Sleep Disordered Breathing
How oral dysfunction can create a ripple effect of problems
Imagine waking up to a pool of drool on your pillow. Or the roar of your dad snoring 3 bedrooms over. Or waking up on the opposite side of the bed that you started the night on, covers ruffled everywhere and sheets coming out.
As common as these things sound, they are not “normal”. These signs can be a few of the many signals that our sleep is not quality and is suffering.
What are some of the first signs of oral dysfunction?
Sleep disordered breathing is almost always initially caused from oral dysfunction (other reasons exist, but this is the most common). It can become a bigger issue when secondary symptoms arise due to the effects of oral dysfunction (more on that below). The first signs of oral dysfunction are the common signs of a tongue tie, which contributes greatly to the extent of oral dysfunction. A brief and basic list of those signs include:
Difficultly latching on breast or bottle to feed (slide on and off frequently, frustration while feeding, not able to properly suck, clicking/smacking noises, coughing/gagging, loss of milk during feeds, biting/chewing/chomping the nipple, etc)
Mouth breathing/open mouth posture, snoring, noisy breathing
Recessed jaw (the lower half of the jaw is much more retracted or pulled in than the upper half)
Symptoms of reflux/excessive gassiness
Feeds that take longer than 20 minutes, frequently falls asleep during feeds, eating more frequently than 2-3 hours (this symptom may vary - sometimes cluster feeding and falling asleep while feeding is very common in babies - this is more of a symptom in conjunction with the others).
Nipple pain in mother (lasting longer than a few days after birth)
How does Oral dysfunction cause issues with sleeping?
Our tongue is the “epicenter” of development. Our face and upper airway are formed around our tongue. It is the midline of our body and allows are face and body to grow symmetrically. When there is a restriction, there is a breakdown on how our head, face and airway are developed. When our tongue is dysfunctional (ie. tethered to the floor of the mouth, poor range of motion, weak, low tone, etc) - we are typically left with a high and narrow palate, an underdeveloped airway and jaw, a dysfunctional swallow and a mouth that has a hard time closing to promote closed mouth nasal breathing. Open mouth breathing causes quite a ruckus for us during the day and most especially at night, when our body is supposed to be healing and regenerating.
Oral dysfunction = mouth breathing
Mouth breathing —> causes a host of other symptoms:
Snoring / Airway restrictions
Bruxism (teeth grinding/clenching)
Waking up frequently throughout the night
Restless sleep, sleeping in odd positions, sleeping with odd head positioning
Wake up not feeling refreshed or well rested
Chronic bedwetting
Enlarged tonsils/adenoids
High/narrow palate, crowded teeth
Trouble with certain speech sounds
Dark circles under eyes due to lack of high quality sleep
All of these symptoms reduce the quality of sleep. Mouth breathing encourages fast, shallow breathing. This can inhibit us from getting into the deep stages of sleep. For normal development of the brain, deep sleep is vital. This lack of quality sleep puts our body into a stress response (fight or flight) and can lead to symptoms of ADHD, behavioral, emotional and mood dysregulation and sensory processing disorders.
What can you do if your child is struggling with oral dysfunction and sleep disordered breathing?
Oral dysfunction can be a very intimidating path to deal with as a parent.
As a parent of an infant, you will want to first seek out a provider or therapist specifically trained in evaluating oral motor and whole body functioning. This can be an OT, PT, SLP or IBCLC with training in TOT’s (tethered oral tissues). One provider may fit your situation better than the next. This provider can create a plan for your baby, which may include therapy, a tongue tie release and/or bodywork/fascial work.
As a parent of a toddler, a good first step would be to locate an “airway savvy” dental provider. They will be able to guide you in a treatment plan that may include therapy, expansion, tongue tie release and/or body/fascial work.
As a parent of a child older than 4, an airway savvy dental provider and/or a myofunctional therapist would be a great place to start. These providers will guide you with a treatment plan that will help retrain the muscles of the tongue, lips, and face to allow for proper tongue placement, while also addressing some of those common symptoms of oral function (ie. expansion or other oral devices to help with jaw growth/high and narrow palate, potential tongue tie release, etc).
Each child presents with their own unique and individual journey, so a provider that is able to evaluate their special needs and determine a plan of treatment specifically for your child will be your best bet for a positive outcome!