Breathing Easier: Noninvasive Therapy Helps Treat Sleep Apnea

Most of us are familiar with a condition known as obstructive sleep apnea, when soft tissue near the throat obstructs air flow during sleep. But there are two things you may not know – that obstructive sleep apnea or sleep-disordered breathing can occur in children, and there’s a noninvasive option that offers hope to treat the condition in both children and adults.

The treatment is orofacial myofunctional therapy (OMT), an individualized regimen of exercises designed to re-pattern oral and facial muscles. Conditions treated involve a variety of disorders including muscle dysfunction of the tongue, lips, jaw and face. A common disorder is “tongue thrust,” where the tongue is incorrectly placed during swallowing and resting, leading to the improper growth and shaping of the palate. Orthodontists have referred patients to this therapy for decades as additional treatment for muscle issues that orthodontic appliances can’t fix.

Recent research has elevated the role of OMT as an effective treatment to help correct sleep-disordered breathing in children. Mouth breathing during sleep, whether caused by tonsils, allergies or other problems, directly affects tongue position and strength of the oral muscles, leading to abnormal airway development in a growing child. OMT can eliminate mouth breathing during sleep, which can stop a child’s progression to obstructive sleep apnea.

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Christian Guilleminault, MD, and Roberta Kelley

“There’s always been a focus on the importance of nasal breathing in kids, but now there’s increased focus with studies showing OMT plays a critical role in clearing and maintaining the airway,” says Roberta Kelley, a speech-language pathologist and certified orofacial myofunctional therapist at Virginia Mason.

The impact of OMT in the prevention and treatment of sleep-disordered breathing was identified by renowned expert Christian Guilleminault, MD, professor of psychiatry and behavioral science, Stanford Center of Sleep Sciences and Medicine. Virginia Mason sleep medicine physicians Matthias Lee, MD, and Oneil Bains, MD, both completed sleep medicine fellowships at Stanford University under the directorship of Dr. Guilleminault.

As evidence accumulated showing OMT’s positive effects on pediatric sleep-disordered breathing, Drs. Lee and Bains began referring select sleep study patients to Roberta. “I’ve gone from treating one myofunctional patient a week to sometimes treating five patients a day,” says Roberta, one of only three providers certified in OMT in the Seattle area. “This is a noninvasive treatment. The patient commits to daily exercises to correct the tongue position, tongue-resting posture and nasal breathing.”

Currently Roberta sees more adults than children, benefiting from OMT when other sleep apnea treatments, such as CPAP, aren’t tolerated by the patient. A 2015 analysis of multiple study results showed OMT reduced the severity of obstructive sleep apnea by 50 percent in adults and 62 percent in children.

While OMT has yet to be recognized as a mainstream therapy for sleep-disordered breathing and obstructive sleep apnea, Virginia Mason’s Sleep Medicine team, with Roberta’s support, offers patients access to a leading-edge treatment.

“There are multiple benefits of OMT, including the improvement of symptoms related to sleep-disordered breathing, snoring and obstructive sleep apnea,” says Roberta. “It is truly a quality-of-life enhancing therapy.”

Do you live with someone who snores?

Do you live with someone who snores? If so, you might suspect sleep apnea, a condition caused by repeated closures of the upper airway during sleep. While not everyone who snores has sleep apnea, the disorder affects up to 17 percent of the population and over time can lead to other serious health problems, including high blood pressure, heart disease and stroke.

Until recently, confirming a diagnosis of sleep apnea required a monitored overnight stay in a sleep center, such as the one at Virginia Mason. Now thanks to better technology and improved criteria for patient selection, the overnight sleep test can be completed at home. The best candidates for at-home testing include overweight patients with loud snoring who may also suffer from high blood pressure or diabetes, and whose partners have observed apnea episodes in the past.

If a Virginia Mason  Sleep Disorders Center physician determines a home test is appropriate, the patient receives instructions on how to use a sleep apnea testing device. The simple device records data while the patient sleeps, which can then be returned to the sleep center or any Virginia Mason regional clinic for analysis.

“Since we started in September, we have seen a lot of patients who would never have come for a test if they couldn’t do it at home,” says William DePaso, MD, medical director, VM Sleep Disorders Center. “This is a big advantage for patients because it breaks down a huge barrier for getting care for a disease that is linked to weight gain, diabetes, fibromyalgia and worse, to say nothing of being tired every day.”

Sleep medicine consultative services are provided at Virginia Mason’s Seattle Main Campus, as well as clinics in Bellevue, Issaquah, Federal Way, Kirkland, Winslow and Lynnwood. Sleep testing is performed in Seattle. For more information or to schedule an appointment, call (206) 625-7180.