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An SLP can help sleep apnea? Whaaaaaaat??!!

Ah, a wonderful suggestion for some information regarding sinus issues sparked my latest topic.  Although this is linked to sinus issues, the topic of sleep apnea doesn’t directly relate to sinus congestion, yet sleep apnea affects our breathing, our sleep patterns, our brain cells, and our overall health and wellness.  

I spent the better part of a rainy week last week diving into a research rabbit hole on all things related to speech language pathology and sleep apnea.  I have called sleep disorder clinics before, trying to talk about how my services might be able to help patients.  However, at the time, I only had surface knowledge to talk about my services and how they can assist with sleep disorders.  Now I come to the conversation, fully armed with informative ammunition, to explain why people with sleep apnea NEED ME! 

First, let’s talk about what sleep apnea really is!  It is a collapse of your pharynx when you sleep.  It typically happens at the end of your exhale, as you begin to inhale.  The intensity of the collapse varies on the stage of sleep you are in.  Just having sleep apnea increases your risk for hypertension, cardiovascular disease, excessive daytime sleepiness, cognitive function disorders, and chronic inflammation.

Can we go back to the word pharynx?  It’s a medical term, you don’t hear that often.  It refers to the “tubing” from your nose down to your vocal folds, where air *should* be flowing freely. As you breathe in through your nose; the air goes through your nostrils, past your sinus passages, down to your throat, through your vocal cords (all your pharynx) and then down into your lungs – and back out and in and out and in and out again.

Follow the link here:  https://www.google.com/url?sa=i&url=https%3A%2F%2Fwww.mayoclinic.org%2Fparts-of-the-throat-pharynx%2Fimg-20005644&psig=AOvVaw1beSp4Uih2pVGrxUQpDuk6&ust=1614092277696000&source=images&cd=vfe&ved=0CAIQjRxqFwoTCIiC-7ng_e4CFQAAAAAdAAAAABAe for an excellent image of the pharyx from the Mayoclinic.com.

The reasons for the collapse are still being researched.  9% of middle aged men and 4% of middle aged women have been diagnosed with OSA.  Researchers have found a connection between obesity, hormones, and size of the upper airway.  According to articles, Obstructive Sleep Apnea (OSA) is 2-3x more likely to be in men.  

Use of a Continuous Positive Airway Pressure (CPAP) machine is the most effective treatment for the cessation of the airways collapsing, at this time.  Sometimes the machines can be cumbersome, especially if they don’t fit correctly.  If you have a CPAP and you don’t use it because it doesn’t fit right, you need to call someone and have it refitted!  Your brain cells are worth it.    

Now, why speech therapy for snoring?

As I’m sure you already know, OSA is more than just snoring.  OSA has periods where a person actually stops breathing!  In fact, you get diagnosed with OSA if you have more than 15 episodes of apnea, no breathing, an hour.  

What happens when you don’t breathe? 

Your blood is unable to take oxygen to the other parts of your body, including your brain.  This leads to confusion, difficulty with attention, excessive daytime sleepiness, and brain fog.  Also, your body is unable to get rid of the waste carbon dioxide (CO2) to make room for more oxygen, therefore carbon dioxide builds up into your system, called hypercapnia.  Hypercapnia results in damage to organs and respiratory failure.  EEK!!

An SLP can address a few issues.  The first being pharyngeal strengthening!  There is a wide body of research that indicates strengthening the pharyngeal muscles can decrease the risk of collapse.  

And, it just so happens, that a licensed speech language pathologist, with a specialty in swallowing, knows alllllllllll the pharyngeal exercises because we use them to help people decrease their risk of aspiration all the time!  Less collapsing of the airway will improve your sleep and to maintain adequate amounts of oxygen in your blood.  Thus decreasing your risk of respiratory failure.  Also, more oxygen leads to less cognitive difficulties because your body is finally getting enough oxygen.  

In the study by Guimaraes et al, found that specific oropharyngeal exercises (similar to ones used for dysphagia) “improved objective measurements of OSAS severity and subjective measurements of snoring, daytime sleepiness, and sleep quality.” Which suggests that a skilled speech language pathologist, using oropharyngeal exercises, may be able to provide alternative (from CPAP) therapy for the treatment of OSA!

Secondly, we can assist with cognitive therapy to reduce that “brain fog.”  We have all had “those days” where we didn’t get enough sleep the night before, and we can’t think straight.  We can’t concentrate on what other people are telling us.  We can’t make sense out of simple logic.  Operating on continuously disrupted sleep is no joke.  When this “fog” happens over and over, the feeling becomes “normal” and therefore we stop trying to pay attention to what people are saying, we stop trying to make sense out of information.  It’s too hard for our brain and so we don’t. Our brain stops trying.  

BUT

Just that simple act of not trying, creates a pathway in our brain, so that it will quit even recognizing that it SHOULD try to figure it out, and it creates larger problems down the road, like dementia.  YOUR BRAIN IS A USE IT OR LOSE IT type deal.  “Neural circuits not actively engaged in task performance for an extended period of time begin to degrade.” (Kleim & Jones, 2008)

You read it:  If you do not use your brain for a specific task for a long period of time, the ability to use your brain for that task will go away!   If you think about it, you know it happens.  My Aunt Anne taught me how to play euchre, but I haven’t played it in so long, I don’t remember how.  I didn’t use my brain for it, now the information is gone.  I have to re-learn it. 

That’s the super cool thing about the brain… YOU CAN RELEARN.  (Ah, but I digress.  I love talking about neuroplasticity!  That’s a whole different BLOG topic.)

Back to this topic, sleep apnea and speech therapy:  An adult-focused speech language pathologist can be well versed in creating a therapy plan to increase your attention, memory, processing, thinking, and overall day-to-day functioning.  GOODBYE “brain fog”! 

So, to summarize:

  1.  An SLP can address sleep apnea with pharyngeal strengthening to minimize risk of airway collapse during sleep.
  2. An SLP can address cognitive dysfunction that has resulted from the loss of oxygen during the airway collapse.

Well, there you have it; just one more reason to seek out a licensed speech pathologist!

As always, if you have burning questions, please comment below or email me.  Until next time!

Cheers!

References:  

Fonseca, Maria Ines Pires.  Pereira, Tlemo.  Caseiro, Paulo.  “Death and Disability in Patients with Sleep Apnea – A Meta-analysis”.  Arq Bras Cardiol.  2015.

Guimaraes, Katia., Drager, Luciano., Genta, Padro., Marcondes, Bianca., and Lorenzi-Filho, Geraldo.  “Effects of Oropharyngeal Exercises on Patients with Moderate Obstructive Sleep Apnea Syndome.”  American Crit Care Med.  Vol 179 pp962-966.  2009.

Klein, Jeffery A., Jones, Theresa A., “Principles of Experience-Dependent Neural Plasticity:   Implications for Rehabilitation After Brain Damage.”  Journal of Speech and Hearing Research.  Vol 51.  February 2008.  

Ryan, Clodagh & Bradley, Douglas.  “Pathogenesis of Sleep Apnea.”  American Physiological Society.  2005.  journals.physiology.org/journal/jappl.