Sleep and breathing are essential to human development, health and daily life. The typical human breathes more than 25,000 breaths each day and swallows up to 1000 times per day. The breathe-suck-swallow pattern is one of the final and most important skills a full-term fetus learns before entering the world. Similarly, sleep is cornerstone to human health and function. Many studies have shown that sleeping fewer than 8 hours per night can increase a patient’s risk for a variety of health conditions. Researchers are also finding that quality of sleep is just as important, if not more important, than quantity of sleep. Breathing during sleep has a major impact on both sleep quantity and quality. Sleep-disordered breathing can put a person’s health, and sometimes even their life, at great risk. First, let’s define terms related to problems with sleep breathing:
Sleep-Disordered Breathing (SDB): “refers to a collapse at any level of the upper airway resulting in abnormal breathing patterns during sleep. SDB can reduce oxygenation of the brain, change in neural physiology and function and a lack of restorative sleep essential to optimal daytime functioning.” (Nicole Archambault, ASHA Leader, February 2018).
Obstructive Sleep Apnea (OSA): “a sleep-related disorder that involves a decrease or complete halt in airflow despite an ongoing effort to breathe. It occurs when the muscles relax during sleep, causing soft tissue in the back of the throat to collapse and block the upper airway.” (American Academy of Sleep Medicine)
Pediatric Obstructive Sleep Apnea (POSA): “a sleep disorder in which [the] child’s breathing is completely or partially blocked repeatedly during sleep. The condition is due to narrowing or blockage of the upper airway during sleep.” (Mayo Clinic)
Recent research has shown a significant increase in the incidence of sleep-disordered breathing. A growing body of research has also shown that orofacial myofunctional disorder (OMD) and sleep-disordered breathing are often comorbid, or exist together. Research has also shown strong correlations between orofacial myofunctional therapy (OMT) intervention and better outcomes for patients with sleep-disordered breathing (SDB) including diagnoses of obstructive sleep apnea (OSA), and pediatric obstructive sleep apnea (POSA).
A recent study in Nature and Science of Sleep reviewed the outcomes of 11 research studies. The literature review concluded that OMT provides the following positive outcomes for adult and pediatric OSA patients:
OMT Benefits in Adult OSA Patients
- reduced the severity of OSA
- reduced the severity of snoring
- decreased apnea hypopnea index (AHI)
- reduced arousal index
- improved subjective symptoms of daytime sleepiness and sleep quality
- improved quality of life
OMT Benefits in Pediatric OSA Patients
- decreased apnea hypopnea index (AHI)
- increased oxygen saturation
- improved orofacial myofunctional status
While diagnosing and explicitly treating sleep-disordered breathing and obstructive sleep apnea are not within a speech language pathologist’s or orofacial myofuncitonal therapist’s scope of practice, it is within our scope of practice to provide Orofacial Myofunctional Therapy. Research supports that OMT can serve as an effective adjunct to other obstructive sleep apnea interventions. If a patient shows signs or symptoms of undiagnosed sleep-disordered breathing, I commonly make referrals to sleep specialists and ENTs for evaluation of airway structure and function to ensure that patient symptoms are thoroughly evaluated and effectively addressed by the necessary team of specialists.
Danielle Klee, M.A., CCC-SLP: Speech Pathologist & Myofunctional Therapist 