Continuous positive airway pressure (CPAP) is tolerated poorly by many patients with obstructive sleep apnea (OSA). Certain patients have experienced positive outcomes with less-obtrusive interventions (e.g., mandibular advancement devices, weight reduction), and, now, Brazilian researchers introduce yet another alternative — oropharyngeal exercises. A study that published in May 2009 looked at oropharyngeal exercises to help OSA. Thirty-one patients with moderate OSA (apnea-hypopnea index, 15–30 events hourly) were randomized to weekly sessions that involved instruction in either oropharyngeal exercises (intervention group) or deep-breathing exercises (control group); patients repeated the exercises at home daily. A speech pathologist taught the intervention program, which involved repetitive exercises of the soft palate, tongue, and facial muscles, as well as breathing, speech, swallowing, and chewing exercises (video). At 3 months, mean apnea-hypopnea indexes were unchanged in the control group but had decreased significantly in the intervention group (from about 22 to about 13 events hourly). Sleepiness and sleep-quality scores also improved significantly only in the intervention group. Source: Published in Journal Watch. Guimarães KC et al. Effects of oropharyngeal exercises on patients with moderate obstructive sleep apnea syndrome. Am J Respir Crit Care Med 2009 May 15; 179:962. Comments: although no diet, weight loss or improvement in over health has been studied in combination with these exercises, it seems that simply  reducing the size of the neck would help reduce sleep apnea._BA