Treating Airway Difficulties – CPAP or Myofunctional Therapy?

Image via S. Bea, licensed CC BY-SA 2.0

One of the most common treatments for severe airway constriction and obstructive sleep apnea (OSA) are continuous positive airway pressure ventilators, or CPAPs. These devices are worn to help sufferers breathe more easily at night.

While it may provide temporary relief, a CPAP is not a cure. Orofacial Myofunctional Therapy may offer another path back to wellness–one that’s safer, more comfortable, and that offers a greater sense of control over recovery. Rather than alleviating the symptoms, myofunctional therapy seeks to improve the structure of the oral cavity, enabling the airway to permit easier, healthier breathing.

Abnormal Breathing

Respiration is not as simplistic as dragging air in and out of our lungs. The physical process involves dozens of muscles throughout our face and neck which determine the diameter of the esophagus, including indirect affectors like the tongue, tonsils, adenoids, and other soft tissue in the oral cavity. Collectively, these systems form the airway, and imbalances in any of them can constrict airflow.

Abnormal breathing is any habitual pattern that alters the way we move or utilize air. Depth, timing, rate, and breathing consistency are all important factors in maintaining proper respiration, and all of them can be affected in different ways by abnormal breathing.

Normal nasal breathing provides an appropriate volume of clean, warm, moist air to the lungs. Normal breathing supplies nitric oxide, a vasodilator that assists in proper oxygen exchange. A collapsed or restricted airway encourages mouth breathing and is especially common at night when patients cannot consciously avoid the habit.

During the daytime, on the other hand, mouth breathers will adopt a forward head posture in order to open up their airways. This is subconscious reaction to a negative stimulus, and these individuals are usually not aware of the habit having formed. The takeaway is that the airway shapes our behavior in whatever way allows us to breathe, whether we want it to or not.

Symptoms and Signs May Include:

Loud snoring disturbing others, breathing cessation during sleep, abrupt awakenings with shortness of breath, dry mouth in the morning or sore throat, morning headaches, insomnia, sleepiness during the day, lack of attention, irritable, sleepy and gasping for air.

Causes of Abnormal Breathing

Causes of abnormal breathing include everything from tongue-tie (aka tethered oral tissues or ‘TOTs’) to sinus infections, allergies, swollen or lax oral tissues, and excess throat thickness due to obesity[1]. It is also closely associated with age, as the older we get the more likely small imbalances can manifest as larger problems. Left untreated, tissue abnormalities promote structural weaknesses around the airway, which eventually constrains normal breathing to a significant degree.

A close up of the teeth with a spoon in it

Risks of Delaying Treatment

Abnormal breathing usually does not present immediate changes in our health. Over time, however, it can lead to debilitating conditions like chronic snoring as a result of obstructive sleep apnea. This directly affects the quality of our sleep, which goes on to degrade every aspect of our lives. What’s worse is the problem is self-sustaining, since abnormal usage of muscles and tissues can reshape the maxilla, palatine and mandible bones as well as the craniofacial complex as a whole. This in turn makes it even harder to reform breathing patterns.

Sleep Apnea

Obstructive sleep apnea is a condition most people associate with heavy snoring during sleep. It presents in both adults and children and is directly caused by enlarged adenoids or tonsils, or a generally narrow airway[2].

Over time it can produce mood disorders due to lack of sleep, as well as constant fatigue and cognitive decline. Interrupted breathing patterns lead to a decline of oxygen to the brain (hypoxia), which can cause memory loss, seizure, or even coma[3].

There is a pervasive misconception that beyond chronic daytime sleepiness, OSA is a fairly benign affliction. Nothing could be further from the truth, especially if it is left untreated. Severe long-term cases of obstructive sleep apnea have even been linked to massive heart attacks and death[4].

Other serious conditions linked to untreated OSA include:

  • Fatty liver disease
  • Type 2 diabetes
  • Hypertension
  • Arrhythmia
  • Obesity
  • Metabolic syndrome
  • Erectile dysfunction
  • Stroke

OSA should not be confused with Central Sleep Apnea, which manifests similar symptoms but stems from a different cause altogether. CSA occurs when the muscles which control breathing experience a neurological dysfunction when communicating with the brain.

How OSA Is Treated

Due to the potential seriousness of OSA, many patients are treated with extreme measures. Surgery may be necessary to physically repair the airway obstruction. Other cases are treated by monitoring respiration in a sleep study.

Depending on the result of the sleep study, doctors may fast-track a continuous positive airway pressure ventilator for the patient to wear. CPAPs work throughout the night to apply gentle pressure to the airways to ensure they remain unobstructed.

How Effective Are CPAPs?

While CPAP ventilators may provide relief, they should not be thought of as a cure. Symptoms of OSA and obstructed airways will diminish while the device is being worn, but as soon as the patient stops using it, symptoms return in full force. CPAP does not cure obstructive sleep apnea; it only provides a temporary stopgap.

Risks of Long-term Usage

A sunset over the ocean with an orange sky.

Long-term use of CPAP can even be dangerous. Common side effects include dry throat, dry nose, and sore eyes[5], and it can lead to an increase in respiratory infections or even pneumonia[6]. Patients must be diligent in cleaning the device, not to mention contend with the constant discomfort of sleeping with a mask and ventilator nearby.

While great technological strides have been made to improve the size and noise of CPAP, many patients find wearing it every night cumbersome, if not downright disruptive to their sleeping patterns. Even if CPAP is effective at treating patients’ OSA, it is worth very little if the experience of wearing CPAP prevents a peaceful, comfortable night’s sleep.

Orofacial Myology provides an alternative treatment which is non-invasive and comfortable for all.

A Better Path with Myofunctional Therapy

To assist in restoring proper airway functioning, patients must attend to the source of the issue instead of relying solely on a CPAP. As we have seen with OSA, the disorder is often caused by physical imbalances. Myofunctional therapy can help tone and tighten the structures and tissues of the face and neck to restore unobstructed breathing.

Eliminating airway difficulties and sleep apnea may not always require surgery or uncomfortable machines. By working with a certified orofacial myologist (COMâ„¢), patients can enjoy improved health over time, all without invasive methods or painful temporary solutions.

Can Myofunctional Therapy Replace CPAP or Surgery?

Myofunctional therapy does not seek to replace traditional methods of treatment, but rather to augment their effectiveness or prevent patients from needing them in the first place. By reforming how patients make use of the various systems that form the airway, better breathing comes from the bottom up. Orofacial myology is not prescriptive, but therapeutic. Patients with CPAP who work regularly with a COMâ„¢ report experiencing far more efficient recovery following surgery or diagnosis of OSA.

It’s important to realize that CPAP is an option, rather than an inevitability. Before resorting to drastic and expensive measures, try improving the tone of the lining of the mouth, muscles of the throat and the other internal systems that together form a healthy airway. Orofacial Myology provides an alternative treatment which is non-invasive and eschews the need for uncomfortable equipment.

Who Performs Myofunctional Therapy?

A COM™ is certified by the International Association of Orofacial Myology (IAOM) and receives extensive training with in-depth investigation into the etiologies, symptoms, and treatment variances of orofacial myofunctional disorders. Their focus goes deeper than simply treating symptoms with therapeutic exercises; a COMTMstrives to uncover the “why†underlying the breathing issue in order to develop a comprehensive and fully informed wellness.

Smart Recovery

A certified orofacial myologist can help patients of all ages manage and recover from a wide variety of airway difficulties. COMâ„¢s also work closely with ENTs (as well as other case-appropriate medical professionals) to properly diagnose sleep apnea and suggest the safest and most effective treatments possible. With a COMâ„¢ on your side, you know you won’t be fast tracked to a temporary measure like a CPAP machine. Multi-disciplinary professionals must work together for the best interest of the patients.

In some cases, COMs can provide therapy to sleep apnea sufferers to help them. For post-surgery clients, orofacial myology therapy can also assist with rehabilitation, greatly improving the odds of a full recovery.

Another benefit of consulting with a certified orofacial myologist is the ability to analyze your particular situation and search for the best path to complete health. COMâ„¢s are deeply invested in airway health, and will provide everything from educational resources to alternative treatment plans and referrals depending on your needs.

Rather than simply treating the symptoms of your sleep apnea, Orofacial Myologists search for the root causes. Often times, there are hidden issues that have gone unidentified, or else are treated under an umbrella diagnosis. From there, your COMTM will help you discern the best course of action for your treatment.

Your OSA Consultation

If you or someone you know is suffering from obstructive airway difficulties related to sleep apnea or may require a CPAP, know that there may be a better, more effective solution.

As a certified orofacial myofunctional therapist, I can help. Call me today to set up an appointment and we’ll discuss your situation. I’m happy to offer teletherapy sessions so you may receive treatment in the convenience and comfort of your own home.

Do you suffer from obstructive sleep apnea or other airway difficulties? Before getting a CPAP, book your consultation with Patricia Pine RDH, COM at 480-442-1590/847-207-7463or by visiting







Want to learn more about the tongue and soft tissues that affect the airway? Pick up a copy of our book, Please Release Me – The Tethered Oral Tissue Puzzle!

Muscles In Harmony