Are you suffering from a restless sleep? Have you had a disturbed sleep for years? Well, recent research has highlighted that this restlessness may be because of sleep apnea, which is a result of an unusual condition called tongue-tie (ankyloglossia).
What is Sleep Apnea?
Sleep apnea is a serious sleep disorder that occurs when a person’s breathing is interrupted repeatedly during sleep. There are two types of sleep apnea:
- Central Sleep apnea—this has nothing to do with the airway being blocked. This occurs when the brain fails to send a signal to breathe to the muscles. Because the respiratory control center is unstable, breathing becomes a problem.
- Obstructive sleep apnea— this occurs when the upper airway becomes blocked during sleep. The soft tissue in the back of the throat collapses as the person sleeps, reducing or completely stopping his/her airflow. Myofunctional therapy is recommended for this kind of sleep apnea.
What is Ankyloglossia?
Ankyloglossia, also known as tongue-tie or a short frenum, is an abnormal condition, which restricts the mobility of the tongue. Tongue-tie occurs when the lingual frenum is short.
Everyone has a frenum—a piece of tissue under the tongue that tethers it to the floor of the mouth. When it is of the right length, it has elastic properties and does not interrupt with the movement of the tongue when sucking, eating, talking, and clearing of the teeth to prepare for swallowing.
However, when a person has a short lingual frenum, it has a negative effect on the person’s oral development. The person with a tongue-tie will have difficulty lifting the tongue to the upper teeth and shifting it from side to side. They will not be able to stick out their tongue past their lower teeth and will have trouble while eating, speaking, licking, and swallowing. A person with a short lingual frenum has a tongue that is heart-shaped or that appears notched. You can read more about tongue tie here
Why does the position of the tongue matter?
The position of the tongue is very important. The tongue is a powerful muscle that can change the shape of your face and teeth, and the way you talk and breathe.
To have the correct facial feature, the tongue needs to be in the right position. The correct posture for the tongue is when your lips are touching each other (without straining); your tongue is relaxed along the palate, with the rear end of the tongue pulled back and the tip of the tongue resting behind the top front teeth (not pushing it).
If the tongue is not placed like this and is putting pressure on the bottom part of the mouth, the maxilla— upper jaw bone— changes structure, resulting in a long and narrow shaped face. The lack of pressure from the tongue pushes the cheeks inside and cause the teeth to crowd.
Other than this, the position of the tongue matters because it can cause breathing problems, including sleep apnea.
The short lingual frenum leads to a restricted use of the tongue and a lower placement of it in the mouth. Both these conditions are linked to an altered palate development, disproportionate growth of the lower jaw and lack of mid face development. Together, all of these results in the development of a smaller airway, which is more prone to collapse during sleep, causing obstructive sleep apnea.
What does research say about sleep apnea and tongue-tie?
As an online myofunctional therapist, I have experienced many patients who suffer from both sleep apnea and ankyloglossia. Recently, research has started showing a link between the two problems, which has given my therapy scientific evidence.
In 2015, a study, published in the International Journal of Pediatric Research, highlighted that children aged 2-17 with a tongue-tie condition had orofacial features, which put them at risk of a collapsed upper airway. Children with a short lingual frenum were more likely to engage in mouth breathing that increases upper airway resistance and inflamed tonsils, both of which can cause sleep apnea. The mouth breathing further worsens orofacial features, which is why it is essential to seek treatment as soon as possible.
You can read full study here
What can be done if you have tongue-tie and sleep apnea ?
Tongue-tie is a condition that exists since birth. If untreated, it can cause many problems, which worsen as the person grows older. The most common treatment for Ankyloglossia is lingual frenectomy—a surgical procedure in which the frenum is removed.
However, many researches, including the one mentioned above, indicate that surgery alone is not a good option. As the child from birth holds the tongue in one position, he develops a habit of mouth breathing and lowered tongue position, which cannot be solved just by surgery. This is where my service as a practicing myofunctional therapist comes in.
As an online myofunctonal therapist, I engage my clients in exercises that help in the correct placement of tongue and that allow for proper breathing.
However, I am a strong believer of individualized treatment plans and, therefore, I work with my client’s doctor every step of the way to come up with the right treatment program, exercises, and correct diagnosis.
My therapy caters to both adults and children from all over the world.