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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

+Mouth breathing

+ Lips apart/mouth open

+ Restless sleep/moves a lot

+ Sleeping in strange positions

+ Multiple awakenings

+ Enuresis/or getting up multiple times to urinate

+ Sweating

+ Bruxism (teeth grinding)

+ Hyperextension of the neck

+ Awaking tired, in spite of ample sleep.

Image by Annie Spratt


+ 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)

  • Phonology

  • 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.

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