Podcast 531: Mouth Breathing Is Wrecking Your Sleep (and Focus)

(Intro)

KARESE: And before I can get to talk to her about what I knew, she immediately interrupted me and says, "Whoa, whoa, whoa. You've never told me that he had any problems with sleep." There's a direct correlation, between there's a 70% overlap between the symptoms of ADHD and sleep deprivation in children. 

MARTIN: Greetings everyone. Martin Pytela here for Life Enthusiast podcast and with me today Karese Laguerre. And Karese has a story that I have not heard before and if I haven't heard it, I don't know if you have heard it. Welcome Karese.

KARESE: Thank you. Thank you. I'm so happy to be here.

MARTIN: Yeah, it's great. I am totally curious to hear from you. What is a good client that should meet you? What are they experiencing that they don't know that there's a solution for it?

KARESE: Well, that is a great question. As a myofunctional therapist, I think there's a number of reasons why people could visit me, as with a multitude of professions. However, the most glaringly obvious will be those who are having difficulty breathing predominantly through their nose. So if you are a mouth breather, if you have any oral facial pain, like with your TM joint, specifically your TMJ, that'll be a big trigger. And a lot of swallowing dysfunction in the aspect of you know when you're swallowing, you are swallowing and your tongue is pressing against your teeth or pushing forward as you're swallowing. So those would be like the big big things.

MARTIN: Yeah, that actually is a big deal. There are so many people who don't realize that mouth breathing is actually robbing them of a lot, in fact mouth breathers tend to depress their IQ, right?

KARESE: Oh yes, absolutely. Because you're not getting good quality oxygen. We're meant to breathe through our nose, and the nose is going to filter. It's going to warm and humidify that air, and it's going to optimize it with nitric oxide so that we get better oxygenation. Whereas through the mouth, you get none of those processes. So it leads you to a lower quality of respiration, which is going to impact you overall.

MARTIN: Yeah. Lower quality of life, lower quality of everything. All right. So, that's a big deal really. And of course, does that also link back to snoring?

KARESE: It does link back to snoring. Very good association there. So, when we're sleeping, we of course need to breathe. We need to breathe all the time. But what you're really hearing when you're snoring is the sound of your breath. So it’s the air meeting resistance as it's trying to get into or through your upper airway.

MARTIN: Right on. Okay. So any one of you out there, if you're listening to a loved one or if you're watching a loved one, you need to point it out to them. Self-awareness is rare. Although many people will know it about themselves that mouth breathing is not the best policy in the world. So let's get sciency. So you call it myofacial.

KARESE: Myofunctional.

MARTIN: Myofunctional.

KARESE: Yes.

MARTIN: Okay. Myo for muscle, right?

KARESE: Yeah. Myo’s for muscle and then function for functioning.

MARTIN: Yeah. Right on. Okay. Well, please dive in. Please take it apart. Tell me, tell me what, right?

KARESE: Right. So, as a myofunctional therapist I think the easiest comparison I have is that myofunctional therapy is kind of like personal training. It's kind of like having a personal trainer for all the muscles below your eyes but above your shoulders, so what we do in that beautiful range of muscles there, we help to facilitate strengthening, coordination and just proper function of those muscles. There's so many important things below your eyes but above your shoulders. So whether it is your upper airway, whether it's your teeth, whether it's your nose, whether it's your throat, there's all these important spaces that are encompassed by soft tissue. And so how that soft tissue functions is going to be vital to the rest of your ability to,

MARTIN: I can just imagine that you would help me be a better speaker and a singer. 

KARESE: We do actually help, yes, with some speakers and singers. Singers particularly, because there's so much of the voice that is involved in breathing, and how everything will resonate through the upper airway, and so you have to have the ability to manage that.

MARTIN: Right. Okay. So do you work with grown-ups only, or how do you apply it, or do you start with the little ones?

KARESE: What's interesting is that it can be done for a variety of ages, anywhere from age five all the way through to 99 plus. When you're working with children, because they're so malleable and they still have growth potential, you see the impact that you make when you have myofunctional therapy. So, yes, they're breathing better, they're sleeping better, they may be speaking better, they're doing everything better. Where you are actually going to see it manifest is in their teeth, like how everything lines up and their skeletal growth patterns are going to be optimal.

MARTIN: Right.

KARESE: Where some people, if you intervene early enough, you might not need any sort of braces or anything for the children later on. But when it's adults, you're going to get all the functional changes, but you won't get any of the real big structural changes. So, you might not see any changes in the teeth and your skeletal formation because all of that is already rigid and set.

MARTIN: Yeah, I shouldn't gloss over it. Let's just explain what happens when you correct the problem.

KARESE: Yeah. So when you correct the problem, the problem is often improper rest posture. So what your tongue, your lips, and your cheeks do when you're in active function, chewing, eating, speaking, any of that. That has a smaller impact than all that time that you spend not doing those things. So the rest posture is actually the most important. At rest, our tongue should be lightly suctioned. So suctioned, not just touching, but lightly suctioned against our pallet, which is the roof of the mouth. And it should be completely suctioned. So from just behind the upper front teeth, you want the pallet from the front all the way to the soft pallet. So all the way in the back, like where you would feel your uvula, that tongue should be engaged. That's going to wonderfully help to connect the floor of the nose with the roof of the mouth and that's going to stimulate nasal breathing number one. Number two, you're going to be able to communicate with your vagus nerve. So, you get some autonomic nervous system regulation by being able to be in that posture. We want our lips to be sealed, and we want primary nasal breathing, and that's rest posture. The tongue, the lips, and breathing through our nose.

MARTIN: Right on. So, once you correct it, what can people expect? The first thing that popped into my mind was, “oh okay I can see that the autonomic nervous system will get calmer.” Because when you don't have it, it stays, well I should say it differently, once the tongue is up against the roof of the mouth, the parasympathetic does take over so people do relax and heal and feel calmer and all of that.

KARESE: Absolutely. So that's one of the first things that you'll start to see, you'll start to sleep better because you'll be breathing optimally. So when we think about sleep at night, we just have to remember that we all lie down to go to sleep. Ideally, everybody lies down to go to sleep. And when you're lying down, you have the pressures of gravity, and all the soft tissues start to relax and your muscles relax. But when you are strengthened in those muscles, they gain a better patency, and you get your tongue up and out of the airway when it's in proper rest posture. And so you're facilitating optimal room for breathing. which leads you to more restorative, high quality sleep. So, you're able to sleep better. You're able to eat better. Some people taste food better. They feel like there's things that they weren't able to really adequately enjoy before. And so, you're able to introduce new foods. A lot of people like it with their children because sometimes picky eating winds up getting some resolution. You're able to introduce more things there, too. You're able to get more stability. There are people who do braces multiple times over. They'll be in their adulthood, they'd be like, "Oh, I've done it twice, three times, or I've worn my retainer, and things just move all the time." You get stability because those soft tissue pressures at rest are very well-balanced. So, you'll breathe better. You'll have less dysfunction when you're eating, and you'll be able to regulate your autonomic nervous system. You'll just have better clarity of mind because you're sleeping better. There's just so much.

MARTIN: Yeah. Feeling rested upon rising in the morning is such a big difference compared to not, right?

KARESE: Oh yeah.

MARTIN: And so you'll be feeling smarter too, as a result?

KARESE: Absolutely. Absolutely. You just have more access to your mind. We lose so much gray matter when we get poor sleep. And people think, “oh, you know, I can catch up on sleep, or I'll sleep when I'm retired, or sleep whenever.” But you're really declining your cognitive capacity.

MARTIN: Isn't that something? All right. Well, that's definitely worth exploring. 

KARESE: Yeah.

MARTIN: So, how do you do it?

KARESE: So, with all sorts of muscles, I think when we as people think about muscles conceptually, everybody really understands it from shoulders down. If I wanted six-pack abs, somebody would be able to tell me, I need to be able to work out. I need to eat right. I have to make lifestyle changes. I can't be as sedentary and so forth. Well, muscles really don't change regardless of where they're located in the body. And so, muscles shoulders up in my wonderful work area require that same amount of dedication. I still need you to have a good diet and to eat well and to make sure that you're living with good lifestyle choices on top of us being able to exercise and work out, which is where the myofunctional therapy comes in. A lot of it really does start off with muscles that we exercise and we work out and we try to get a wonderful harmonious foundation and balance, but then we start building in different activities because now we have to pair and coordinate muscle patterns, and so it really is a collection of exercises and activities that help us build new patterns for function.

MARTIN: All right. So this is sounding like a much bigger picture than just from shoulders up.

KARESE: Oh yeah. Yeah. Yeah. Yeah.

MARTIN: Okay. So I mean the sort of thing that I'm thinking of is, belly hanging out or the pelvic floor not functioning, right? Or who knows what else. Do you get into that too?

KARESE: All of this stuff is so interconnected. So there is a component of weight management that goes along with sleep and breathing, but definitely that goes along with our inability to adequately use our diaphragm, which is the top of that pelvic floor. Our tongue, interestingly enough, nobody ever thinks about this, but our tongue is actually connected to our diaphragm and all the way down to our toes through a deep line fascia. And fascia is a very thin band of connective tissue that's wrapped around all of our muscles, but we have a very long connection from our tongue that goes all the way down through to the diaphragm and all the way down to the toes. Now, when we're looking at our deep line fascia, we have to remember that when things are tight or restrictive or if it pulls more on one side than another, so if you have asymmetric function, you're going to get a tilt. It'll impact your posture. It'll impact your ability to really maintain a stable core and pelvic floor. And so you do have to work on the whole body as a unit. I think we get so conditioned to medical insurance, dental insurance, vision insurance l everything is so separate, that we forget that all these things are really together. Just because you see a separate doctor for your mouth doesn't mean that everything that happens in your mouth doesn't adequately impact your health.

So yes, it's just very important that we understand that it's all connected.

MARTIN: Yeah, I love what you're saying about the integration of everything to everything else, because when we see a human holistically, we have a chance of fixing it. When we silo individual problems onto, “I want to help with this muscle over here.” That usually leads to frustration and nothing good happens.

KARESE: Absolutely. 100%.

MARTIN: Great. Huh. So you could teach me how to get my, I don't know, belly that's not firm enough, or maybe my pelvis is not tilted correctly, or who knows what else, right?

KARESE: Yeah, I could definitely work on it. So, what we do is we really work on, I try to stay in my wonderful zone of genius and I maximize what we can get out of adequately breathing and getting your belly engaged and working on the diaphragm and diaphragmatic exercises, but I like to work in tandem with other providers too who can then take that the next step level up because that's their zone of genius.

MARTIN: All right. So, can you do this remotely?

KARESE: Absolutely. Absolutely. I think that's one of the only beautiful things that kind of came out of COVID, is that we've all kind of learned how to work and see each other over the computer. And so, yes, that is equally as effective as seeing somebody in person as seeing somebody virtual. I get a lot of great success online.

MARTIN: So, I can call you from Australia and everything's going to work out.

KARESE: Absolutely. I actually know our time zones because I have a couple of clients across Australia, and so we're able to match things up very beautifully. But yes,

MARTIN: Lovely. Okay. So I guess maybe we should try and describe the how, right? How do people engage with you? Let's just say that they have discovered that they have a problem. They would like to have it fixed because after all, well, anyway, where are we going to find you? I found the website that was themyospot.com, right?

KARESE: Yes. So, themyospot.com, people can find me there all the time. It always starts off with a free consultation. So, I do the complimentary consultations. I'll talk to anybody about myofunctional therapy. But I go in with the understanding and I try to help everybody else understand too, that I might not be your first line of service, I might not be the person you need to see first. And so if that's not the case, I'm not going to take any money from you to help you determine and navigate where you do need to be. 

So we talk, we discuss, we see if Myo is the right next step for you, and then from there we can move forward and do an evaluation, and then start doing some weekly or bi-weekly sessions. And for most people with myofunctional therapy, it takes somewhere between 6 to 10 months to finish a myofunctional therapy program. So, it's a very long-term commitment, but just like I said before, it's kind of like muscles from the shoulders down. If you wanted to develop your body in the gym, you would anticipate a time frame of such. And so, same thing with the muscles above the shoulders. We're taking some time to really develop that. So, you can always find me on my website. You can schedule directly from my website a consultation. Or I'm also on social media as well. So Instagram, Facebook, Tik Tok, all of them. My handles,

MARTIN: Wow. You’re everywhere.

KARESE: Yeah, all of my handles are also The Myo Spot. So it would be that @TheMyoSpot.

MARTIN: All right. I think it would be helpful if you could share some specific examples, such as, I had such and such clients. Here's what happened. Here's how we started. Here's where we ended up. Can you think of some stories?

KARESE: I mean, I have a lot of stories. I can talk from a personal experience with my son because I always like to share that story. I think that's a really enlightening one. And then I'll talk about an adult client or a couple of adult clients that I've had in the past. But, I also write about all of these things in my book, Accomplished, which is available on Amazon.

MARTIN: Let's not forget, ‘Accomplished?’

KARESE: Yes. Accomplished. How to sleep better, eliminate burnout, and execute goals. That's available on Amazon. But I talk about my son there. And I think this is a really important story for any parents that might be listening. So my son, I remember in kindergarten, he's 5 years old and he's supposed to be paying attention and being attentive and learning new things. And every day for circle time where they would read a story, he would not be attentive. In fact, most of the time he was inattentive. And the only time he would pay attention the teacher would tell me is if she could, if he could see in the ray of sun that would come through the window. The little dusts floating, he would be watching those very intently, but other than that, nothing would be able to redirect or gain his attention. And I'm thinking to myself as she's saying this, well, he's five. He's not going to want to pay attention. What 5-year-old wants to pay attention? And then he goes into elementary school, and it's first grade, second grade, third. And each year it's the same story from just a new teacher. And I'm like “But he's six, but he's seven. But he's eight.”

MARTIN: So, you're finding excuses, but he's not focusing.

KARESE: We're playing this game. We're playing this game year after year. But it really became very very poignant to me when it was fifth grade. And in fifth grade, his teacher was like, "He's not going to make it through. You have to get this addressed." And so, we waited to see the top pediatric neurologist in our state. And we waited about six months for that appointment. When we got in, it was really just a checklist that it felt like she went through, and does he do this? Is he doing that? Yada yada yada, boom, here's a script. And he was diagnosed with ADHD, and we got a script for medication, and we were just on our way. We waited six months for that 15 minutes, and in that,

MARTIN: Was he really suffering from a chemical deficiency?

KARESE: Well, we'll get to that. In that year and a half that we worked with her, we went through three different medications because none of the medications were really working or helping. And in that time, I learned about myofunctional therapy, and it was brought to my attention that there may be something I need to look more into. How is he breathing? How is he sleeping? And we happened to coincide me learning all of that with our next appointment. And my next appointment with the pediatric neurologist, she's ready to give me a script for a fourth medication. I said, "You know what? No. What I want to do is I want to look at his sleep. And before I can get to talk to her about what I knew, she immediately interrupted me and says, "Whoa, whoa, whoa. You've never told me that he had any problems with sleep." There's a direct correlation between, there's a 70% overlap between the symptoms of ADHD and sleep deprivation in children.

MARTIN: To which I would have said, "Whoa, whoa, whoa. You never brought it up."

KARESE: Exactly. And that just absolutely blew my mind. I was never once asked about his sleep. Had I been asked in that year and a half that we've been seeing her, I would have definitely observed his sleep, noted it, informed her, and whatever. Instead, we were just given medication. And so once I learned that there was something that we needed to work on, of course, we went and we got the sleep study, and of course, he was not sleeping optimally. He had pediatric obstructive sleep apnea. And we start doing myofunctional therapy. And this young boy, who from early on was inattentive and was struggling to make it through school. He is going to be 21 next week, but he was able to graduate high school. So, we were able to address the issues. We got him to sleep better, and this young man was so sharp inside. He was able to graduate high school a year ahead of all of his peers at the age of 17. And he is just thriving. And I think for most parents, what we need is always to look for a differential diagnosis, particularly with ADHD, because that's not something that you get blood work for. It doesn't show up on an MRI. There's nothing that definitively tells you about that. It's all symptoms. And so it's important that we can look at alternative diagnosis and treatments so that we're not just medicating unnecessarily.

MARTIN: This absolutely shocks the daylights out of me. The first time I'm hearing it and I've been around it a lot, that sleep deprivation or inadequate sleep is actually correlated straight over inattentiveness or ADD behaviors.

KARESE: Yeah. Nobody would really put it together because I think we think about sleep deprivation as fatigue in adults, but in children, it just manifests differently. They're inattentive. They're hyperactive. They just, it's not what a sleepy adult looks like.

MARTIN: Right. This is really shaking me to the core because I care so much about children and I'm not in favor of pushing pills into problems. So just as you're describing the experience, it's like how dare they not lead with the question, how is he sleeping?

KARESE: Exactly. Especially when it's clearly something that was known and to not bring that to the forefront was very upsetting for me as,

MARTIN: Time wasted, right?

KARESE: Yes. Yes.

MARTIN: He could have probably graduated three years ahead.

KARESE: Who knows? Who knows? But we just,

MARTIN: Well, at least you have a smart boy. That's a good thing.

KARESE: It is. It is. I'm very proud of him. He's a wonderful young man.

MARTIN: Okay. That's really nice to hear.

KARESE: Yeah. We also have wonderful success stories with adults, too. We’ve got some great cases where we've been able to get some people to come off of their CPAP. So, a CPAP is a continuous positive airway pressure machine that essentially forces air into your upper airway. That way, it holds open all of the muscles, and you're able to breathe adequately while you're sleeping.

MARTIN: By the way, just a sidebar, if any one of you has tried to sleep in the same bed with somebody who's got a CPAP on, it's not enjoyable.

KARESE: Oh, no. It's like a twofold, right? It's not enjoyable when they're not wearing it because they're snoring or gasping, or it's scary in that way. And when they are wearing it, it's just noisy. It’s a lot.

MARTIN: It's not fun at all.

KARESE: It’s a lot. So, the CPAP when you think about what it does, I think we need to go back to physiology and then you'll kind of understand why myofunctional therapy does wonderful things for our adults in this way. If we think about a person who has six-pack abs, let's just put them on the beach. It could be male, female, whatever. We're going to put them on the beach. They're gonna lie down on their beach towel, and now we have forces of gravity that are impressed upon them. As they lie down on that beach towel, those abs don't go anywhere. Look just as good standing upright as they do laying down.

MARTIN: Just gravity holding it down.

KARESE: Yeah. Let's talk about somebody who has maybe a beer belly, and we're going to put them on that same beach. We lie them down on a beach towel, and that beer belly, it doesn't sit or look the same. Now, with these forces of gravity, everything shifts and it moves. And it's not the same as the taut and tight, strong abdominal muscles that stay put even with the gravity. So, let's just think about that in terms of our upper respiratory tract because our upper respiratory tract is predominantly soft tissue. It's all supported by soft tissue. So with that, we have to think that the first stages of sleep, first we lie down, and that's gravity that's imparting on us. But then the first stages of sleep, muscle relaxation begins, and it only becomes even more so as we go through different stages of sleep. And if those muscles are not already strong enough that they're sitting up, if you have more of a beer belly type of soft musculature, you're more prone to it closing and collapsing on itself because everything shifts, it moves. 

And then gravity, and you're more likely to get those gasping, the snoring, and the struggling to sleep. So, what the CPAP does is it holds it open. But what myofunctional therapy does is it gives you a six-pack airway where the muscles are strong and able to obtain more patency even at relaxation. And so, we've got wonderful stories where people have been able to come off of their CPAP, where their AHI’s, which is one of the diagnostic metrics for obstructive sleep apnea decreases. And so we get a lot of people who go down from moderate to mild or no sleep apnea and it's absolutely fabulous. There's also a lot of wonderful aesthetic benefits, too. I worked with a couple of patients who have done plastic surgery where they’ve had implants, cheek implants, chin implants, fillers, botox, you name it. They go through all the stuff and spend hundreds of thousands. But when you actually work on the musculature, it gives you a wonderful definition and symmetry that you can't duplicate, at least not long term.

MARTIN: The facelift from inside. Yeah.

KARESE: Exactly. Exactly.

MARTIN: Which is the correct way to do it, right? It's when you're talking about the six-pack of the abdomen again, you cannot fake it by putting some kind of, I don't know, spandex affair over your beer belly and try to push it up.

KARESE: Exactly. 

MARTIN: Would be the same thing as if you just had your firm musculature.

KARESE: Yeah. Yes.

MARTIN: Wow. That's a very good analogy. Makes me understand it. Well,

KARESE: Yeah.

MARTIN: Okay. So, you have, well, I guess people waking up tired stop waking up tired. They start waking up full of life.

KARESE: Yes. Fully refreshed, ready to be more productive, show up as their best self. I like to say they function on full. Instead of functioning, you wake up, and you're on like half a tank of energy. You're functioning on full when you get great sleep.

MARTIN: Well, worth twice the price of admission. All right. So, I think this explains it well. Do you think we covered the whole thing. Or am I missing a point?

KARESE: No, I think that was really good. I think we went over a lot of great points.

MARTIN: Yeah. All right. So, let's look it up one more time. It's called TheMyoSpot.com 

KARESE: Yes.

MARTIN: And you can find it on multiple social media or the website itself. And let's not forget the book. What did you call it again? Awareness?

KARESE: Accomplished. So, it's accomplished. How to sleep better, eliminate burnout, and execute goals. It's available on Amazon.

MARTIN: All right. Well, Karese Laguerre, this was a really, really mind-opening session for me. I really appreciate having met you here and introducing you to the Life Enthusiast test audience, and let's just see how many will need your help. I would not be surprised if it's a sizable percentage.

KARESE: Oh yeah, me either.

MARTIN: Yeah.

KARESE: Thank you so much for allowing me to share on your platform.

MARTIN: That's awesome. Very happy to have met you. Okay. Thank you, Karese. This is Martin Pytela, life-enthusiast.com. Come and see us at the website. Thank you.