Delving Into Sleep-Disordered Breathing (SDB)
Delving Into Sleep-Disordered Breathing (SDB): Its Impact on Breathing and Airway Function – A Whole-Patient Approach
Sleep-disordered breathing (SDB) encompasses a spectrum of conditions characterized by abnormal breathing patterns during sleep, including chronic mouth breathing, snoring, obstructive sleep apnea (OSA), central sleep apnea (CSA), and upper airway resistance syndrome (UARS). These disorders can significantly impact airway function and oral health. Airway disruptions can lead to disrupted sleep, reduced oxygenation, increased risk of cardiovascular disease , Alzheimer’s, memory loss, and more. Addressing SDB requires a whole-patient approach that focuses on accurate diagnosis, effective comprehensive treatment, and management of associated health conditions to improve breathing, sleep quality, and overall health.
Sleep apnea and SBD are traditionally treated with:
- Continuous positive airway pressure (CPAP), a machine that uses air pressure to keep airways open while you sleep. Importantly, compliance to use of CPAP on a consistent basis is less than 50% of users, and can be accompanied by side effects including congestion, nosebleeds, and dry mouth.
- Mandibular advancement devices (MAD) are oral appliances designed to move the mandible (lower jaw) forward during sleep to open up the airway. Side effects can include pain in the jaw or TMJ, changes in bite occlusion, or dry mouth.
- Surgical intervention, including maxillomandibular advancement (MMA), now has increased supporting evidence of the improvement of OSA with functional retraining and strengthening of the oral muscle groups (lips, tongue, jaws, & face).
Other important factors play a role in SDB and related disorders, such as nasal hygiene and airway patency that can be affected by chronic congestion, inflammation, and allergies.
The Connection Between Sleep-Disordered Breathing and Airway Function
Sleep-disordered breathing directly affects airway patency and the efficiency of gas exchange during sleep. In conditions like OSA, physical obstructions in the airway lead to repeated apneas or hypopneas, causing significant drops in oxygen levels and fragmented sleep. These disturbances not only impact nighttime breathing but also have daytime consequences, including reduced focus and attention, memory loss, systemic hypertension, cognitive dysfunction, and decreased quality of life.
- Impact on Oxygen Saturation: Intermittent apneas result in fluctuating oxygen levels, stressing the cardiovascular system.
- Disruption of Sleep Architecture: Frequent arousals prevent the progression through the natural sleep stages, impairing sleep quality.
Distinguishing Sleep-Disordered Breathing's Impact
The impact of sleep-disordered breathing on airway function is characterized by its occurrence predominantly during sleep, differentiating it from other respiratory conditions that may affect breathing both day and night. This distinction is crucial for guiding diagnostic evaluations, such as polysomnography, and tailoring treatment strategies to improve nighttime airway function and breathing.
Prevalence and Clinical Importance
The prevalence of sleep-disordered breathing in the general population highlights the importance of recognizing and addressing this condition. Left untreated, sleep-disordered breathing can lead to significant health complications, including cardiovascular disease, metabolic syndrome, and impaired cognitive function. Early intervention and management can mitigate these risks and enhance patient outcomes.
Underlying Causes
Contributors to sleep-disordered breathing and its impact on airway function include:
- Anatomical Factors: Structural abnormalities, such as enlarged tonsils or a deviated septum, can predispose individuals to airway obstruction.
- Functional Factors: Low tongue resting posture, reduced tone and strength in the oropharynx, poor swallow habits, forward head posture, or core body strength.
- Neuromuscular Control: Dysfunction in the muscles controlling the airway may lead to collapse during sleep.
- Obesity: Excess weight can increase the risk of airway obstruction due to fatty tissue in the neck area.
Identifying Symptoms
Symptoms that may indicate sleep-disordered breathing include:
- Mouth breathing
- Snoring
- Daytime Sleepiness
- Observed Apneas: Episodes where breathing stops during sleep, often reported by a bed partner
- Enuresis (bed wetting)
- Tossing and turning
- Grinding and clenching teeth
- Frequent waking or getting up to use the bathroom
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Diagnostic and Treatment Pathways
A comprehensive approach to addressing sleep-disordered breathing involves a care team:
- Primary Care Provider (PCP): Identifying comorbidities that may be related to SDB.
- Speech Pathologist: Specializing in oromyofunctional therapy (OMT) to assess oropharyngeal function as a contributing factor and provide treatment to improve breathing, sleeping, eating, and talking.
- Ear, Nose and Throat Doctor (ENT or Otolaryngologist): to identify any airway obstructions.
- Orthodontists: identifying and treating structural limitations to the airway.
- Sleep Medicine: to conduct a polysomnography (sleep study), diagnose SBD, and determine the need for assistive devices (CPAP, MAD, etc.) or treatment.
BreatheWorks' Integrated Care Approach
BreatheWorks‘ Integrated Care Approach
At BreatheWorks, we employ a whole-patient approach to managing sleep-disordered breathing and its effects on airway function. Rather than look at one piece of the puzzle, we assess overall oropharyngeal, head, neck, and core function. At BreatheWorks we like to be the quarterback, lead the plays and coordinate the efforts. Our integrated care strategy includes:
- Whole-Patient Assessment: Conducted by a Speech-Language Pathologist, we take a detailed case history to get a clear picture of your body’s story and assess the function of the breathing mechanism when it comes to sleep health. We will observe how the muscles perform tasks like speaking, chewing, swallowing, clearing your teeth, and breathing and identify the contributing factors that may relate to your symptoms.
- Tailored Treatment Plans: Combining medical interventions with behavioral changes to address the root causes of sleep-disordered breathing.
- Collaborative Expertise: Engaging dentists, orthodontists, primary care providers, physical therapists, pulmonologists, sleep specialists, and nutritionists to provide comprehensive care.
- Support and Education: Offering resources and guidance to help patients understand their condition, manage symptoms, and improve sleep and breathing.
Conclusion
Sleep-disordered breathing profoundly impacts breathing and airway function during sleep, with significant health implications if left untreated. A comprehensive, whole-patient approach that addresses the multifaceted nature of these disorders can lead to improved airway patency, enhanced sleep quality, and better overall health outcomes. BreatheWorks is committed to supporting individuals with sleep-disordered breathing, providing personalized care plans designed to optimize breathing and airway function, and improve quality of life.
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Orofacial Myofunctional Disorders (OMD)
Orofacial Myofunctional Disorders (OMD) refer to a group of conditions characterized by abnormal patterns of muscle function and incorrect habits involving the face, mouth, and throat. These disorders can affect various aspects of oral function, including speech, swallowing, breathing, and facial development. Examples of OMD include tongue thrust (where the tongue pushes against or between the teeth during swallowing or at rest), open mouth posture (habitual mouth breathing with the mouth consistently open), and incorrect tongue resting position. OMD can contribute to dental malocclusions, speech articulation difficulties, temporomandibular joint (TMJ) dysfunction, and other orofacial issues.Orofacial Myofunctional Therapy (OMT or MYO)
Orofacial myofunctional therapy (OMT) is a specialized form of therapy designed to address and correct Orofacial Myofunctional Disorders (OMD). It focuses on retraining the muscles of the face, mouth, and throat to achieve proper resting posture, swallowing patterns, and speech articulation. OMT involves a variety of exercises, techniques, and behavioral modifications tailored to the individual’s specific needs and goals. The goals of OMT include improving orofacial muscle strength and coordination, correcting abnormal swallowing patterns, promoting nasal breathing, and enhancing overall oral function and health. OMT is typically provided by speech-language pathologists or therapists trained in orofacial myofunctional therapy techniques.Benefits of Orofacial Myofunctional Therapy (OMT)
Orofacial myofunctional therapy (OMT) can be highly beneficial for individuals with Orofacial Myofunctional Disorders (OMD). By addressing underlying muscle dysfunction and promoting proper oral habits, OMT can help improve speech clarity, correct swallowing patterns, alleviate breathing difficulties, and optimize facial development. However, the effectiveness of OMT depends on various factors, including the severity of the OMD, the individual’s commitment to therapy, and consistency in practicing exercises and techniques. OMT is often recommended as part of a comprehensive treatment plan in collaboration with other healthcare professionals, such as dentists, orthodontists, and ENT specialists, especially when addressing complex orofacial issues.We hold space in our clinicians’ schedules for new patients because we know that early intervention is the best approach. We like to see new patients in less than 2 weeks and typically schedule phase one treatments during the first visit. We can see you virtually or in person. Get started now.