Orofacial Myofunctional Therapy for Sleep Apnea

Posted on November 23, 2015 by Dr. Robb Heinrich

In 1900, 60% of all deaths were from communicable sources such as pneumonia, influenza, tuberculosis and enteritis. Life expectancy was about 49 years of age.  Today, we are living longer and better, an average of 77.8 years old.  Because of the industrial revolution and advances in science, medicine and technology, our lifestyle is much different compared to 115 years ago.  Now, we die from “diseases of lifestyle:” heart disease, cancer and degenerative diseases. We eat more and binge on unhealthy foods, get less physical activity but have more stress and less sleep.   So, our quest for better living and longer life bears the question….are these “diseases of lifestyle” preventable or are they caused primarily because we are living longer?

We know that many of the precursors and risk factors (obesity, diet, exercise and environmental exposures to toxins and chemicals) to these “disease of lifestyle” are preventable.  What we can’t change, however, is simple genetic risk factors, environmental exposure and the fact that as we age our cells break down and mutate.  But lifestyle change is definitely a start to prevention.

Obesity, diabetes, high blood pressure, sleep apnea are chronic disease due to our diet and sedentary lifestyle and they are often related to each other. Sleep apnea, for one, affects 18 million Americans. 10 million are undiagnosed! Untreated, sleep apnea is linked to high blood pressure, strokes and heart attacks and people affected with sleep apnea are 3x more likely to be in a motor vehicle accident.  And we know that excess weight, smoking and diabetes are risks for sleep apnea. There is a strong correlation between these modern diseases: sleep apnea, diabetes, heart disease, high blood pressure and stroke and the unhealthy habits of excessive eating (weight gain), smoking and having a sedentary lifestyle.

Airway obstruction and anatomic factors inside the mouth are leading causes to obstructive sleep apnea. We know with obstructive sleep apnea, there is a partial and complete blockage of the upper airway causing lapses in breathing during sleep. People with small airways, larger tongues, low soft palates, large uvulas, larger neck size and excess weight are more likely to develop sleep apnea due to potential blockage of the airway.  Sinus and nasal congestion also put people at risk as well as smoking as it increases airway inflammation and fluid retention.

Diet, exercise and smoking cessation is the best way to prevent many diseases, including sleep apnea. We can reduce our weight and quit smoking which will decrease neck size, decrease inflammation and fluid retention in the airway and reduce diabetic and cardiovascular risk factors.  However, even relatively healthy people are found to have sleep apnea.  What about them? And Is there anything more we can do?

Another YES! Aside from diet and exercise (which is extremely important), Myofunctional Therapy can assist with treated sleep apnea.  This evidence based treatment has been around for over 30 years but has been underutilized in the US.  Think of it like a physical therapy for your tongue, facial muscles and oropharynx to tone breathing, eating and swallowing muscles and open up the airway. It’s non-invasive and relatively inexpensive.  Techniques include: unblocking nasal passages and learning to breathe correctly, proper resting positions of the tongue, body posture and re-training dysfunctional muscle patterns, strengthening, mobilizing and toning to aid in proper breathing.  Some basic exercises, if done every day, can significantly decrease sleep apnea by 39% in adults and 60% in children (INSERT STUDY) alone.  Those are amazing results!! Therapy also significantly decreases symptoms of sleep apnea such as snoring and decreasing neck circumference. Overall, studies report patients experience better sleep, less daytime sleepiness and headaches and improved cognitive and memory function and work performance.  Myofunctional therapy is best used with CPAP and appliance therapy for moderate to severe apnea and can not only continue to increase oxygen content during sleep but also increase compliance and comfort of CPAP and appliance treatment.

If you are interested in learning more about sleep apnea and myofunctional therapy, it is important to contact a professional myofuncational therapist. An individualized assessment and exercises plan will be prescribed to make sure you are getting the benefits of therapy.