Sleep Apnea – Your Sinus and Your Airway (Podcast)

John Maher: Hi, I am John Maher and I’m here today with Dr. Nammy Patel, founder of Green Dentistry in San Francisco, California, helping patients recognize the vital connection between dental health and whole body health. And author of the bestselling books, Age with Style: Guide to a Youthful Smile and Healthy Living, and Total Wellness: Understanding the Link Between Your Teeth and Your Health. Today, our topic is your sinus and your airway. Welcome Dr. Nammy.

Dr. Nammy Patel: Thanks for having me John, I’m so excited to talk about this. This is my favorite topic. Airway, airway, airway.

How Can Sinus Issues Contribute to Sleep Apnea?

Maher: So how can sinus issues contribute to sleep apnea?

Dr. Nammy: So, sinuses are really important in developmental format and also, it’s part of your functional airway. There are several parts. It’s going to be the nose, the mouth and the back of the throat. Those are the three parts of a functional airway. And you can have a problem here, you can have a problem here or you can have a problem here. In all three spots, it’s going to yield the same response or the result, which is obstructive sleep apnea.

So, the number one thing, let’s start with the nose. We want the air to go through the nose, to the back of a throat and down. Now, if something is obstructed in the sinuses, we’re not going to be able to breathe through our nose. If that’s the case, we’re going to have to open our mouth to be able to breathe because we need air, right? So we’ve got to either find it here or we’ve got to find it there. Those are the only two ways we can get oxygen into our bodies.

Now, if somebody has a sinus obstruction, and it can be for many reasons, one, somebody could just be born like that. Sometimes people are, if they’re not breastfed for a long time, that will cause a problem. If people have had braces and teeth extraction, it’ll cause this kind of problem. Thumb sucking habits will cause this kind of a problem. Even using a pacifier is going to cause sometimes this kind of problem.

The reason why it develops is because when we’re in our childhood, what actually occurs is as a baby is suckling on the breast, the sinus cavity is being built, and as a baby suckles on the breast, certain cells send a signal saying expand the palate, open up the functional airway, that entire airway is made. And that’s usually when we’re babies and happens from zero to about two or so. If somebody is not being breastfed, the sign is not going to get the signal to grow and be a great open airway. The same thing happens if somebody has a thumb sucking habit. What they’re going to do is make the palate like this and make their sinuses small, because they’re signaling the sinus to become smaller. Also, a pacifier does the same kind of thing. The pacifier, again, it doesn’t signal the sinus to grow as it should, and so the sinus will be a lot smaller and sometimes it’s just genetics and evolution, right?

I’m sure everyone’s read Homosapiens and really looking at evolutionarily how we’re changing. When we were… 100 years ago, 200 years ago, our sinus cavities were really big and our heads were smaller, but now we’re all so smart, so our heads are super big and our sinus cavities are becoming smaller as we age and as we go through this evolutionarily. And this is really great because there’s a great book called Breath, and it actually goes through the evolutionary science and looking at different skulls from 2000 years ago to skulls now and skulls a couple hundred years ago, and looking at the trend and seeing how we’re evolving to have smaller sinus cavities and bigger brains.

What is Chronic Sinusitis?

Maher: What is chronic sinusitis and how can that worsen your sleep apnea symptoms?

Dr. Nammy: So chronic sinusitis is, for any of those reasons I talked about, whether it’s even simple evolution or simple genetics or not being breastfed or thumb sucking or anything, or history of braces and teeth extracted, that sinus it becomes smaller, so chronic sinusitis means it’s an inflammation of, so the sinus is really inflamed and irritated, and these sinuses have actually cavities. So they’re actually big old holes. They’re designed to be there for our bodies to be able to filter out any toxins, filter out any junk. That’s what it’s designed for.

So, when somebody has sinusitis, that means that that area is inflamed because their bodies are not able to take away allergens, take away mold or what have you. So that sinus has been irritated for more than six months. Anytime we say something is chronic, it’s been over six months that somebody’s had this condition.

Treatments to Improve Sinus Health and Reduce Sleep Apnea

Maher: And then are there any treatments or therapies that can improve your sinus health and help to reduce sleep apnea symptoms?

Dr. Nammy: Absolutely. There is one of my favorite, favorite, favorite, favorite techniques, and it’s called the nasal cranial release, which is really awesome because you can feel the effects immediately. You have three sinus cavities, so there’s the upper, the middle and then the lower on each side, so we can actually take a small balloon and be able to inflate that into your sinus cavity. So what that does, if there’s any junk or anything in there, it helps drain it out and it helps start opening the sinus cavity so you can get good fresh air in there. I really love doing that because you can feel the results instantaneously. That’s number one.

It’ll also pop any bones that may not be in the right place. What it’ll do is, we have a lot of different bones, especially bones that connect the front of the face to the back of the face. Sometimes they’re not in the right position. Maybe somebody had a concussion when they were younger and were playing volleyball or they were playing football, whatever it is. So we can pop all these bones into place, which is really great, and it really allows that sinus to open up right away.

There’s also things over the counter. My favorite is XClear, which is a chemical and it’s xylitol based and hydrates the sinus and helps open it up chemically, so that’s really great as well. Then the biggest way and the most fun way I like to open up sinuses is really through activating through our bone making cells at the base of the sinus and at the roof of the mouth, through a dental device. As we expand the upper arch, we are able to expand the sinus cavity and get it to drain in the proper place, and that is always a lot of fun. So yeah, there’s several ways we can open up the sinuses non-surgically.

Can Sinus Infections Cause Sleep Apnea?

Maher: Okay. A lot of people get sinus infections. Can that contribute to sleep apnea as well? And then are there ways to prevent that?

Dr. Nammy: Yeah, absolutely. Majority of the time, people who have sinus issues do develop sleep apnea over a period of time, and that’s because their sinuses are congested. They’re not able to breathe really well, they’re breathing through the mouth. For example, if they gain weight, women go through it during pregnancy, hormonal changes, things like that. We talked about not having enough acetylcholine earlier, not enough vitamin Bs that’ll cause our muscles not to be as strong. So a lot of different things will cause chronic sinusitis to be present.

The key is that we want to get rid of it because all it’s going to do, anything with sleep apnea is going to actually obstruct a functional airway. And so like I said, you can either have obstruction here, you can have obstruction here, and a lot of people with chronic sinusitis actually also have a post-nasal drip, and that post-nasal drip makes it almost impossible. It makes it so hard to not have things fall back in the back of the throat, which causes a lot of irritation and more swelling of the tongue, more swelling of the oropharynx, and it causes a lot of issues as well.

Can An Ear, Nose, and Throat Doctor Help with Sleep Apnea?

Maher: Should I consider maybe seeing an ear, nose and throat doctor, in addition to my dentist when talking about sleep apnea and sinus issues?

Dr. Nammy: Absolutely. I highly encourage working with an ENT physician because they’re able to actually treat polyps. Sometimes patients have polyps. Polyps are basically, it’s a benign, it’s not a tumor, it’s tumor-like substance that actually grows in the sinus cavities, especially if somebody has had mold exposure, chronic sinusitis as we’re talking about and now that body has had it so much that it’s now creating extra tissue, and so an ENT would be able to surgically remove that extra polyp or that extra tissue in order for the patients to be able to breathe better through the nose. So there’s always a reason to see an ENT.

I think honestly, the best way to work with an ENT is actually working with someone like me who focuses on the functional airway and with an ENT, because both of our tools combined can make you feel better for a lifetime, because right, we don’t want you to go through a polyp surgery and then you keep needing it. I mean, they can help you with the polyp surgery, they can clean that out. Now I can expand your sinuses non-surgically and get you breathing really well through the nose, maybe use some ozone therapy and things like that to induce healing, and then we’ve both worked together and now you’re happy for a lifetime.

Appliances to Help Reshape Sinuses

Maher: Tell me a little bit more finally, about these appliances that you can add to your mouth to reshape your mouth and then in turn reshape your sinuses as well.

Dr. Nammy: Absolutely. We actually have appliances that go on the upper and the lower, and depending on… We actually first take a CT scan to really figure out where the problem is, and we customize all of the appliances for you specifically. The beauty of teeth, and the reason why we can work with this is because teeth actually have stem cells at the roots of the teeth, and we like them… The periodontal ligament is what is in the root of the teeth, like tree has soils in its roots, right? Those roots, they’re very important.

They can be very nutritious because that’s where all the nutrition really is. So these roots are really great because they have stem cells in them. We actually know the bone making cells and the frequency in which we can activate it, so if we can activate it works really well to expand the sinuses, expand the functional airway, and here is where vitamin D becomes really important. We really need that vitamin D in order to help make sure that the bone making cells are able to make more bone and expand that sinus really well for you.

Maher: All right, well that’s really great information, Dr. Nammy. Thanks again for speaking with me today.

Dr. Nammy: My pleasure.

Maher: And for more information about Green Dentistry, you can visit the website at sfgreendentist.com. Or call (415) 433-0119.