Optimal nighttime sleep breathing:
+ Nasal breathing
+ Lips closed with tongue suctioned to hard palate
+ Quiet breathing; should not be audible or noisy
Open or pursed lips/dry lips (Thome-Pocheco, 2015 et al.)
Low forward tongue position (Harari et al., 2010; Correa et al., 2008)
Short upper lip with reduced function (Abreu et al., 2008)
Voluminous & everted lower lip (Abreu et al., 2008)
Anterior oral seal: lip to tongue (Harari et al., 2010)
Hypotonic oral facial musculature (Abreu et al., 2008)
Forward head posture (Cuccia et al., 2008; Krakauer & Guilherme, 2000)
Facial retrusion (Valera et al., 2006)
Posterior cross bite, open bite, overjet (Valera et al., 2006)
Nasal congestion (Harari, 2010)
Drooling (Kuroishi et al., 2015)
Halitosis (Motta et al., 2011)
Hyponasal speech (Kuroishi et al., 2015)
Alterations of muscle activity for speaking, chewing, & swallowing (Dutra et al., 2006)
Impacts of mouth breathing can be seen effecting reading comprehension, mathematics, and working memory. (Kuroishi et al., 2015)
What to look for:
+ Snoring or audible breathing
+ Gasping for air/cessation of breathing
+ Lips apart/mouth open
+ Restless sleep/moves a lot
+ Sleeping in strange positions
+ Multiple awakenings
+ Enuresis/or getting up multiple times to urinate
+ Bruxism (teeth grinding)
+ Hyperextension of the neck
+ Awaking tired, in spite of ample sleep.
+ 25-50% of preschoolers have sleep problems (Lavigne et al., 1999)
+ 80% of children with neurodevelopmental conditions have sleep problems (Ipsiroglu et al., 2015).
+ 6-9 fold increase in the expected incidence of OSA among first grade children who ranked in the lowest 10th percentile of their class (Gozal, 2008).
+ Sleep plays an integral part in the development & plasticity of the brain (Frank, Issa, & Stryker, 2001).
+ “Sleep disorders can impair children’s IQ as much as lead exposure” (Bronson & Merryman, 2009, p. 33).
+ “We find that a history of sleep-disordered breathing alone increased the odds by 40 percent of a child having a special educational need.” - Karen Bonuck, PhD, Sleep Researcher, Albert Einstein College
Autonomic Deregulation (increased sympathetic tone & “fight or flight” mode) impacts the brain’s ability to access the prefrontal cortex critical for learning.
Neurocognitive impact specifically to areas of executive function skills
Academics (meta-analysis looking at reading comprehension, reading, spelling, math, science)
Socialization (issues with emotional regulation leading to aggression, twice as likely to exhibit bullying behaviors)
Behavioral health and emotional well-being (issues with self-regulation and behaviors, higher risk for depression in teens with OSA)
Oral functions: speech, swallowing, and chewing.
Why Choose Link to Communication?
Link to Communication, LLC, collaborates with other airway-trained professionals. It is the only private speech and feeding clinic in Lincoln housed within a dental office to better collaborate with the dental community. Within our office there is a CBCT/I-CAT (3D-Dental Scan), trained doctor in airway assessment and sleep apnea treatment.
+ Myofunctional therapy decreases apnea-hypopnea index by approximately 50% in adults and 62% in children.
+ Myofunctional therapy could serve as an adjunct to other obstructive sleep apnea treatments.
Camacho M., Certal V., Abdullatif J., Zaghi S., Ruoff CM., Capasso R., & Kushida, CA. (2015). Myofunctional therapy to treat obstructive sleep apnea: A systematic review and meta-analysis. Sleep, 38(5), 669-675.
The Tongue Was Involved, But What Was the Trouble? The search for the cause of a preschooler’s difficult behavior leads to a surprising discovery.
Nicole Archambault, EdS, MS, CCC-SLP