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airway disorders & sleep: what you need to know

What is your airway and why does it matter?

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From your very first breath at birth to the final exhale that will leave your body, your life depends upon your airway.
Your airway consists of a complex network of tubes that enables air to enter and exit your body with each inhale and each exhale. Depending on its severity, an airway obstruction decreases or completely blocks the flow of air to your lungs.
Whether you are awake or asleep, young or old, healthy or sick, your survival depends upon your ability to bring air into your body to your lungs. Your lungs, in turn, utilize oxygen and carbon dioxide for the benefit of every living cell in your body.
By ensuring a steady stream of air to your system, a healthy airway allows your cells to grow, your brain to function, and your body to move. Without breath, your body quickly shuts down. All of your body’s systems including the respiratory, circulatory, digestive, nervous, and immune systems, depend upon a functioning airway.

 

How important is breath?

Breath is a requirement for life that is so basic we often take it for granted. Most of our breathing is unconscious. You will take about 500 million breaths in your lifetime. In the past minute, you’ve taken between 12-20 breaths, probably without giving it a second thought.

Just how important is breathing? Many survivalists think about basic necessities in terms of the “rule of threes”. Although each person is different, an average adult can survive roughly:

  • 3 weeks without food
  • 3 days without water
  • 3 minutes without oxygen

What does this tell us about the hierarchy of needs? That air is vital to our survival. Perhaps breath is more important and fundamental than we give it credit for.  

Whether or not we put it into practice, most of us know that eating the right amount and the right kind of food will help prevent disease and enjoy better health. We’re often reminded to drink enough clean water to stay hydrated. But how often do you gauge the quality of your breathing, the amount of air you consume, and the way you consume it? How often do you practice breathing exercises to tone and strengthen our airway muscles?

Could something as simple as the way you inhale and exhale relate to how healthy or sick you are?  A growing body of science says yes.  Airway disorders have a significant impact on mental and physical health, affecting everything from sleep to learning.

Most adults engage in some form of disordered breathing, and even worse, we consider it normal. Disordered breathing is not only detrimental to our mental and physical state in the present moment, it is also causing many serious diseases and disorders.

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Effects on mental & physical health

Airway-Centered Disorder (ACD) is a potential cause for some of the most prevalent physical and mental health issues of our times.

Airway disorders and disordered breathing hamper the body’s many systems with consequences that affect virtually every aspect of health.


Sleep-related issues:
  • Snoring
  • Restless sleep
  • Obstructive sleep apnea (OSA)
  • Fatigue
  • Insomnia

Dental issues:
  • Dental caries
  • Teeth grinding
  • Dental disease

Mental health and behavioral issues:
  • Dementia
  • Anxiety
  • Depression
  • Memory loss
  • Hyperactivity

Respiratory issues:
  • Asthma
  • Allergies
  • Chronic respiratory infections

Serious and chronic health issues:
  • Hypertension
  • Heart disease
  • Diabetes
  • Migraine headaches
  • Chronic pain
  • Excess weight

Acute vs. chronic airway obstruction

When your airway is blocked due to a foreign object (such as choking on a piece of food) or due to swelling (such as anaphylactic shock from an allergic reaction), it is called an acute airway obstruction. This is usually life-threatening and requires immediate medical attention to remove or resolve the blockage or reduce inflammation.

Oxygen deprivation caused by a full airway obstruction can cause a heart attack or brain damage within minutes. But what happens if, rather than a complete blockage all of a sudden, our bodies are slowly deprived of oxygen over time due to breathing problems?

There are many other less obvious (yet extremely common) forms of chronic airway obstructions and disordered breathing. These impair the body’s normal function by reducing the quantity and quality of air entering the body. Even a partial restriction of the airway can cause serious damage over time. Disordered breathing often goes undiagnosed for years, until troubling symptoms begin to appear.

 

Nasal breathing vs. mouth breathing

In a healthy airway, the nose and nasal cavity are able to fulfil their unique roles and maintain optimum oxygen and carbon dioxide levels in the blood. Nasal breathing (inhaling and the exhaling exclusively through the nose) provides many benefits for wellbeing in both the short and long-term. The nose is the most efficient and the safest way to bring air into the lungs. In contrast to this, disordered breathing often involves some degree of mouth breathing.

 

Nasal Breathing

Mouth Breathing

Mouth stays moist with saliva. Saliva remineralizes teeth to protect them from cavities. Mouth becomes dried out, preventing saliva from remineralizing teeth and increasing the risk of dental caries (also known as cavities).
Nose filters and moistens air from the outside environment, protecting the body from bacteria and viruses thereby decreasing the risk of illness and infections. Unfiltered air enters the body through the mouth, allowing viruses and bacteria to contaminate the body, lungs, and digestive tract. Increased bacteria in the mouth can lead to dental caries, inflamed tonsils, throat infection, etc.
Upon inhalation, the nose brings outside air temperature closer to internal body temperature. Body is less equipped to regulate the temperature of air entering the body. This air enters the body at temperatures that are hotter or colder than body temperature.
Nasal breathing tends to be slower and deeper. Longer exhales result in better mood, relaxation and balance. Mouth breathing tends to be more shallow and fast, which results in the body not getting enough air, causing stress, panic attacks and anxiety.
In nasal breathing, the body unconsciously shifts between one nostril and the other, balancing the hemispheres of the brain and assisting in energizing and relaxing the body as needed. This stimulates the parasympathetic nervous system’s “rest and digest” response. With prolonged mouth breathing the body remains in a state of stress, stimulating the sympathetic nervous system’s “fight or flight” response, which inhibits important functions like digestion and restoration.

 

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Effects of disordered breathing from infancy to adulthood

Airway obstructions and disordered breathing affect virtually parts of the body and systems, which is why the signs and symptoms are so varied. The longer you have an impaired airway, the more effects it will cause with each passing year. Disordered breathing has a lot to do with patterns, habits, and compensation for an obstruction.

What are the signs and symptoms of a chronic airway disorder or disordered breathing?

Airway health is intimately connected to the body’s vital systems and functions. These form a complex web of relationships. If you’ve ever asked yourself the simple question “why do I snore?” you’ll find there is much more than meets the eye (or nose).

The following are just a few examples of signs and symptoms at different stages of development. Many of the signs and symptoms described below can be experienced throughout a lifetime, not just at the developmental stage shown below:

Infancy & Early Childhood:
  • Infant Sleep Apnea
  • Irritability
  • Difficulties with breastfeeding
  • Torticollis
  • Early Childhood Cavities (ECC)

Childhood:
  • Crowded, crooked teeth (malocclusion)
  • Bags under the eyes
  • Night terrors/difficulty sleeping
  • ADD/ADHD
  • Teeth grinding
  • Difficulty paying attention in school

Teens:
  • Anxiety
  • Depression
  • Excessive belching/burping
  • Poor posture
  • Falling asleep in class
  • Underbite or overbite

Adulthood:
  • Fatigue
  • Migraine headaches
  • Neck tension
  • Restless sleep
  • Mild cognitive impairment

Older adulthood:
  • Obstructive Sleep Apnea (often requiring a CPAP machine)
  • Heart issues
  • Falling asleep at the wheel of the car
  • Dementia
  • Memory issues
  • Hypertension

What causes chronic airway obstruction?

There are many causes of chronic airway obstruction including:

  • Deviated septum - this is when the thin wall between your nasal passages is displaced to one side, causing one part of the nasal cavity to be larger than the other.
  • Oral restriction (such as tongue tie, lip tie, or buccal tie) - this is when an oral tether in the mouth is too short, too tight, or too thick, restricting normal tongue mobility and hampering healthy oral function.
  • Abscess - this presents as a tender, swollen mass within the tissue, usually caused by inflammation of the glands and/or infection.
  • Respiratory condition - a number of conditions such as cystic fibrosis, emphysema, and chronic obstructive pulmonary disease (COPD) are closely related to chronic airway obstruction

 

Airway disorders & sleep

Sleep is fundamental to mental and physical health, mood, and quality of life. When you fall asleep at night, your unconscious handles all of your basic physical functions like breathing and heart rate until you wake up. If your airway is compromised, your body will interrupt sleep to keep you alive. Poor sleep and disordered sleep, such as insomnia, restless sleep, and excessive daytime sleepiness (hypersomnia) are often related to an airway issue.


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Sleep apnea and snoring

If you have sleep apnea, your breathing is interrupted, starting and stopping abruptly during sleep. People with sleep apnea have been known to have hundreds of episodes in which they stop breathing during the night. This is often accompanied by loud snoring. Some report a gagging or choking sensation or waking up gasping for air. A small jaw bone and oral restriction such as a tongue tie can contribute to sleep apnea.

What to do if you think you have an airway issue or disordered breathing

Most people with a sleep disorder such as sleep apnea are put on a CPAP machine or medicated with pharmaceuticals to manage symptoms. However, this type of approach fails to address the root cause. If you are looking to get to the bottom of your airway issue, the first step is to surround yourself with trusted healthcare professionals who understand airway health, breathing, and sleep disorders.

In some cases, therapy or even sleep surgery can help. Sleep surgery can be performed by surgeons trained in craniofacial surgery, otolaryngology, and oral maxillofacial surgery. A septoplasty can correct a deviated septum and a release procedure can resolve an oral restriction such as tongue tie, lip tie, or buccal tie.

The best results are achieved with an interdisciplinary team of professionals who can address the root cause of an airway or sleep disorder. Then these professionals collaborate to create a coordinated plan that includes both interventions, devices (if necessary), and therapy. A comprehensive plan may include myofunctional therapy, occupational therapy, advanced orthodontics, oral surgery, and more.


Sleep study

For many people with airway issues and dysfunctional sleep patterns, a sleep study is helpful in getting data that can lead to a diagnosis and treatment plan. Known as a polysomnogram (PSG) is usually conducted in a special lab, where sleep specialists can record and analyze data about you while you sleep. Specialized devices are used to monitor your breathing, movements, heart rate, and oxygen levels, while an EEG monitors your brain activity. This information then informs your treatment and the types of professionals who can help.

Breathing techniques and exercises

In his influential book Breath: The New Science of a Lost Art, author James Nestor illustrates how ancient breathing techniques can actually improve airway health in the modern world.

Ancient texts and accounts of indigenous cultures before colonization describe the benefits of nasal breathing and the risks of mouth breathing.

For example, Pranayama is one of the eight limbs of yoga. The Sanskrit word prana refers to the “vital life force” or the universal energy that vitalizes all matter.

Helpful yogic breathing practices include:

  • nadi shodhana - alternate nasal breathing can help calm and energize your body and mind throughout the day.
  • yoga nidra - a deep state of relaxation and awareness, which helps you prepare for restful, restorative sleep.

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Whether they are a part of a spiritual tradition or simply a practical fitness routine, specific breathing exercises tone the airway muscles, improving airway health, breathing, and sleep.
A good place to start is by simply bringing awareness to the quality of your breath. Focus on nasal breathing (making sure your inhale and exhale are through the nose) with the mouth closed and tongue plastered firmly to the roof of the mouth.



Ready to learn more & get specialized support?

We created health:latch circle to increase education, awareness, and support around the issues of airway health, oral dysfunction & oral restrictions.

The circle makes it easy for you to surround yourself with caring and knowledgeable healthcare professionals across many healthcare fields and healing modalities who can guide and advise you through the ups and downs of diagnosing, treating, and recovering from the long-term effects of an oral restriction, early childhood cavities and more.

The health:latch circle is a radically kind, community-based online platform that allows interested parents and professionals to ask questions, learn together and connect to trusted professionals who are committed to helping families thrive.

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