Sleep Medicine Commons^™

Proceedings Of The 2023 Iaom Convention, International Association Of Orofacial Myology

International Journal of Orofacial Myology and Myofunctional Therapy

The International Association of Orofacial Myology (IAOM) held its 2023 Convention in Chandler, Arizona from October 13 - 15. The Proceedings of the Convention contain abstracts and summaries of podium and poster presentations.

What Are We Missing In Adult Obstructive Sleep Apnea Clinical Evaluation? Review Of Official Guidelines, Eduardo J. Correa, Carlos O´Connor-Reina, Laura Rodriguez-Alcalá, Diego M. Conti, Alberto Rabino, Peter M. Baptista, Maria-Teresa Garcia-Iriarte, Guillermo Plaza

International Journal of Orofacial Myology and Myofunctional Therapy

Purpose: This article presents a narrative review of current recommendations for the clinical evaluation and management of adult patients with obstructive sleep apnea (OSA) to identify points missing from a myofunctional perspective.

Methods: The authors reviewed current official guidelines for adult patients with OSA, searching clinical evaluation and treatment recommendations for myofunctional therapy.

Results: None of the current guidelines for evaluation of adult OSA recommend performing a myofunctional evaluation. Only two guidelines consider myofunctional therapy (MFT) as a treatment modality for adult patients with OSA.

Conclusion: Despite the role of the pharyngeal dilator muscles as an …

Advances And Updates On Open-Access Publishing By The Ijom, Nancy Pearl Solomon

International Journal of Orofacial Myology and Myofunctional Therapy

An online, open-access, no-fee model of the International Journal of Orofacial Myology and Myofunctional Therapy (IJOM) was established in December 2020 and includes all archived articles back to the journal’s origin in 1975. While aiming to increase content for the journal, the Editorial Review Board (ERB) has also been diligent about maintaining high standards for publication. This note From the Editor highlights recent publications, conference proceedings, and special issues. It also lists updates and challenges in terms of policies and practices. The IJOM remains both a traditional association-supported journal and is on the cutting edge of open-access publishing.

Tonsillectomy In Children With 22q11.2 Deletion Syndrome., Jill M. Arganbright, Paul Bryan Hankey, Meghan Tracy, Srivats Narayanan, Janelle R. Noel-Macdonnell Phd, David G. Ingram Md

Manuscripts, Articles, Book Chapters and Other Papers

Tonsillectomy is one of the most common procedures performed in children, however there are currently no published studies evaluating tonsillectomy in children with 22q11.2 deletion syndrome (22q11DS). With this study, our goal was to investigate the indications, efficacy, and complications of tonsillectomy in a pediatric cohort of patients with 22q11DS. This is a retrospective chart review of patients in our 22q Center's repository. Inclusion criteria were a diagnosis of 22q11DS and a history of tonsillectomy or adenotonsillectomy. Data collected included: indications for tonsillectomy, preoperative and postoperative polysomnography (PSG) results, and surgical complications. In total, 33 patients were included. Most common …

Proceedings Of The 2022 Iaom Convention, International Association Of Orofacial Myology

International Journal of Orofacial Myology and Myofunctional Therapy

The International Association of Orofacial Myology (IAOM) held its 2022 Convention in Kansas City, Missouri from October 21 - 23. The Proceedings of the Convention contain abstracts and summaries of podium and poster presentations.

Proceedings Of The 2022 Icap Conference, International Association Of Orofacial Myology

International Journal of Orofacial Myology and Myofunctional Therapy

The International Consortium of Ankylofrenula Professional (ICAP) held its 2022 Conference in Vancouver, Canada from September 1 to 4, 2022, titled ‘Untangling Ankylofrenula: Collaborative Approaches to Best Practice Management’. The Conference Proceedings includes abstracts and summaries of plenary, concurrent, lightning and virtual presentations.

Behavioral Parent Training For Adhd And Sleep: A Dream Pair, Whitney Rolling

Research Days

Background: Estimates for children with attention-deficit/hyperactivity disorder (ADHD) and comorbid sleep disorders range from 25-75% (4,5,10). Among childhood sleep disorders, behavioral insomnia is one of the most common, with the treatment of choice being behavioral parent training (BPT) (4). BPT therefore is a common treatment element for both sleep disturbance and ADHD and presents a unique opportunity for more holistic pediatric care.

Objectives/Goal: Our objective was to implement and evaluate a behavioral sleep intervention in an ADHD behavioral parent training (BPT) program. Goals of the intervention were to decrease behavioral sleep symptoms, increase sleep duration, and decrease ADHD impairment.

Methods/Design: …

Obstructive Sleep Apnea In Neonates., Indira Chandrasekar, Mary Anne Tablizo, Manisha Witmans, Jose Cruz, Marcus Cummins, Wendy Estrellado-Cruz

Manuscripts, Articles, Book Chapters and Other Papers

Neonates have distinctive anatomic and physiologic features that predispose them to obstructive sleep apnea (OSA). The overall prevalence of neonatal OSA is unknown, although an increase in prevalence has been reported in neonates with craniofacial malformations, neurological disorders, and airway malformations. If remained unrecognized and untreated, neonatal OSA can lead to impaired growth and development, cardiovascular morbidity, and can even be life threatening. Polysomnography and direct visualization of the airway are essential diagnostic modalities in neonatal OSA. Treatment of neonatal OSA is based on the severity of OSA and associated co-morbidities. This may include medical and surgical interventions individualized for …

Functional Nasal Breathing Rehabilitation: Effectiveness And Feasibility Of An Online Integrative Breathing Therapy Protocol, Rosalba Courtney, Roger Engel, Sandra Grace, Anna Potts, Brooke Riordan, Kaitlyn Ireland, Courtney Osbourne, Avinash Sukhtankar

International Journal of Orofacial Myology and Myofunctional Therapy

Purpose: Nasal disuse and mouth breathing are associated with negative structural, functional, postural, occlusal, and behavioural changes. While there is some research to suggest that nasal breathing exercises can reduce mouth breathing, clinical protocols have not been extensively investigated. The purpose of this research was to determine the feasibility and effectiveness of a nasal breathing rehabilitation protocol based on Integrative Breathing Therapy principles called Functional Nasal Breathing Rehabilitation (FNBR).

Methods: Twenty-three participants with symptoms of nasal obstruction and self-reported mouth breathing completed the 4-week online FNBR training. Outcome measures included the Nasal Obstruction Symptom Evaluation (NOSE) scale, a numeric rating …

Treatment Considerations For Obstructive Sleep Apnea In Pediatric Down Syndrome, Erica Gastelum, Marcus Cummins, Amitoj Singh, Manuel Montoya, Gino Luis Urbano, Mary Anne Tablizo

Goal 3: Good Health and Well-Being

Children with Down syndrome (DS) are at high risk for developing obstructive sleep apnea (OSA) compared to children without DS. The negative impact of OSA on health, behavior, and cognitive development in children with DS highlights the importance of timely and effective treatment. Due to the higher prevalence of craniofacial and airway abnormalities, obesity, and hypotonia in patients with DS, residual OSA can still occur after exhausting first-line options. While treatment commonly includes adenotonsillectomy (AT) and continuous positive airway pressure (CPAP) therapy, additional therapy such as medical management and/or adjuvant surgical procedures need to be considered in refractory OSA. Given …

Meet The Journal’S Editorial Review Board Members, Nancy Pearl Solomon

International Journal of Orofacial Myology and Myofunctional Therapy

I am honored to take on the role as Editor-in-Chief (EIC) of the International Journal of Orofacial Myology and Myofunctional Therapy (IJOM). To prepare for my role as EIC, I set two major goals to address today’s quickly evolving publication standards and the expansion and growth of the discipline of orofacial myofunctional disorders. The first was to establish an on-line submission and review process and an on-line archive for all past articles. The second critical goal was to recruit and enlist an international group of highly respected scientists and doctoral-level practitioners who represent diverse topics related to orofacial myofunctional disorders …

Review Of New Trends In Myofunctional Therapy: Occlusion, Muscles And Posture, By Saccomanno And Paskay (2020), Jayanti Ray

International Journal of Orofacial Myology and Myofunctional Therapy

The field of myofunctional therapy (MT) is complex, as it covers theoretical and practical information on many topics to effectively assess and treat orofacial myofunctional disorders, also known as myofunctional disorders, including tongue thrust, tongue posture, tongue-tie, orthodontic concepts, oral habits, and more. This review summarizes the strengths and usefulness of the book New Trends in Myofunctional Therapy: Occlusion, Muscles and Posture (Saccomanno & Paskay, 2020). The review informs the audience about various important features of the book, chapter materials, and the overall usefulness of the content for professionals working in MT. Providing cutting-edge information, the book draws substantive support …

Perceptions Of Tongue-Bulb Comfort And Stability With And Without Anti-Slip Patches During Assessments Of Tongue Strength And Endurance, Heidi A. Vanravenhorst-Bell, Lucy M. Cook

International Journal of Orofacial Myology and Myofunctional Therapy

Purpose: The Iowa Oral Performance Instrument (IOPI) is commonly used to measure tongue strength and endurance. The tongue, however, is reported to periodically move from its intended placement on the IOPI bulb during measurement. This study sought to determine one’s perception of tongue-to-bulb slippage with and without two anti-slip patches (Patch1 – flexible fabric, Patch2 – hypoallergenic micropore fabric) and whether measures of tongue strength and endurance differed across the three IOPI bulb conditions.

Method: 40 healthy adults were randomly assigned to perform tongue strength and endurance procedures by elevating either the anterior (n = 22) or posterior ( …

Iaom President's Greeting 2021: 50th Anniversary Celebration, Amanda Moore Chastain

International Journal of Orofacial Myology and Myofunctional Therapy

The 50^th Anniversary Address delivered by the President of the International Association of Orofacial Myology at the Annual IAOM Convention held online October 22-24, 2021.

Proceedings Of The 50th Annual Iaom Convention

International Journal of Orofacial Myology and Myofunctional Therapy

The International Association of Orofacial Myology (IAOM) held its 50^th Anniversary Convention virtually in 2021. The Proceedings of the Convention contain abstracts and summaries of the presentations. Topics include: history of orofacial myology, mastication, palatal expansion, temporomandibular disorder, clinical research methods, tethered oral tissues, frenuloplasty, case report, nasal breathing rehabilitation, sleep disordered breathing, parasomnias, evolution and comparative zoology, reticent children, orofacial myofunctional therapy.

Sleep Patterns And Problems Among Children With 22q11 Deletion Syndrome., Jill M. Arganbright, Meghan Tracy, Susan Starling Hughes, David G. Ingram Md

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: To delineate sleep habits and problems in children with 22q11.2 deletion syndrome (22q11DS).

METHODS: Thirty children, age 1-15 (mean 6.8) years, participated in the study, which was an internet-based anonymous survey of parents of children with 22q11DS administered via the 22q11.2 Foundation. The main outcome was the Childhood Sleep Habits Questionnaire (CSHQ).

RESULTS: Scores on the CSHQ demonstrated clinically significant sleep problems in 29 of the 30 children. When compared with previously reported normative values for typically developing children of the same age, children with 22q11DS had significantly greater sleep problems. Only 30% of children had previously undergone sleep …

Sound Dampening Headband For Infants, Alexandra A. Mccullough, Mohammad Rasool, Alison Romisher, Robert S. Pugliese, Pharmd, Bcps, Bon Ku, Md, Mpp

Phase 1

Background: Noise in the Intensive Care Nursery (ICN) has been linked to sleep disruption, vital sign destabilization, abnormal development, and stress response induction in infants. Specifically, a sound level ≥60 decibels (dB) was linked to sleep disruption in infants, and the American Academy of Pediatrics (AAP) set a maximum recommended sound level of 45dB in ICNs. The present work was conducted to confirm that the Jefferson ICN exceeds the 60dB and 45dB levels, like most hospitals do, and to conduct preliminary testing on materials for a wearable intervention to reduce infants’ exposure to noise.

Methods: A group of …

Creating A Noise-Reducing, Wearable Intervention For Newborns In The Nicu, Mohammad Rasool, Alexandra A. Mccullough, Alison Romisher, Robert S. Pugliese, Pharmd, Bcps, Bon Ku, Md, Mpp

Phase 1

Background: Excessive auditory stimulation can have negative effects on the growth and development of newborn babies. The American Academy of Pediatrics states that newborns should not be exposed to sounds in excess of 45dB while they are in the hospital, however noise levels in NICUs across the country are often between 50-100dB. A design project was conducted to develop an intervention that could reduce infant exposure to excessive noise.

Methods: Neonatologists, nurses, audiologists, music therapists, sound designers, soft materials experts, and medical device designers were interviewed and consulted throughout the design process. A 24-hour sound recording using a REED-SD-4023 meter …

A Qualitative Study On Adequate Sleep In Preschool Children – Can We Sleep On It?, Seema Zainulabdin Lasi, Noreen Afzal, Somal Kayani

Human Development Programme

Sleep is a significant marker of physical and psychological health. The present research was undertaken to explore perceptions of parents, teachers and pediatricians about preschool children’s sleep patterns, habits, and problems from urban Karachi, Pakistan. A qualitative research approach was employed; data collection methods were Focus Group Discussion (FGDs) and Key Informant Interviews (KIIs). The themes identified were children’s sleep patterns, sleep environment, sleep rituals, distractions, sleep problems, the impact of inadequate sleep, and recommendations to improve. Emergent themes were inconsistency of rules from parents, lack of opportunities for outdoor physical activity, different kinds of stresses, social and cultural events …

Enhancing The Evidence Base In Orofacial Myology, Hope C. Reed

International Journal of Orofacial Myology and Myofunctional Therapy

The purpose of this article is to stimulate research in orofacial myology. The research-to-practice gap may be reduced by highlighting concepts relating to evidence-based practice. Information is also presented on the International Association of Orofacial Myology Institutional Review Board process.

Development Of Lip Closing Function During Taking Food Into The Mouth In Children With Down Syndrome, Tomoko Isoda, Fumiyo Tamura, Takeshi Kikutani, Miki Mizukami

International Journal of Orofacial Myology and Myofunctional Therapy

Children with Down Syndrome (DS) show developmental retardation of gross motor function including acquisition of oral movements related to eating and swallowing. To characterize the process of development/acquisition of eating/swallowing function of children with DS, interlabial pressure (IP) during taking food into the mouth was assessed. This study included 99 children with DS (birth to 4 year-old), and 112 age-matched control children showing typical development. IP during taking food into the mouth was measured as an objective index of lip closing function. The system for measuring IP during taking food into the mouth consisted of a strain gauge-pressure sensor connected …

Feasibility Of Using A Tongue-Activated Joystick By Healthy Pre-Teen Children, Mariana Souza Amaral, Ranata Maria Moreira Moraes Furlan, Guilherme Andre Santana, Clarice Magnani Figueiredo

International Journal of Orofacial Myology and Myofunctional Therapy

PURPOSE: To investigate the motivation and the effects of: tongue movement direction; resistance force level; repetition number; and sustained tongue contraction duration on tongue motor performance in healthy pre-teen children using computer games. METHODS: An analytical observational cross-sectional study was conducted with 15 healthy 11-13 year-old children with normal lingual strength. The participants played six computer games using a tongue-controlled joystick. The series varied the time for continuous force application on the target (3 and 5 seconds) and the target force level (0.5, 1 and 2 N). After the tests, the participants answered a questionnaire about their impressions and reactions …

Investigating Factors Related To The Acquisition Of Masticatory Function In Down Syndrome Children, Miki Mizukami, Takeshi Kikutani, Miwa Matsuyama, Keigo Nagashima

International Journal of Orofacial Myology and Myofunctional Therapy

Down syndrome (DS) has the highest prevalence of any chromosomal abnormality identified in newborns. DS children have specific eating and swallowing difficulties such as poor tongue control, mouth opening, swallowing food without chewing, and both facial and occlusal abnormalities. DS children are also at high risk of aspiration, and swallowing food without chewing is considered to be a factor associated with increased risk of aspiration and eating problems. This study aimed to identify factors preventing the acquisition of masticatory function in DS children. The subjects were 75 outpatient DS children (44 males, age range 12 to 36 month-old, mean age …

Current Practice Patterns In The Diagnosis And Management Of Sleep-Disordered Breathing In Infants., Rachana Kombathula, David G. Ingram Md, Zarmina Ehsan Md

Manuscripts, Articles, Book Chapters and Other Papers

STUDY OBJECTIVES: Currently, there are no universally accepted guidelines for diagnosis and management of sleep-disordered breathing (SDB) in infants. The purpose of this study was to survey pediatric sleep medicine providers regarding their current practice patterns for diagnosis and management of SDB in infants.

METHODS: An anonymous, web-based survey with 71 questions was distributed via the PEDSLEEP and Ped-Lung listserv, which serve as a hub of communication for pediatric sleep and pulmonary medicine providers worldwide.

RESULTS: Fifty-four providers from eight countries completed the survey. Ninety-six percent of providers reported performing sleep studies in infants with 53% performing more than 30 …

Clinical Effectiveness Evaluation Of Laser Therapy And Dry Needling In Treatment Of Patients With Myofascial Pain In Masseter Muscle, Diego A. Oliveira, Rafael De Almeida Spinelli Pinto, Larissa De Oliveira Reis, Isabela Maddalena Dias, Isabel Cristina Goncalves Leite, Fabiola Pessoa Pereira Leite

International Journal of Orofacial Myology and Myofunctional Therapy

Myofascial pain is considered a type of muscular TMD, being common in patients with musculoskeletal pain associated with active or latent trigger points. Among the therapeutic options, there are low-intensity laser therapy and dry needling. The aim of this study was to compare the efficacy of these two therapies in the masseter muscles of patients with myofascial pain. Ten patients diagnosed with myofascial pain, with or without limitation of mouth opening, were randomly divided into two groups for treatment with low intensity laser therapy (G1) (n = 5) or dry needling (G2) (n = 5). The pain symptomatology and the …

Facial Burn During Orthognathic Surgery: Case Report, Jessica C. Avelar, Marcio Jose De Campos, Raphaella Barcellos Fernandes, Sergio Luiz Da Mota Júnior, Marcelo Reis Fraga, Robert Willer Farinazzo Vitral

International Journal of Orofacial Myology and Myofunctional Therapy

Despite the fact that the advances in surgical techniques have contributed to the reduction in the number of complications associated with orthognathic surgery, problems resulting from different phases of treatment, treatment planning, and postoperative period may occur. This paper presents a case of facial soft tissue lesion, burn in the lower lip region, in a patient with Class III malocclusion during orthognathic surgery. A 22-year, 3-month-old male patient with Class III malocclusion was burned in the paramedian region of the lower lip due to unnoticed overheating of the low-speed handpiece during sagittal osteotomy of the left mandibular ramus. The injury …

Self-Care Treatment On Patients With Wakefulness Bruxism, Tainara Lopes De Castro Bastos, Rafael De Almeida Spinelli Pinto, Isabela Maddalena Dias, Isabel Cristina Goncalves Leite, Fabiola Pessoa Pereira Leite

International Journal of Orofacial Myology and Myofunctional Therapy

Objective: To evaluate self-care efficacy on reduction of pain and wakefulness bruxism before the treatment with the stabilization splint. Methods: Sixty patients were divided into two groups: 30 belonging to the group that received the self-care guide (G1) and 30 belonging to the control group (G2) who were advised to wait for the beginning of the treatment with the stabilization splint. G1 received a self-care guide for immediate application before any intervention for bruxism treatment. The instructions were given as tips to follow every day for 1 month. Before being given to the patient, the guide was read aloud and …

Examining The Effects Of Ankyloglossia On Swallowing Function, Kliss Moulton, John Anthony Seikel, Joni Grey Loftin, Nancy Devine

International Journal of Orofacial Myology and Myofunctional Therapy

Oropharyngeal dysphagia (OPD) involves difficulty during one or more of the stages of swallowing, resulting in difficulty moving the bolus from the mouth to the stomach. A deficit in tongue mobility, such as that found with ankyloglossia, may affect the oropharyngeal transit time of the bolus and predispose a person to OPD. This study was conducted to examine the possible relationship between tongue tie and oropharyngeal dysphagia. Data were gathered on 8 participants (5 females, 3 males) between the ages of 12-43 years. The Lingual Frenulum Protocol (Marchesan, 2012) was used to determine tongue tie. An Iowa Oral Performance Instrument …

Juvenile Dermatomyositis - A Case Report With Review On Oral Manifestations And Oral Health Considerations, Pritesh Ruparelia, Oshin Verma, Vrutti Shah, Krishna Shah

International Journal of Orofacial Myology and Myofunctional Therapy

Juvenile Dermatomyositis is the most common inflammatory myositis in children, distinguished by proximal muscle weakness, a characteristic rash and Gottron’s papules. The oral lesions most commonly manifest as diffuse stomatitis and pharyngitis with halitosis. We report a case of an 8 year old male with proximal muscle weakness of all four limbs, rash, Gottron’s papules and oral manifestations. Oral health professionals must be aware of the extraoral and intraoral findings of this rare, but potentially life threatening autoimmune disease of childhood, for early diagnosis, treatment, prevention of long-term complications and to improve the prognosis and hence, the quality of life …

Intermittent Hypoxemia In Preterm Infants, Elie G. Abu Jawdeh

Theses and Dissertations--Clinical and Translational Science

Intermittent hypoxemia (IH) is defined as episodic drops in oxygen saturation (SpO₂). Virtually all preterm infants have IH events. Extremely preterm infants have hundreds of IH events per day. The extent of IH is not apparent clinically as accurately documenting cardiorespiratory events for day-to-day patient care management is challenging. High resolution pulse oximeters with 2 second averaging time are currently the ideal methods to measure IH. We have developed novel methods and processes to accurately and efficiently calculate an IH profile that reflects to spectrum of the problem.

The natural progression of IH is dynamic. There is low …