Tongue & Lip Ties |3 min read

Tongue Ties and Sleep: Understanding the Hidden Connection

Here at Wisconsin Tongue Tie Institute, I am privileged to educate parents of infants and young children on how a small strand of tissue that connects our tongue to the floor of the mouth (lingual frenulum) can significantly impact various aspects of our lives if it restricts ideal tongue movement. This condition is referred to as a ‘tongue-tie’. Parents usually grasp the negative effects of a tongue-tie on feeding and speech quite easily—these are the most common issues our patients face. However, at every appointment, we emphasize the broader implications. We explain that an untreated tongue-tie can also lead to problems with dental, orthodontic, and airway development, mouth breathing, and difficulties achieving restful sleep.

You might wonder, “Can this tiny strand under our tongues really cause so many issues?” Unfortunately, in my practice at De Pere Smiles, I witness the adverse effects of untreated tongue ties firsthand with numerous adult dental patients. Often, I meet a new patient with a restrictive tongue tie, and our conversation starts with, “Has anyone ever told you that you are tongue-tied?” and ends with, “Wow! I never knew a tongue-tie could cause so many issues!”

Here’s a straightforward explanation of how tongue-ties relate to sleep issues: The ideal growth and development of our upper jaw (palate) begin in the early weeks of gestation. Our tongue acts as a scaffold for our palate, resting and suctioning on the roof of our mouth. This upward and lateral pressure from our tongue widens our palate, thus stimulating ideal nasal passage development and facilitating easy nasal breathing. However, a tongue-tie typically restricts the tongue’s upward movement. Without this natural scaffolding, the palate develops narrowly (refer to the attached diagram). Since the nasal cavity’s floor is the same bony structure as the palate, a narrow palate results in a narrow nasal passage, making nasal breathing much more challenging than breathing through a wide passage. Essentially, when a tongue is limited in its ideal upward movement, it predisposes us to mouth breathing.

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So, what’s the big deal if I breathe through my mouth when I sleep?

Why is nasal breathing so important, anyway? Breathing through the nose allows our parasympathetic nervous system (rest and digest) to dominate, while mouth breathing triggers our sympathetic nervous system (fight or flight). If we breathe through our mouths during sleep, being in this fight or flight state can significantly affect our ability to reach deep sleep levels, which are crucial for recharging our batteries and feeling well-rested. Additionally, mouth breathing dries out our oral cavity, leading to a host of problems such as tonsil enlargement (which can obstruct our airway and cause snoring or sleep apnea) and altering the composition of bacteria in our mouth (leading to gum disease and tooth decay).

Ok, I breathe through my mouth when sleeping. Is there anything I can do to change that?

To assist as many people as possible, we have recently introduced myofunctional therapy as a new offering for our patients. This therapy’s goals include promoting nasal breathing (both awake and during sleep), ensuring the upper and lower lips are sealed, establishing the ideal resting posture of our tongue, and correcting swallowing patterns. Essentially, this therapy serves as a specific workout for the muscles of our mouth and airway, enabling us to achieve optimal sleep. More information about myofunctional therapy will soon be available on our website, TongueTieWI.com.

Our primary goal at WTTI is to educate our patients, their parents, referring providers, and the broader community about the severe problems that tongue-ties can cause. By effectively screening for, diagnosing, and treating tongue ties in infancy, we can set the stage for a lifetime of healthy breathing and sleeping. As Dr. Saroush Zaghi at The Breathe Institute aptly puts it, “Tongue up, lips closed, healthy breathing through the nose!”

Breathe well 🙂

-Dr. Chris

tongue tie

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