Sleep disordered breathing

Sleep-related breathing disorders (SRBDs) incorporates a clinical septum of chronic snoring, upper airway resistance syndrome (UARS), obstructive sleep apnea syndrome, (OSAS)

Sleep disorders are more common than you might realise and impact many facets of life, contributing to multiple issues. 

Children

Sleep apnea in children has been linked to ADHD, lower IQ and other types of learning difficulties. Children who breathe loudly or snore most nights, especially with their mouth open should be assessed for sleep apnea and airway obstruction. 

Signs of OSA in children: 

• dry mouth in the morning

• Irritability

• Fatigue during the day

• Dark circles under the eyes

• Night terrors

• Frequent urination at night

• Teeth grinding

• Headaches

• Reflux

• Snoring or loud breathing

• Limited concentration

• Mouth breathing

• Bed wetting

• Excessive sweating at night

• Moving around a lot in bed

• Gasping for air, choking or coughing at night

The consequences of untreated OSA in adults and children may include: 

• Depression, anxiety, irritability and inability to regulate emotions

• ADHD

• Lower IQ

• Learning difficulties

• Increased risk of hypertension

• Weight gain

• Increased risk of heart failure

• Growth and development delay

• Poor concentration and brain fog

• Poor memory

Adults

Sleep apnea and the milder forms of sleep disordered breathing can lead to insomnia, daytime sleepiness, brain fog, chronic pain, increased risk of hypertension, diabetes, dementia, cancer and weight gain. 

Signs that you may have sleep disordered breathing: 

• daytime sleepiness

• Choking or gasping during the night

• Waking up with a headache

• Chronic pain

• Anxiety

• Brain fog

• Concentration problems

• Snoring

• Memory and mood changes

• Unrefreshing sleep

• High blood pressure

• Neck pain

• Jaw pain

• Weight gain

Recent studies have also linked mild forms of sleep disordered breathing to fibromyalgia, chronic fatigue syndrome and other somatic syndromes. 

Sleep apnea also exacerbates symptoms of asthma and COPD. 

Treatment

CPAP - Considered the gold standard of treatment. However there is poor tolerance and common complaints and therefore generally not well tolerated. 

Mandibular advancement splint - This oral appliance which supports the jaw and optimises the airway can be an appropriate alternative to the CPAP. 

These appliances are custom made by dentists and thus is up to the experience of the dental practitioners and their knowledge of the anatomy and physiology of sleep apnea. 

More Pathways works with the best functional dentists to refer and work with in getting you to the right place to receive the best care.

More Pathways integrative approach

Correct breathing control It is becoming increasingly clear that treatment of ventilatory control is important for successful outcomes in patients with sleep apnea who do not respond adequately to CPAP and oral appliances. More Pathways assesses this ventilatory control (or “loop gain”) with validated and evidence based measures.

Correct breathing patterns Patients with hyperventilation disorders demonstrate persistent abnormalities of breathing control at night. Chemosensitivity (which is what drives the tempo of breathing) rises with hyperventilation which increases the instability of breathing at night. {{Read more about hyperventilation here }}

Nasal rehab Nasal breathing harnesses the gas nitric oxide, which plays a role in the maintenance of muscle tone and regulation of neuromuscular pathways in the pharyngeal (throat) muscles. {{read more about nasal breathing here}}

Improve tone of throat and tongue muscles The stability of the airways are important during sleep as they tend to relax. Using particular breathing and voice exercises we can strengthen these muscles to maintain tone at sleep. We look at the importance of the tongue as it plays a key role in maintaining an adequate airway.

Sleep and lifestyle advice Learning appropriate sleep hygiene in knowing what’s best to set the brain and body up for a restful and restorative sleep. Reducing arousal threshold (the ease in which a sleeping person is awakened) by addressing the nervous system and sympathetic tone.

Reducing inflammation The repeated episodes of upper airway closure during sleep lead to intermittent hypoxia, sympathetic activation, cytokine release and cardiovascular morbidity and mortality and there have been repeated studies to demonstrate the association of sleep disordered breathing with inflammation. Two randomised controlled trial, one utilizing diaphragmatic breathing (64) and another inspiratory resistance training attribute improvements to generalized metabolic and anti-inflammatory or autonomic nervous system regulating effects of the breathing exercises.

Appropriate referrals More Pathways has a brilliant network of health professionals such as the appropriate functional dentists which could help you with a mandibular advancement splint. We know the best orofacial myofunctional therapists to help build tone of the tongue and airway muscles and pathways to appropriate airway informed ENTs to have a closer look at airway obstructions.

More Pathways Therapy for sleep disordered breathing include

• Breath retraining

• Voice and movement

• Manual therapy

• Relaxing breath work

• Nasal rehab

• Education