The Role of Myofunctional Therapy for Sleep Apnea

Sleep apnea can be a debilitating condition. Poor sleep can affect just about every area of one’s life, from their mood to their weight. What people don’t know about sleep apnea is there is more than just one way of treating it with a loud, bulky, inconvenient CPAP machine. One of these treatment methods is Myofunctional Therapy. Keep reading for more information on Myofunctional Therapy, how it works, and how it can benefit those suffering from sleep apnea.

What is Myofunctional Therapy?

Myofunctional Therapy is a type of treatment to help disorders of the muscles and functions of the face and mouth. According to the Academy of Orofacial Myofunctional Therapy, Orofacial Myofunctional Disorders are disorders of the muscles and functions of the face and mouth. OMDs may affect, directly and/or indirectly, breastfeeding, facial skeletal growth, and development, chewing, swallowing, speech, occlusion, temporomandibular joint movement, oral hygiene, the stability of orthodontic treatment, facial esthetics, and more.

Since OMD’s are essentially muscle weaknesses of the face, performing strength exercises can help improve them. Much like exercises of any other part of the body, the more you do it, the stronger you will become. Through these exercises, the tongue will move into a more natural and normal resting posture which will help in many areas.

These include:

• Better sleep
• Help with snoring
• Better moods
• More energy
• Better facial symmetry
• Straighter teeth
• The ability to move oral muscles properly
• Better and correct use of the muscles to assist with swallowing, chewing, suction, and breathing

The entire Myofunctional Therapy process generally takes about six months to complete for most patients, though the exact amount of time depends on the severity of issues, as well as the patient’s commitment to performing the exercises as directed (for young patients, this also includes parent participation to ensure their child completes the exercises).

What is Myofunctional Therapy Used For?

Myofunctional Therapy is used to treat Orofacial Myofunctional Disorders. These include difficulties with:

• Eating
• Speaking sounds like, “s” in “sun,” “sh” in “ship,” or “j” in “jump.”
• Breathing
• Swallowing
• Drinking

Some signs of an OMD may include the following:

• Someone who always breathes through the mouth or has difficulty breathing through the nose.
• Limited tongue movement.
• Eating may be messy or difficult. Keep in mind that it is normal for babies to stick their tongue out and push food out of their mouth. Over time, they do this less.
• An overbite, underbite, and/or other dental problems.
• The tongue pushing past the teeth, even when a person is not talking or using the tongue.
• Drooling, especially beyond age 2.
• Difficulty closing the lips to swallow.
• Picky eaters in children.

Can Myofunctional Therapy Change Your Face?

Yes, Myofunctional Therapy can change your appearance. At the start of Myofunctional Therapy, the face may not be symmetrical. The tongue is not in the proper position, which can cause mouth breathing and dental issues. Once therapy begins, the facial structure will lengthen and become more symmetrical.

Long Face Syndrome is a side effect of myofunctional issues. Long face morphology is a relatively common presentation among orthodontic patients. Classical features include an increased lower facial height, anterior open-bite and a narrow palate. Once these are corrected through Myofunctional Therapy, one’s appearance will change.

Statistics on Myofunctional Therapy

• Myofunctional therapy decreases apnea-hypopnea index by approximately 50% in adults and 62% in children, according to Stanford Medicine.
• Lowest oxygen saturations, snoring, and sleepiness outcomes improve in adults, according to Stanford Medicine.
• In the general population 30‐40% of individuals have an orofacial myofunctional disorder (Orofacial Myology Second Edition Hanson and Mason)
• 70‐80% were still swallowing correctly 5 years after treatment, maintaining correct lingual resting posture day and night, and had habituated consistent nasal breathing. (Hahn and Hahn 1992)
• 40% of digit suckers had learning and behavior problems in school (Rosemarie A. Van Norman, an expert in the field of thumb sucking)

Proper Tongue Position and Rest Posture

In order to better understand how Myofunctional Therapy works for sleep apnea, it is important to first understand the importance of proper tongue position. This includes:

• Gently resting the tongue on the roof of the mouth
• The tongue is away from the teeth
• Lips are closed
• The teeth are slightly parted
• You should be able to breathe through your nose

If you rest your tongue on the bottom of your mouth or up against your teeth, this is bad tongue positioning. Bad tongue positioning can lead to:

• Dental issues such as crowding, grinding, or decay
• Neck pain
• Jaw pain
• Flatter face shape
• TMJ
• Bad posture
• Sleep apnea

Nose Breathing vs Mouth Breathing

Breathing is obviously an essential function of the body, so why is it so important that it happens through the nose and not the mouth? Breathing through the mouth is appropriate in some circumstances, such as if the nose is congested from allergies or a cold, or after an individual begins exercising. Otherwise, breathing should happen comfortably through the nose. If not, issues may occur.

Issues that arise from chronic mouth breathing include:

• Slower than normal growth rate in children
• Irritability
• Increased crying episodes at night for children
• Large tonsils
• Dry, cracked lips
• Problems concentrating at school or work
• Daytime sleepiness
• Weight gain
• Chronic allergies
• Recurring sinus infections
• Anxiety
• Increased stress
• Bad breath
• Throat and ear infections
• Snoring and poor sleep

How Myofunctional Therapy Helps Sleep Apnea

The good news about sleep apnea is that it is treatable in many ways. Depending on the severity of your sleep apnea, your lifestyle, and your comfort level, you can try different things until you find what is right for you. Myofunctional Therapy is a great treatment because it involves no medication, all you need to do is stick with the exercises to see results.

Sleep apnea typically occurs if there is an obstruction. By eliminating that obstruction, better breathing can occur. In many cases with Myofunctional Therapy, the obstruction can be facial muscles and the tongue. Through improving their proper position, breathing will become corrected and more natural.

Myofunctional Therapy Exercises

Myofunctional therapy consists of specific oral and facial exercises designed to address the improper Myofunctional habits that cause orthodontic and/or breathing issues. Patients will be asked to perform these exercises regularly to help develop healthier habits and realign the jaw muscles, ultimately aiding in the ability to maintain optimal oral posture, breathe through the nose, swallow properly, and more. In some cases, an oral appliance may be required to help train the tongue and jaw.

It is best to perform these exercises under the care of a medical professional. However, typical Myofunctional Therapy exercises include:

1. Pushing up your tongue. Place the tip of the tongue against the hard palate on the roof of the mouth, just behind the top teeth, and push upwards and hold for 5 seconds. Repeat 10 times.
2. Touch your nose. Stick out your tongue and try to touch the tip of your nose and hold for 10 seconds, then relax. Repeat 10 times.
3. Touch your chin. Stick out your tongue and try to lick the bottom of your chin and hold for 10 seconds, then relax. Repeat 10 times.
4. Push your tongue to the left. Stick out your tongue and move it as far as you can to the left and hold for 10 seconds, then relax. Repeat 10 times.
5. Push your tongue to the right. Stick out your tongue and move it as far as you can to the right and hold for 10 seconds, then relax. Repeat 10 times.
6. Roll your tongue. Fold the edges of your tongue toward the middle lengthwise, so it looks like the end of a taco shell. Stick it out as far as you can while keeping it folded and hold for 10 seconds, then relax. Repeat 10 times.
7. Click your tongue. Make a loud clicking sound with the tongue against the roof of the mouth. Click the tongue for 15 seconds and then repeat 10 times.
8. Push your tongue against a spoon. Push the tip of your tongue firmly against a spoon held in front of your lips for 10 seconds. Keep the tongue straight and don’t let it point downwards. Repeat 10 times.
9. Hold a spoon with your lips. Place the handle of a metal spoon between your lips and hold it in place with only your lips for 10 seconds. Do not place the handle between your teeth. Try to keep it parallel to the floor. As your strength improves, you can place other small objects on the spoon for added weight (i.e., sugar cube). Repeat 10 times.
10. Hold a button in your mouth. For children and adults who are not at risk of swallowing a button, tie one to a piece of string at least 10 cm in length. Place the button between the teeth and lips. Purse your lips tightly and pull out on the string, not letting it slip out. Pull for 10 seconds, then relax. Repeat 10 times. For added difficulty, place the button flat between the lips.

How To Avoid Poor Oral Habits

One of the best ways to treat Orofacial Myofunctional Disorders, aside from Myofunctional Therapy, is to avoid poor oral habits in the first place. This all starts in the home with your children — even when they are newborn babies!

Some ways to avoid poor oral health include:

• Breastfeed if possible. There are many reasons an individual may not be able to breastfeed. Making sure your baby is fed and that your mental health is good are the most important things. However, when it comes to oral health, bottle feeding and pacifiers can cause issues such as drooling, nail-biting, and choking.
• Avoid thumbsucking. The habit of thumbsucking, or digit sucking, can lead to deformation of the upper and lower arches of the mouth. It can cause dental problems and lead to poor oral posture.
• Sucking on objects. Pacifiers, lollipops, and more can all cause issues to the mouth if done continually through childhood.

Ready to Get Help for Your Sleep Apnea?

According to the American Heart Association, 1 in 5 adults has sleep apnea. Sleep apnea can present many dangers, including:

• High blood pressure
• Asthma
• COPD
• Diabetes
• Stroke
• Heart attack

It can also lead to chronic daytime fatigue, difficulty concentrating, weight gain, and much more. In children, this can be misdiagnosed as ADD or ADHD. Luckily, getting help for Sleep Apnea is easy and it is a treatable condition.

At Gorman Health and Wellness, our oral healthcare specialist and licensed dental hygienist—Melina—is trained in Myofunctional Therapy, enabling her to properly diagnose poor oral habits/function and custom-tailor treatment plans to meet the unique needs and goals of each patient for optimal results. If you are interested in Myofunctional Therapy for yourself or a loved one, we encourage you to learn more by reading the detailed information provided on this page, or simply contact our practice today to schedule a consultation.

If you are ready to get help for your sleep apnea issues, we can help.