breathing and sleep issues from tight muscles

[sumihari]

Hi,

Since October 2007  I have been struggling with breathing issues. I also have a bad deviated septum but had no problems with breathing or sleep. In October 2006 , I suffered from benign positional vertigo which was finally resolved by a neurologist in April 2007. It apparently was caused by sleeping on my left side which come to think of it I never did for most of my life.

Despite the vertigo being resolved, what I seem to have now is a forward head posture, stiff muscles and joints in the jaw, neck and shoulders and hips. But most of all I have breathing issues and the sides of my neck, shoulder  and
jaw seem all jammed up . I used to have severe restriction in my rib cage which affected my breathing. My physio gave me some exercises which helped fix this and my breathing is better.  I feel better and can breathe better when my head is tilted less forward and jaw  slightly back. This is what the oralfacial specialist and phsyio is helping me achieve.

What puzzles me about this is that if anything at all my lower jaw seems too backwards and yet when I try to keep it forward, it gives me headaches. In fact there is a sleep apnea team here in Sydney Australia whom I have an an appointment with next year who use a mouth splint to place the jaw and tongue away from the throat to help patients.  The only radiographic change was that my neck has lost some lordosis. Since October 2007 I have ringing in my left ear, my problem side and again seen the neurologist to be told everything checked out fine. Have had MRI's and numerous neck X-rays, TMJ x-rays and consulted 2 ENT's .

So can a muscular skeletal problem cause so much distress, and sleep issues. Why are my muscles in the jaw, neck and shoulder jamming up ? Medication does not seem to help  How can I fix this problem.

Thanks
Sumi

[sumihari]

I think I understand the difference between the head tilted forward vs head tilted up, sounds similar but I think I know what you mean. I got confused because in both positions my head is forward . But just a moment ago with my forward head I did try the two positions and there was indeed a difference in the space in the throat. The head tilted forward restricts my throat and the other one opens the space. It is a very helpful piece of information and thank you again.

Sumi

[sumihari]

I am somewhat confused by your answer.

Quote "If you now have your head tilted forward somewhat, especially during sleep, it can definitely narrow your upper airway, especially the space behind the tongue. When your head is tilted up (extended), this space opens up" . Doesn't head tilted forward and head tilted up (extended) mean the same thing? If so why would the head tilted forward narrow the airway and yet the tilted up (extended) opens the space.

I do know when I sleep in a forward head posture that my lower jaw is jamming my neck. Even though in theory it might open my upper airways as my jaw is forward, I cannot sleep nor breathe well in this position. Wouldn't pulling the lower jaw forward only make the forward head posture worse? I still will go ahead with my sleep apnea consultation. I still am puzzled by the conflicting advice by the jaw specialist and the sleep apnea.

I appreciate your response especially the mention of an inexpensive low-tech boil and bite models for snoring - any particular types?


Thank you

Regards,

Sumi

[Steven Y Park, MD]

Regardless of what happened in October 2007, something changed your sleeping pattern  or position which caused less efficient sleep, creating a vicious cycle of increased generalized muscle tension and spasm. If you now have your head tilted forward somewhat, especially during sleep, it can definitely narrow your upper airway, especially the space behind the tongue. When your head is tilted up (extended), this space opens up. If you aren't breathing properly, then you won't sleep properly. I suggest you follow-up with you sleep apnea team, and consider undergoing a formal or in-home sleep apnea test for more definitive diagnosis. The mandibular advancement device should help, as well as CPAP. The dental device pulls your lower jaw forward, which pulls your tongue forward. If you have a long wait, there are inexpensive low-tech boil and bite models that are sold over the internet for snoring, which does the same thing, but not as well as the formal device. An alternative but complementary option include acupuncture.