MD, Robson Capasso MD, and Clete A. Kushida MD, PhD1, -Source-

Objective: 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.

Conclusion: Current literature demonstrates that myofunctional therapy decreases apnea-hypopnea index by approximately 50% in adults and 62% in children. Lowest oxygen saturations, snoring, and sleepiness outcomes improve in adults. Myofunctional therapy could serve as an adjunct to other obstructive sleep apnea treatments.

PMID: 29275425

2018, Stanford, USA, Review, PMID: 29275425, Macario Camacho, Christian Guilleminault, Justin M Wei, Sungjin A Song, Michael W Noller, Lauren K Reckley, Camilo Fernandez-Salvador, Soroush Zaghi, -Source-

Purpose: Oropharyngeal and tongue exercises (myofunctional therapy) have been shown to improve obstructive sleep apnea. However, to our knowledge, a systematic review has not been performed for snoring. The study objective is to perform a systematic review, with a meta-analysis, dedicated to snoring outcomes after myofunctional therapy.

Conclusions: This systematic review demonstrated that myofunctional therapy has reduced snoring in adults based on both subjective questionnaires and objective sleep studies.

PMID: 16377643

2005, Zürich, Switzerland, Randomized Controlled Trial, PMID: 16377643, Milo A Puhan, Alex Suarez, Christian Lo Cascio, Alfred Zahn, Markus Heitz, Otto Braendli, -Source-

Objective: To assess the effects of didgeridoo playing on daytime sleepiness and other outcomes related to sleep by reducing collapsibility of the upper airways in patients with moderate obstructive sleep apnoea syndrome and snoring.

Conclusion: Regular didgeridoo playing is an effective treatment alternative well accepted by patients with moderate obstructive sleep apnoea syndrome.

PMID: 30032464

2019, Arizona, USA, Randomized Controlled Trial, PMID: 30032464, Umesh Goswami, Adam Black, Brian Krohn, Wendy Meyers, Conrad Iber, -Source-

Purpose: Upper airway exercises for snoring treatment can be effective but difficult to administer and monitor. We hypothesized that a brief, relatively simple daily upper airway exercise regimen, administered by a smartphone application, would reduce snoring and encourage compliance.

Conclusions: Smartphone application-administered upper airway training reduces objective and subjective snoring measures and improves sleep quality.

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