Uncovering Signs of Sleep-Related Breathing Disorders!

Surrounded bed, into my by the sounds of sirens going off, I sat up in awake with fear, listening for clues to gain insight where there was a fire. Adrenaline rained through body telling me our lives were in danger. “Which room is on fire?” I asked myself. Was it my 3-year-old child’s room, with the sounds of gasping and choking on his large tonsils? Was the danger in my own bedroom as my husband’s mouth was open, not breathing until he gasped to get his next breath? His deviated septum and low tongue posture were like a pinch in the fire hose preventing the life-sustaining oxygen from entering his body. I cannot sleep because I need to find solutions to restore their airways and save my family from the lack of oxygen and restorative sleep.

According to the Sleep Foundation, “Sleep-related breathing disorders are conditions of abnormal and difficult respiration during sleep, including chronic snoring and sleep apnea. Some sleeprelated breathing disorders have limited health impact, but others can have serious consequences because of their potential effects on sleep and the balance of oxygen and carbon dioxide in the blood.”

Sleep-Related Breathing Disorders, SRBD, cover a spectrum of medical conditions ranging from Upper Airway Resistance Syndrome, UARS, to severe Obstructive Sleep Apnea, OSA, and are frequently accompanied by snoring.

The American Dental Association encourages dentists to screen patients as part of the comprehensive medical and dental history to recognize symptoms. The Epworth Sleepiness Scale can be given to patients to determine their level of daytime sleepiness.

Obstructive sleep apnea increases the risk of developing hypertension, heart disease, strokes, and diabetes. Plus studies have shown an association between OSA and an increased likelihood of premature death. The patient’s health history can reveal signs of SRBD. As the red flags are uncovered, ask the patient about their history of snoring, daytime sleepiness, and if it is impacting their quality of life.

I worked in dental practices as a dental hygienist for over 30 years, however, I did not know how to recognize the red flags of SRBD. Over the last 7 years, I have immersed myself in the study of Orofacial Myology, sleep, and airway. Currently, I am now practicing as a Certified Orofacial Myofunctional Therapist.

As an Orofacial Myofunctional Therapist I have witnessed the value of finding the root cause and restoring healthy oral function. The field of Orofacial Myofunctional Therapy (OMT) is growing rapidly due to the recognition of its value with research and demonstration of positive outcomes for those suffering from Orofacial Myofunctional Disorders (OMDs).

Many people have habitual mouth breathing habits that result in the muscles and orofacial functions adapting to a disordered breathing pattern, which may create OMDs. OMDs can affect craniofacial skeletal growth and development, low tongue posture, and breathing and sleep concerns.

• Airway obstructions
• Mouth breathing habits
• Sleep-related breathing disorders
• Low forward tongue posture
• Dysfunctional swallow
• Tethered oral tissue (tongue-tie)
• High narrow palates
• Malocclusion
• Noxious oral habits

When I am asked to speak for dental study clubs, I have had dentists share with me how difficult it is to incorporate airway assessments into their busy practice.

“These days, dentists are under a lot of strain and are being pulled in 10 different directions. Give us a quick and easy guide to assess airway and make that decision to say a referral and further eval is needed. What are the red flags that should prompt the dentist to say to the assistant the patient needs a referral? The protocol needs to be fast and efficient as I am feeling pulled to get to the next patient.”

To support the dentists looking for simple solutions to implement an airway screening, I created the ABC-2 Airway Screening, focusing on airway, breathing, patient concerns, and collaboration with the integrative medical and dental teams.

ABC-2 Airway Screening©

A: Airway Nasal clarity, large tonsils, tongue space, tongue posture, Mallampati score

B: Breathing Mouth or nose breathing. Habit or obstruction.

C: Patient Concerns Snoring, sleep-related breathing disorders, OSA, daytime sleepiness, TMJD, restricted lingual frenulum, bruxism, occlusal wear,

As an Orofacial Myofunctional Therapist I have witnessed the value of finding the root cause and restoring healthy oral function.

impact of lack of sleep on health

C-2 Collaboration Sleep physician for sleep studies and CPAP, sleep dentist for Oral Appliance, Orthodontist for expansion and occlusion, ENT to evaluate nasal clarity, tonsils, adenoids, Oral surgeon, Frenectomy provider, Allergist, Orofacial Myofunctional Therapist to restore nasal breathing and oral function.

1. Breathing through the nose filters the air, to reduce allergens, bacteria, and viruses before it enters the body. Air inhaled through the nose is both warmed and moisturized.
2. Breathing through the nose, you harness various properties of nitric oxide. Nitric oxide plays a role in the dilation of the blood vessels in the lungs so that oxygen can be properly absorbed from the air.
3. Breathing through the nose protects oral health. When an individual inhales through their mouth, the oral cavity becomes dried out, which can increase acids in the mouth, decay, and gum inflammation
4. Breathing through the nose helps the facial muscles and bones develop correctly. Proper oral rest posture with lips closed and tongue resting on the roof can support healthy craniofacial development and occlusion.
5. Breathing through the nose lessens the chance of snoring by reducing open mouth breathing and allows for proper tongue to palate posture.
6. Breathing through the nose activates the parasympathetic nervous system. And at night it helps the body rest, digest, and recuperate.

The Orofacial Complex plays a critical role in life-sustaining tasks, such as eating, drinking, and breathing. The orofacial muscles also play an essential role in our growth and development, as well as our dental and airway health.

What if we shift our focus to preventing fires in the first place in children?

If the tongue and lips are not functioning correctly, crowded teeth and underdeveloped jaws can be the result. Underdeveloped jaws can lead to a lack of tongue space in adults.

There are a growing number of children and adults with sleep disturbed breathing and sleep apnea. Kids who are not getting restorative sleep can present as having a lack of concentration and attention issues.

Studies show many adults with sleep apnea do not know they have it. Utilizing sleep questionnaires and oral screenings including airway and oral function can have significant benefits on the early detection of airway, sleep, and OMDs in the dental office.

To uncover why we are having trouble sleeping and breathing we must look for clues in the oral facial complex for where there are airway obstructions and work with a collaborative medical and dental team to restore the ability to breathe.

We can use positive airway pressure such as CPAP to maintain the airflow, however, I would suggest we shift our focus to include identifying and eliminating the root cause of the mouth breathing habit and collapse of the airway.

Snoring is a siren warning us of dangerous conditions. Resolve and restore as early as possible!

The fire is out, my loved ones are safe! It brings me peace of mind to know my son and husband are now breathing better, sleeping better, and living their best life by eliminating the obstructions and restoring their nasal breathing and sleep.

Can you think of anyone in your home or dental practice that may have mouth breathing or sleep concerns? Oral health professionals are a critical part of the health care team to improve health and wellness!

Recognize, restore and resolve airway restrictions by uncovering the why!

Specializing in the airway, breathing and oral function, she is helping those with orofacial myofunctional disorders at her practice, Facial Function, collaborating with an integrative team of medical and dental providers.

As a National Speaker her goal is to empower the dental team to recognized airway and sleep disorders in the dental practice to grow their practice and healthy airways.