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SLEEP & AIRWAY

Snoring is common, but not normal. It is dysfunctional breathing caused by resistance in the airway. Snoring often comes from nasal obstruction, either inflammation and/or structural problems within the nose. Nasal obstructions within the nose include: inflamed or overgrown turbinates, deviated septum, and concha bullosa (air-filled bone). Snoring also comes from an inflamed and elongated soft palate that vibrates as air moves passed it. This is made worse by mouth breathing. Snoring can be improved by addressing the root causes, such as using nasal sprays, nasal dilators, getting nasal surgery, tightening the soft palate with non-invasive laser procedures, and mouth taping to ensure nasal breathing. 
 

 

Upper Airway Resistance Syndrome (UARS) is an often undiagnosed sleep breathing disorder. It comes from partial airway obstruction that causes symptoms similar to sleep apnea, but is routinely missed on take home sleep studies; however, it can be diagnosed by a sleep physician using polysomnography. 
 

 

Obstructive Sleep Apnea (OSA) is caused by brief airway collapses that temporarily stops breathing. This has numerous health consequences that has been linked to nearly 200 medical conditions. Symptoms include: snoring, nocturnal bruxism (teeth clenching, grinding), temporomandibular joint disorder (TMD), excessive daytime sleepiness, fatigue, repeated awakenings, tossing and turning, waking up to pee, waking up gasping or chocking, mouth breathing, dry mouth in the morning, morning headaches, irritability, difficulty concentrating, anxiety, depression, nightmares, decreased libido, erectile dysfunction, night sweats, and bedwetting (mostly in children).
 

 

Central Sleep Apnea (CSA) is caused by a failure of the brain to send a signal to breathe. It is less common than OSA, however, can be mixed with OSA, and often reduced when OSA is effectively treated. 
 

 

UARS and OSA can be effectively managed by an oral sleep appliance. Those with moderate to severe OSA may be a candidate for CPAP (continuous positive airway pressure), which is a device that forces air through the airway to keep it from collapsing. An oral sleep appliance and CPAP do not address root causes, but can effectively manage the symptoms. It is important to understand the root causes of your sleep breathing disorder. 

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​ROOT CAUSES OF SLEEP BREATHING DISORDERS INCLUDE:

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  • Small jaws

  • Nasal obstruction 

  • Overweight 

  • Tongue-tie

  • Airway inflammation

  • Elongated soft palate

TREATMENTS, DEPENDING ON THE ROOT CAUSE, MAY INCLUDE:​​

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  • Oral sleep appliance to posture the lower jaw forward to allow for more tongue space and reduce oropharyngeal airway collapse 

  • Jaw development with a functional orthodontic appliance that creates more tongue space, facial symmetry, and craniofacial support 

  • Jaw surgery (orthognathic surgery) that advances the jaws to provide more tongue space and therefore open the oropharyngeal airway 

  • Nasal sprays to reduce inflammation inside the nose

  • Nasal dilators to prevent nasal valve collapse 

  • Nasal surgery to remove or reduce physical obstructions inside the nose and correct nasal valve collapse 

  • Weight loss to reduce excess weight around the neck that contributes to a collapsing oropharyngeal airway

  • Tongue-tie release (with orofacial myofunctional therapy) to restore proper tongue posture on the palate 

  • Orofacial myofunctional therapy to improve tongue posture, breathing, airway toning, swallowing, and speech 

  • Anti-inflammatory diet (including alcohol and drug reduction) to reduce nasal and oropharyngeal airway inflammation and collapsibility 

  • Non-invasive laser treatments to tighten an inflamed and collapsable soft palate and surrounding soft tissues

Image by Marissa Rodriguez

Lightwalker Nightlase

Solea Sleep

Non-invasive laser treatments, such as Fotona Lightwalker NightLase and Solea Sleep, deliver light energy at specific wavelengths that tighten the soft palate and surrounding tissues commonly involved in snoring and oropharyngeal airway collapse, such as in obstructive sleep apnea and upper airway resistance syndrome.

Before NightLase

After NightLase

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HOW ORAL APPLIANCES CAN HELP:

Oral sleep appliances for mandibular advancement support the oropharyngeal airway and jaw joints to relieve symptoms of obstructive sleep apnea, upper airway resistance syndrome, and snoring.

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Sleep breathing disorders are on a spectrum. A small amount of resistance in the upper airway, such as a nasal valve collapse or deviated septum, can cause the tissues of nose, soft palate and/or throat to collapse. Identifying the cause of the airway resistance is paramount to effectively reversing or managing sleep breathing disorders.

Functional orthodontic appliances can be effective for jaw, face, and airway development with or without mandibular advancement for airway support and bite alignment for jaw joint stability. Our jaws development around our upper airway in relation to the forces of our neck and face muscles, especially the tongue. If we don’t breathe properly or have a tongue-tie while our faces are developing, then the jaws may be too small creating crowded misaligned teeth, crowded collapsible airways, and compromised posture.

If our feet and/or pelvis are out of alignment while we are learning to walk, it may create a twist in our body and our face. Determining the cause of deficient jaw development is the first step on the pathway back to health. With stable posture, jaws can be predictably developed with functional orthodontic appliances to create more tongue space, facial symmetry, and craniofacial support. 

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