1 00:00:00,000 --> 00:00:21,700 Hi everyone and welcome to Airway First, a podcast from the Children's Airway First 2 00:00:21,700 --> 00:00:22,700 Foundation. 3 00:00:22,700 --> 00:00:26,020 I'm your host Rebecca Downing. 4 00:00:26,020 --> 00:00:29,080 My guest today is Patrick McKeown. 5 00:00:29,080 --> 00:00:36,060 Patrick is the creator, CEO and director of Education and Training at the Oxygen Advantage. 6 00:00:36,060 --> 00:00:40,600 Director of Education and Training at the Boteco Clinic International and President 7 00:00:40,600 --> 00:00:43,560 of the Boteco Professionals International. 8 00:00:43,560 --> 00:00:49,080 He is a leading international expert on breathing and sleep and author of bestselling books 9 00:00:49,080 --> 00:00:52,360 including The Oxygen Advantage. 10 00:00:52,360 --> 00:00:57,220 His focus is to empower more people every day to breathe better, feel better and achieve 11 00:00:57,220 --> 00:00:59,760 their potential. 12 00:00:59,760 --> 00:01:07,120 You can find out more about Patrick at OxygenVantage.com and BotecoClinic.com. 13 00:01:07,120 --> 00:01:11,760 And now let's jump into my conversation with today's guest, Patrick McKeown. 14 00:01:11,760 --> 00:01:14,960 All right, thank you so much for joining us today, Patrick. 15 00:01:14,960 --> 00:01:16,360 I really appreciate it. 16 00:01:16,360 --> 00:01:17,960 Sure, it's a pleasure. 17 00:01:17,960 --> 00:01:20,040 Thanks for inviting me, Rebecca. 18 00:01:20,040 --> 00:01:21,280 Absolutely. 19 00:01:21,280 --> 00:01:27,880 And a lot of what we were going to talk today, I just kind of want a level set for parents, 20 00:01:27,880 --> 00:01:35,560 so the expectation is focused more on proper breathing and things, ways that we can help 21 00:01:35,560 --> 00:01:39,520 children that have breathing issues to help them with some of the other elements, like 22 00:01:39,520 --> 00:01:43,400 the mental aspect, so that anxiety, things like that. 23 00:01:43,400 --> 00:01:46,440 There's a number of fronts to it. 24 00:01:46,440 --> 00:01:53,040 Interestingly, today, I went in on PubMed, which is accessible to all parents. 25 00:01:53,040 --> 00:01:59,680 I put in mouth breathing and malocclusion, and it brought up something like 749 papers. 26 00:01:59,680 --> 00:02:07,080 I spent a half an hour to an hour going through just randomly selecting papers. 27 00:02:07,080 --> 00:02:15,280 And looking at the connection that mouth breathing and malocclusion, so Crocatete, for example, 28 00:02:15,280 --> 00:02:17,280 the connection is really, really common. 29 00:02:17,280 --> 00:02:22,720 Now, does it necessarily show that there's cause and effect, but the connection is there 30 00:02:22,720 --> 00:02:24,760 all the same? 31 00:02:24,760 --> 00:02:30,480 And this has been debated since 1909, and probably even before that. 32 00:02:30,480 --> 00:02:37,760 In Dentistry, I remember reading an article that was published in the journal Cosmic Dentistry, 33 00:02:37,760 --> 00:02:41,040 and it was by an author called DeJohn. 34 00:02:41,040 --> 00:02:44,800 And they were talking about the effects of mouth breathing, and the child was in a tentive 35 00:02:44,800 --> 00:02:51,680 in school, the child's face was dull and expressionless, the teacher was accusing the child of not 36 00:02:51,680 --> 00:02:53,840 paying attention. 37 00:02:53,840 --> 00:02:58,360 And then I asked the question, we haven't moved on in over 100 years. 38 00:02:58,360 --> 00:03:01,080 How come has this been forgotten about? 39 00:03:01,080 --> 00:03:02,600 And I have my own personal journey. 40 00:03:02,600 --> 00:03:05,160 I got into breathing because of my own issues. 41 00:03:05,160 --> 00:03:10,560 Most people who work in this field fell into the field of breathing primarily because of 42 00:03:10,560 --> 00:03:12,720 dealing with their own issues. 43 00:03:12,720 --> 00:03:15,840 And as a kid, I was very frustrated in school. 44 00:03:15,840 --> 00:03:21,600 And I was frustrated in school because we're required to sit there and to absorb information 45 00:03:21,600 --> 00:03:26,520 and to be attentive to what the teacher is saying, but we don't have the energy levels 46 00:03:26,520 --> 00:03:28,640 to back it up. 47 00:03:28,640 --> 00:03:30,000 We're sitting there with brain fog. 48 00:03:30,000 --> 00:03:34,880 We're sitting there with fatigue because of, and very often, a sleep disorder. 49 00:03:34,880 --> 00:03:37,160 And I had that sleep disorder. 50 00:03:37,160 --> 00:03:40,160 So at 14 years of age, I left school never to go back to school. 51 00:03:40,160 --> 00:03:45,440 And this was back in the 1980s, and I'd say people sometimes shocked when they heard that. 52 00:03:45,440 --> 00:03:49,920 I wrote about it first in the book, Atomic Focus, which was published last year. 53 00:03:49,920 --> 00:03:53,200 So it's not something that you go and tell everybody about, you know. 54 00:03:53,200 --> 00:03:57,200 But I left school out of a total sense of frustration that there was no point in me 55 00:03:57,200 --> 00:04:02,520 being there if I wasn't picking up on what the teacher was saying. 56 00:04:02,520 --> 00:04:06,480 And yet in junior school, I was very up at the top of the class. 57 00:04:06,480 --> 00:04:11,440 Now, it turned out that I did go back to school one year later, and I studied hard, 58 00:04:11,440 --> 00:04:16,720 and I got my grades and I got into university, and it could have been a lot easier. 59 00:04:16,720 --> 00:04:21,680 So we as a society, we're labeling children as whether they are intelligent or not based 60 00:04:21,680 --> 00:04:24,000 on their academic achievement. 61 00:04:24,000 --> 00:04:29,680 But in order to excel academically, you need to be able to focus and concentrate. 62 00:04:29,680 --> 00:04:30,800 Right. 63 00:04:30,800 --> 00:04:33,600 Focus is narrowing your attention to one thing. 64 00:04:33,600 --> 00:04:38,640 So deciding what are you actually going to place your attention upon. 65 00:04:38,640 --> 00:04:42,320 Concentration is the act of holding your attention on that one thing. 66 00:04:42,320 --> 00:04:44,640 So you might be reading a particular book. 67 00:04:44,640 --> 00:04:49,520 Are you able to hold your attention on the text as you're reading the book? 68 00:04:49,520 --> 00:04:54,720 And your attention span is the length of time that you're able to hold your attention on one thing. 69 00:04:54,720 --> 00:05:03,280 Now, in order for us to excel, we need to have both focus, concentration, and also attention span. 70 00:05:03,280 --> 00:05:10,320 So the kids in terms of that are being labeled as being intelligent or not. 71 00:05:10,320 --> 00:05:12,880 Nobody is teaching them how to concentrate. 72 00:05:12,880 --> 00:05:15,600 Nobody is talking about attention span. 73 00:05:15,600 --> 00:05:19,280 And very few people is talking about the connection with poor sleep. 74 00:05:19,280 --> 00:05:21,440 What about these kids? 75 00:05:21,440 --> 00:05:26,880 What about the 25 to 50 percent of children who are persistently mal breathing? 76 00:05:26,880 --> 00:05:28,560 Who are snoring? 77 00:05:28,560 --> 00:05:30,400 Who are stopping breathing during sleep? 78 00:05:30,400 --> 00:05:37,520 And these are the three hallmark symptoms, mal breathing, snoring, and apnea. 79 00:05:37,520 --> 00:05:41,120 Those children are going to have sleep disruption. 80 00:05:41,120 --> 00:05:46,000 They're not going to do as well academically as the children with good breathing. 81 00:05:46,000 --> 00:05:54,000 So society have forgotten about the kids who have mal breathing and sleep disorders. 82 00:05:54,000 --> 00:05:59,920 It was no different for me back 40 years ago when I was that nine year old child. 83 00:05:59,920 --> 00:06:01,840 Or the child that's sitting in the classroom today. 84 00:06:01,840 --> 00:06:04,640 But leave goes beyond that. 85 00:06:04,640 --> 00:06:15,440 If parents put in into PubMed or put into Google, Karen Bonnock, B-O-N-U-C-K, and pediatrics, 86 00:06:15,440 --> 00:06:23,520 or Karen Bonnock and sleep disorder breathing, they'll pull up a paper that she conducted. 87 00:06:23,520 --> 00:06:26,640 It was published in the journal Pediatrics in 2012. 88 00:06:26,640 --> 00:06:30,320 And she looked at 11,000 British school kids. 89 00:06:30,320 --> 00:06:34,800 She looked at children who had sleep issues at age five if untreated. 90 00:06:34,800 --> 00:06:37,040 Now a sleep issue is simple snoring. 91 00:06:37,040 --> 00:06:42,560 And I don't mean to talk about simple, but most often these kids, it's completely overlooked. 92 00:06:42,560 --> 00:06:46,320 Those children with sleep issues at age five if untreated, 93 00:06:46,320 --> 00:06:50,800 they have a 40 percent increase risk of special education needs by age eight. 94 00:06:50,800 --> 00:06:58,160 So she talked about, if we read that paper, she talked about that the brain is developing 95 00:06:58,160 --> 00:06:59,280 during slow wave sleep. 96 00:07:00,720 --> 00:07:03,760 And slow wave sleep is deep restorative sleep. 97 00:07:04,640 --> 00:07:07,680 But if the child is snoring or mal breathing or stopping breathing, 98 00:07:08,320 --> 00:07:11,280 it prevents the child from going into the slow wave sleep. 99 00:07:11,280 --> 00:07:13,120 And it's affecting development of the brain. 100 00:07:14,000 --> 00:07:19,760 So the children with poor sleep, their IQ levels are going to be significantly reduced 101 00:07:19,760 --> 00:07:21,520 versus the children with good sleep. 102 00:07:22,640 --> 00:07:24,640 And unfortunately, this is being overlooked. 103 00:07:25,440 --> 00:07:29,760 So coming back to PubMed today, looking at that connection, how many children 104 00:07:30,720 --> 00:07:32,640 have overcrowding of teeth? 105 00:07:32,640 --> 00:07:36,960 And when a child is overcrowding of teeth, what is this telling us? 106 00:07:37,840 --> 00:07:41,760 It's telling us not necessarily that the teeth are too big, but the jaws are too small. 107 00:07:42,640 --> 00:07:48,480 There's not enough room for the teeth, because the jaws have not developed the way they should 108 00:07:48,480 --> 00:07:55,520 have developed. And because the jaws are narrower, more V shaped, there's not enough room for the 109 00:07:55,520 --> 00:08:01,280 tongue. The jaws are set back in the face. The tongue is more likely to encroach the airway. 110 00:08:01,840 --> 00:08:07,200 The airway is narrower. The child now is going to have disruptions to their breathing during sleep. 111 00:08:08,080 --> 00:08:12,560 And what's more, this doesn't just affect the child during childhood. 112 00:08:13,280 --> 00:08:15,360 This carries through for the rest of their life. 113 00:08:15,360 --> 00:08:16,400 Right. 114 00:08:16,400 --> 00:08:20,720 So dentistry has debated this for 100 years, but I would say to any parent, 115 00:08:21,840 --> 00:08:25,520 go in on PubMed and put in mild breathing and malocclusion, 116 00:08:26,800 --> 00:08:34,880 put in sleep disorder, breathing, and brain development, and put in these keywords and 117 00:08:34,880 --> 00:08:36,640 look at the papers that you pull up. 118 00:08:36,640 --> 00:08:39,760 Now today, I could not find one single paper. 119 00:08:39,760 --> 00:08:43,520 I'm sure there's a few of them out of 700 plus papers. 120 00:08:43,520 --> 00:08:51,200 You would expect a few, but I could not find one single paper that did not show that 121 00:08:51,200 --> 00:08:55,600 mal breathing children have changes in the shape of their face. 122 00:08:56,400 --> 00:09:01,440 Now, one could argue, well, the child was born with a narrow palate. 123 00:09:01,440 --> 00:09:03,440 The child was born with a high palate. 124 00:09:04,640 --> 00:09:06,800 This infringed the child's nasal cavity. 125 00:09:06,800 --> 00:09:10,960 And as a result, the child had to mal-breathe because the child was feeling that they weren't 126 00:09:10,960 --> 00:09:13,600 getting enough air through their nose. 127 00:09:13,600 --> 00:09:16,000 Okay, that's fine to think of it that way. 128 00:09:16,880 --> 00:09:20,960 Or one could think that while the child was having their mouth open, especially during 129 00:09:20,960 --> 00:09:24,160 those critical growth periods, age one to five years of age, 130 00:09:24,160 --> 00:09:26,720 it's when the fastest growth sport takes place. 131 00:09:27,280 --> 00:09:27,920 Right. 132 00:09:27,920 --> 00:09:32,640 Because the mouth was open and the child was breathing through it, the tongue wasn't able 133 00:09:32,640 --> 00:09:34,160 to rest up in the roof of the mouth. 134 00:09:35,040 --> 00:09:38,800 And because the tongue wasn't resting in the roof of the mouth, 135 00:09:38,800 --> 00:09:40,560 the jaws didn't develop the way they should do. 136 00:09:41,440 --> 00:09:47,760 Now, either way, we have a connection between narrow jaws, longer facial structure, 137 00:09:47,760 --> 00:09:49,680 overcrowding of teeth and mouth breathing. 138 00:09:51,680 --> 00:09:55,200 Whether it's the genetic that the child was born that way, 139 00:09:55,200 --> 00:09:59,280 or whether it's environmental and the genes coming together, 140 00:09:59,280 --> 00:10:04,400 the real issue here is that dentistry one way or the other has a role to play. 141 00:10:04,400 --> 00:10:09,200 Because the dentist is in an ideal position to be able to do something about it, to expand the 142 00:10:09,200 --> 00:10:15,680 palate, to bring in myofunctional therapy, to eliminate oral behaviors such as mouth breathing, 143 00:10:16,320 --> 00:10:23,360 tongue sucking, pacifier overuse of pacifier, eating soft foods, to check tongue tight, 144 00:10:23,360 --> 00:10:29,520 to encourage breastfeeding, because these are all the necessary habits that are important 145 00:10:29,520 --> 00:10:35,200 for the correct development and the growth of the face of the child. 146 00:10:35,200 --> 00:10:40,000 And it goes, we were talking about academics, but it goes beyond that because when the face 147 00:10:40,000 --> 00:10:45,360 grows correctly, the face is good looking. Good looking people have it easier in life. 148 00:10:46,400 --> 00:10:52,320 It's been shown good looking kids will tend to get better marks, 149 00:10:52,320 --> 00:10:55,600 good looking kids will tend to get away with misdemeanors. 150 00:10:55,600 --> 00:11:00,960 And there was a study of individuals put in their photographs were put in front of judges. 151 00:11:02,240 --> 00:11:09,120 And the individuals with the less attractive faces were more prone to receiving a harsher penalty 152 00:11:09,120 --> 00:11:16,320 from the judge. So we as human beings, unknowingly, we do judge individuals based on locks and 153 00:11:16,320 --> 00:11:19,120 probably because it comes down to survival of the species. 154 00:11:19,120 --> 00:11:23,040 A good looking face is the face that nature has intended. 155 00:11:23,040 --> 00:11:26,000 We select our partners based on locks, parking. 156 00:11:26,000 --> 00:11:27,520 Partly, sure. 157 00:11:27,520 --> 00:11:33,600 We select it probably because we know that if I select a good attractive looking moment, 158 00:11:33,600 --> 00:11:38,240 her airway is good, her genetic pooling is good. 159 00:11:38,240 --> 00:11:47,680 So our face is, it's a very important, I suppose, it's very difficult while in terms of the words 160 00:11:47,680 --> 00:11:56,320 and I'm trying to, but our faces, it's almost that our face is the first thing that people see. 161 00:11:56,320 --> 00:11:58,560 It's as a measure of health. 162 00:11:59,680 --> 00:12:01,280 And it comes back full circle. 163 00:12:02,480 --> 00:12:07,680 The children with mouth open, it can contribute to abnormal craniofacial development. 164 00:12:07,680 --> 00:12:11,760 I know there's debate on it, but I am going to come back to, 165 00:12:11,760 --> 00:12:16,800 even if it's a genetic influence in the child who was born with the high upper narrow palate, 166 00:12:16,800 --> 00:12:18,080 something could be done about it. 167 00:12:18,080 --> 00:12:21,040 That's what we need to start recognizing. 168 00:12:21,040 --> 00:12:26,880 And I remember reading an article by an orthodontist called Catherine Vague and she was asking, 169 00:12:26,880 --> 00:12:31,760 is there a role for the importance of nose breathing and orthodontics? 170 00:12:31,760 --> 00:12:36,960 And she was saying that it's difficult because there's a number of scientific questions that 171 00:12:36,960 --> 00:12:37,920 can't be answered. 172 00:12:37,920 --> 00:12:44,560 Number one is, at what age if the child gets the stuff he knows, does it have the biggest impact? 173 00:12:45,200 --> 00:12:49,920 Is it when the child is two years of age and causes mouth breathing or is it six, seven or eight? 174 00:12:49,920 --> 00:12:51,680 Okay, these are the questions she's putting out. 175 00:12:51,680 --> 00:12:57,680 For how long does the child have to breathe through the open mouth before it has a negative impact? 176 00:12:58,560 --> 00:13:01,200 How much nasal obstruction is clinically relevant? 177 00:13:01,920 --> 00:13:03,680 How do you define mouth breathing? 178 00:13:03,680 --> 00:13:10,720 We don't have the answers to these questions, but we have to ask and we have to allow common sense 179 00:13:10,720 --> 00:13:11,360 kick in here. 180 00:13:12,160 --> 00:13:18,880 If the child is persistently breathing through an open mouth when they are distracted during sleep, 181 00:13:19,600 --> 00:13:25,280 during rest, it points that at least for some of the time their mouth is open. 182 00:13:25,920 --> 00:13:28,800 If they're breathing through, their tongue isn't resting in the roof of the mouth, 183 00:13:28,800 --> 00:13:37,520 and that is going to impact craniofacial development, their looks, but also their academic ability, 184 00:13:37,520 --> 00:13:41,360 especially when the airway is compromised due to setback of the jaws. 185 00:13:42,320 --> 00:13:51,200 And not just looks and intelligence, but also how they can function. 186 00:13:51,200 --> 00:13:58,880 We're starting to see this correlation between ADHD and anxiety and depression, things that 187 00:14:01,040 --> 00:14:03,600 in the beginning none of us even thought there was a connection. 188 00:14:03,600 --> 00:14:09,760 But as you dig into it, to your point, if it's impacting your intelligence, 189 00:14:09,760 --> 00:14:14,240 then it is logical to say, obviously it is impacting their emotions. 190 00:14:16,080 --> 00:14:20,640 Because we're in an increased stress response and society is demanding that the child is able 191 00:14:20,640 --> 00:14:25,280 to be attentive. And also there's an awful lot of pressure on kids to get grades. 192 00:14:26,320 --> 00:14:33,920 There's pressure by the parents, there's pressure by the teachers, and the child who is not performing 193 00:14:33,920 --> 00:14:37,120 so well, their self-esteem is going to be affected. 194 00:14:37,120 --> 00:14:41,120 But coming back to ADD and ADHD, in that same paper by Karen Bonock, 195 00:14:42,160 --> 00:14:47,520 she said there are three million children aged between six and 21 years of age in the United 196 00:14:47,520 --> 00:14:53,840 States, three million kids that have issues associated with sleep disorder breathing, 197 00:14:53,840 --> 00:15:00,320 including ADD and ADHD. So can you imagine this is a moral cost, it's an economic cost, 198 00:15:00,320 --> 00:15:08,480 it's a societal cost. Unfortunately, why has it been overlooked? 199 00:15:09,360 --> 00:15:11,840 Why has the importance of breathing in and out through the nose? 200 00:15:11,840 --> 00:15:19,200 Why has the importance, the recognition of correct and resting posture, as a need to 201 00:15:19,200 --> 00:15:25,520 developing forward growth of the jaws, to help open up the airways that child grows into an 202 00:15:25,520 --> 00:15:30,160 adequate good breathing for the rest of their life? How come it has been overlooked? 203 00:15:30,160 --> 00:15:36,080 It's a really pertinent question. It's one that I've been asking myself for about 12, 13 years. 204 00:15:37,280 --> 00:15:40,640 Tomorrow morning, I interview Dr. John Mu and Dr. Mike Mu. 205 00:15:40,640 --> 00:15:48,640 Okay. John Mu is 94 years of age now, and he's been talking about nasal breathing, 206 00:15:48,640 --> 00:15:54,800 correct and resting posture for about 40 or 50 years. Mike Mu is a little bit older than me, 207 00:15:54,800 --> 00:16:01,520 he's in his early 50s. It's going to be a really interesting conversation. And it's going to be 208 00:16:01,520 --> 00:16:07,680 a conversation because what they have been saying, even though they've been, in essence, pioneers 209 00:16:07,680 --> 00:16:14,800 and what they've been saying, there has been some kickback from traditional orthodontists. 210 00:16:15,520 --> 00:16:22,160 And that is really unfortunate because we have to start asking these questions. And I would say 211 00:16:22,160 --> 00:16:28,720 to parents, listen, you go into a restaurant and look at the face of the mouth breathing kid, 212 00:16:28,720 --> 00:16:35,360 you will see it. If mouth breathing didn't have an impact on faces, the term adenoid faces would 213 00:16:35,360 --> 00:16:41,920 never have come into being. So a situation, and it's a medical term, that when the adenoids are 214 00:16:41,920 --> 00:16:45,760 enlarged, the child is not going to feel comfortable breathing through the nose, 215 00:16:46,640 --> 00:16:50,800 because the space at which the nose meets the throat is too narrow, too small. 216 00:16:50,800 --> 00:16:51,360 Right. 217 00:16:51,360 --> 00:16:55,360 The child feels air hunger breathing through the nose, so it switches to mouth breathing. 218 00:16:56,240 --> 00:17:00,000 When the child switches to mouth breathing, they have to drop the tongue. 219 00:17:00,000 --> 00:17:07,200 Adenoid faces are not the change in the face solely because the adenoids are enlarged. 220 00:17:08,080 --> 00:17:15,200 Adenoid faces are the change in the shape of the face owing to the mouth breathing pattern 221 00:17:15,200 --> 00:17:21,520 as a result of the enlarged adenoids. It's not just enlarged adenoids that cause mouth breathing. 222 00:17:22,720 --> 00:17:26,400 It's the mouth breathing that's causing the abnormal impact on the face. 223 00:17:26,400 --> 00:17:35,520 Go in and Google and put in adenoid faces and just take images and you will see image after image. 224 00:17:35,520 --> 00:17:43,200 We see these kids, they could have been beautiful looking kids. They're undergoing orthodontics, 225 00:17:43,200 --> 00:17:49,200 11, 12, 13 years of age. There's often a belief out there that if you straighten teeth, 226 00:17:50,320 --> 00:17:53,280 it will make an enormous impact on the child's face. 227 00:17:53,280 --> 00:18:00,640 Right. And we're doing retractive orthodontics and we're adding insult to injury. We're taking out 228 00:18:01,760 --> 00:18:05,840 teeth and this small airway is getting smaller because we're not 229 00:18:05,840 --> 00:18:07,920 pulling things forward and widening. 230 00:18:08,720 --> 00:18:16,960 Yes. A straight teeth do not create a good looking face, but a good looking face will create straight 231 00:18:16,960 --> 00:18:21,200 teeth because if the face has grown the way it should have gone. 232 00:18:21,200 --> 00:18:26,480 It has room. It has room for the teeth. And then you have to ask, well, 233 00:18:27,120 --> 00:18:31,600 is this just some minority of kids that are experiencing this? Of course not. 234 00:18:32,240 --> 00:18:39,680 You walk into any 11-year-old school classroom and ask how many children here 235 00:18:40,800 --> 00:18:45,680 are undergoing orthodontics and it's probably 60, 70% of these kids. 236 00:18:45,680 --> 00:18:52,240 Right. Right. And as parents, we didn't know because it was none to us. 237 00:18:53,840 --> 00:18:59,440 We're doing it to our children. So now, you know, we're on the second generational impact of 238 00:19:01,040 --> 00:19:05,440 airway and now you're starting to see our generation. I'm licking you in with me. 239 00:19:05,440 --> 00:19:10,880 You're with my generation that we're starting to see these sudden 240 00:19:10,880 --> 00:19:17,200 spikes and high blood pressure and sleep apnea. I mean, how often, 241 00:19:18,160 --> 00:19:22,240 how many people do you know that have CPAP? I mean, it's just common. 242 00:19:22,240 --> 00:19:28,000 It's epidemic. It's epidemic. And Dr. Krushan Gimel, though, who's considered a founding father 243 00:19:28,000 --> 00:19:32,720 of sleep medicine, he talked about a few things that are impacting and increasing the risk of 244 00:19:32,720 --> 00:19:38,000 sleep apnea or sleep disorder breathing. Two of the genesis is one. So for example, 245 00:19:38,000 --> 00:19:43,520 if the child is missing one or more, T. as an adult, and he's saying these are risk factors 246 00:19:43,520 --> 00:19:49,200 that could be identified early in life. So he, when he was working in Stanford, sadly, 247 00:19:49,200 --> 00:19:55,040 he's passed on a patient might walk into his clinic and the patient may be 40 years of age. 248 00:19:56,240 --> 00:20:00,000 The patient is after having sleep apnea for probably 30 of those years. 249 00:20:01,440 --> 00:20:07,200 The patient is missing one or two T. This could have been identified early on life. 250 00:20:07,200 --> 00:20:13,920 This could have been predicted. He also talks about extractions. So for example, extraction 251 00:20:13,920 --> 00:20:18,800 of wisdom teeth, that when there's an extraction, it in turn is making them out smaller. 252 00:20:19,360 --> 00:20:23,920 When the mouth is smaller, there's not enough room for the tongue. And the tongue is nowhere to go, 253 00:20:23,920 --> 00:20:29,360 but back into the throat. Now, of course, a sleep medicine specialist would say it's not just as 254 00:20:29,360 --> 00:20:34,320 simple as that. It's not sleep apnea is more complex, but these are one of the factors. 255 00:20:34,320 --> 00:20:36,880 Right, right. Just to be clear. Yeah. 256 00:20:36,880 --> 00:20:42,000 All of the phenotypes in sleep apnea, there is four in particular in adult sleep apnea. 257 00:20:43,280 --> 00:20:49,840 One is anatomical, but it's the single biggest contributory factor to sleep disorder breathing. 258 00:20:50,800 --> 00:20:55,440 And that would be peak risk is the pharyngeal closing pressure, 259 00:20:55,440 --> 00:20:59,600 the suction pressure at which the airways collapsing. So it's an anatomical phenotype. 260 00:20:59,600 --> 00:21:05,600 There are three others which are non anatomical, but they are also influenced by how we breathe, 261 00:21:06,480 --> 00:21:10,880 such as upper airway recruitment. That's influenced by myofunctional therapy. 262 00:21:11,680 --> 00:21:17,200 Loop gain is influenced by your breathing pattern and your chemo sensitivity to carbon dioxide. 263 00:21:17,200 --> 00:21:21,680 Arousal threshold refers to whether you're a light sleeper or a deep sleeper. 264 00:21:22,240 --> 00:21:25,920 So for example, if you have insomnia, you have lower arousal threshold. 265 00:21:25,920 --> 00:21:29,440 If you're a really, really deep, deep sleeper, you've got higher arousal threshold. 266 00:21:30,400 --> 00:21:36,160 We can still influence true breathing because we can show how to downregulate. 267 00:21:36,880 --> 00:21:41,280 So an individual who is having insomnia, they're overstimulated. 268 00:21:41,920 --> 00:21:45,520 They can't fall asleep readily. Their mind is racing. They're overthinking. 269 00:21:46,160 --> 00:21:49,680 Or they may be waking up at two o'clock or three o'clock in the morning. 270 00:21:49,680 --> 00:21:52,560 They're lying there for an hour or two. They can't fall back to sleep. 271 00:21:52,560 --> 00:21:58,160 So how can we help to downregulate? By changing breathing patterns, 272 00:21:58,160 --> 00:22:01,520 by slowing down the exhalation, by breathing in and out through the nose. 273 00:22:02,720 --> 00:22:05,920 And especially when we have that really slow and soft exhalation. 274 00:22:06,880 --> 00:22:09,200 The body is telling the brain that everything is safe. 275 00:22:10,400 --> 00:22:15,600 When the brain interprets that the body is safe, we're more likely to go back to sleep. 276 00:22:16,400 --> 00:22:20,160 But if we're lying there and we're mouth breathing and fast breathing and hard breathing, 277 00:22:20,160 --> 00:22:25,680 the body is telling the brain that the body is not safe and the brain will keep us up. 278 00:22:26,480 --> 00:22:30,320 So we have to be careful of the communication that the body is telling the brain. 279 00:22:31,200 --> 00:22:34,640 And part of that communication is relayed via the vagus nerve. 280 00:22:36,240 --> 00:22:40,880 80 to 90% of the communication by the vagus nerve is from the bottom up, 281 00:22:40,880 --> 00:22:56,800 from the body up to the brain. And we can tap into that via the breath. 282 00:23:00,320 --> 00:23:04,000 You are listening to Airway First with today's guest, Patrick McEon. 283 00:23:04,960 --> 00:23:08,960 You can find out more about the Children's Airway First Foundation and our mission to fix 284 00:23:08,960 --> 00:23:16,640 before six on our website at childrensairwayfirst.org. The CAF website offers tons of great resources 285 00:23:16,640 --> 00:23:21,760 for parents and medical professionals, including videos, blogs, a recommended reading list, 286 00:23:21,760 --> 00:23:25,040 comprehensive medical research, podcasts, and more. 287 00:23:26,720 --> 00:23:30,880 We also encourage parents to join the Airway Huddle, our Facebook support group, 288 00:23:30,880 --> 00:23:34,880 which was created for parents of children with Airway and sleep-related issues. 289 00:23:34,880 --> 00:23:41,760 You can access the Airway Huddle support group at facebook.com backslashgroups backslashairwayhuddle. 290 00:23:41,760 --> 00:23:47,360 If you're a medical professional or parent that's interested in being a guest on an upcoming episode, 291 00:23:47,360 --> 00:23:55,520 shoot us a note via our contacts page on our website or send us an email directly at infoatchildrensairwayfirst.org. 292 00:23:55,520 --> 00:24:01,440 As a reminder, this podcast and the opinions expressed here are not a medical diagnosis. 293 00:24:01,440 --> 00:24:07,440 If you suspect your child might have an airway issue, contact your pediatric airway dentist or pediatrician. 294 00:24:07,440 --> 00:24:12,880 And now let's jump back into my interview with today's guest, Patrick McEon. 295 00:24:22,880 --> 00:24:29,600 So the mouth-breathing child as I was, poor sleep, were already in an increased stress response. 296 00:24:29,600 --> 00:24:35,280 We can't focus during the day. The adrenaline from sleep has carried through to during the day. 297 00:24:35,280 --> 00:24:39,920 We're sitting in a classroom and mouth open. Mouth-breathing is a faster breathing pattern, 298 00:24:39,920 --> 00:24:44,880 a shallow breathing pattern. This also is telling the brain that we're in a stress response. 299 00:24:44,880 --> 00:24:51,600 So both during wakefulness and also during sleep, how we breathe our airways, 300 00:24:51,600 --> 00:24:57,280 the quality of our sleep is going to influence the balance of the autonomic nervous system. 301 00:24:57,280 --> 00:25:02,320 No child is going to reach their full potential if they have sleep disorder breathing. 302 00:25:02,320 --> 00:25:08,720 And the three hallmark symptoms of this is snoring, mouth-breathing and apnea. 303 00:25:10,720 --> 00:25:16,880 And just to be clear, every time we bring up sporeening kids, I like to mention it's not cute. 304 00:25:16,880 --> 00:25:23,280 It's not normal. As a society, we've made it that way, but it's not. 305 00:25:23,280 --> 00:25:27,600 So if your child is a chronic snore, that is a sign. 306 00:25:27,600 --> 00:25:30,720 We should not hear breathing of a child during sleep. 307 00:25:30,720 --> 00:25:36,240 And also, you might think that, well, an adult having an apnea, 308 00:25:36,240 --> 00:25:40,560 it has to last for about 10 seconds or so. For a child, it's only two breaths. 309 00:25:40,560 --> 00:25:46,000 And all the child has to have is one apnea every hour to be clinically significant. 310 00:25:46,000 --> 00:25:50,160 Now, the other thing that I would say is, any parent who wants to 311 00:25:50,160 --> 00:25:54,720 explore this because the gold standard of treatment for obstructive sleep apnea is 312 00:25:54,720 --> 00:26:00,080 tonsillectomy and adenoidectomy. And in a paper published in the American Journal 313 00:26:00,080 --> 00:26:05,440 of Respiratory and Critical Care Medicine, co-authored, well, the lead author was 314 00:26:05,440 --> 00:26:11,360 batter Chargy. They looked at 578 children who underwent tonsillectomy and adenoidectomy 315 00:26:11,360 --> 00:26:16,160 for sleep disorder breathing. Out of the three hallmarks, 316 00:26:16,160 --> 00:26:30,480 out of the 578 kids, only 27% had their sleep apnea cured post tonsillectomy and adenoidectomy. 317 00:26:31,200 --> 00:26:37,760 73% of these children continue to have residual sleep apnea post T&A. 318 00:26:38,480 --> 00:26:44,800 Now, at the top of that paper, you will read that the efficacy of tonsillectomy and adenoidectomy 319 00:26:44,800 --> 00:26:51,120 in the treatment of sleep disorder breathing in children is unknown. This was published in 2010. 320 00:26:51,760 --> 00:26:55,360 This practice has been carried out with children since the late 1970s. 321 00:26:56,640 --> 00:27:01,200 How can a practice be carried out? And it's not a walk in the park. 322 00:27:02,240 --> 00:27:10,480 Without it's the efficacy of it being known. Now, in fairness, the AHI, which is a measurement 323 00:27:10,480 --> 00:27:16,320 of the sleep apnea severity, it did reduce from 18 events down to four events per hour. 324 00:27:17,200 --> 00:27:22,800 But four events per hour is bordering on moderate sleep apnea with children because five is the 325 00:27:22,800 --> 00:27:29,280 cutoff point. So then we have to ask the question, well, there's something else going on here. 326 00:27:29,840 --> 00:27:36,240 Right, there's still no room. There's no room. And we have to be considering retronatia. We have 327 00:27:36,240 --> 00:27:42,480 to be considering inflammation. We have to be considered our breathing patterns. And it was 328 00:27:42,480 --> 00:27:47,680 Dr. Christian Gimelow again. He spoke about the critical importance of restoring nasal breathing 329 00:27:47,680 --> 00:27:52,320 during wake and sleep as the only valid and complete correction of pediatric sleep disorder 330 00:27:52,320 --> 00:27:57,920 breathing. Restoration of nasal breathing during wakefulness and sleep as the only valid and 331 00:27:57,920 --> 00:28:03,920 complete correction of pediatric sleep disorder breathing. We must teach our children to breathe 332 00:28:03,920 --> 00:28:13,840 in natural nose. And into that, I mean, I would like to take some time to demonstrate some things 333 00:28:13,840 --> 00:28:20,000 parents can show their children. But I don't want to get too far away from it, because you mentioned 334 00:28:20,000 --> 00:28:27,360 inflammation and carbon dioxide. And from reading your books, and I'll put the links 335 00:28:27,360 --> 00:28:32,400 within the show notes, parents can grab them. And because they're great references for working 336 00:28:32,400 --> 00:28:41,440 with kids, but also ourselves. You really stress this part of proper breathing is how we're processing 337 00:28:41,440 --> 00:28:45,360 and working with carbon dioxide, because we were always taught it was just this waste gas. 338 00:28:46,320 --> 00:28:50,800 But it's actually that's part of proper breathing. Could maybe we talk a little bit about that to 339 00:28:50,800 --> 00:28:57,600 help parents understand that. Yeah, you know, as human beings, we breathe in to bring an oxygen, 340 00:28:57,600 --> 00:29:05,120 and we breathe out the excess CO2. But the key is don't breathe out too much of it. Right. It's not 341 00:29:05,120 --> 00:29:10,640 about getting rid of it all. All of it. Right. What does carbon dioxide do? We must have a certain 342 00:29:10,640 --> 00:29:16,960 amount, not too much, not too little, just right. So we're talking about the pressure of carbon dioxide 343 00:29:16,960 --> 00:29:22,320 in the blood, which in turn is influenced by the partial pressure of carbon dioxide in the lungs. 344 00:29:22,320 --> 00:29:28,640 And the pressure of carbon dioxide in the lungs is influenced by how hard and fast we breathe. 345 00:29:29,600 --> 00:29:36,800 So if we're example, I start breathing hard and fast, I'm going to remove too much carbon dioxide 346 00:29:36,800 --> 00:29:42,800 from the lungs as I'm breathing out hard and fast, a lot of volume of air. And with that, 347 00:29:42,800 --> 00:29:47,600 I'm getting rid of carbon dioxide from the lungs. This in turn is going to get rid of carbon dioxide 348 00:29:47,600 --> 00:29:54,960 in the blood. And this in turn is going to cause my blood vessels to constrict. It also causes 349 00:29:54,960 --> 00:30:01,280 hemoglobin, which is the protein that carries oxygen to hold on to oxygen more readily. So 350 00:30:01,280 --> 00:30:06,320 it's ironic that the harder and the faster we breathe, the more blood vessels constrict, 351 00:30:06,880 --> 00:30:13,280 and the less oxygen that's delivered throughout the body. But also the harder and faster breathing, 352 00:30:13,280 --> 00:30:19,440 the brain is interpreting that the body is going into fight or flight. So it needs to, 353 00:30:19,440 --> 00:30:24,960 you know, in terms of breathing, and if somebody is looking at what's the physiology behind this, 354 00:30:24,960 --> 00:30:31,040 just Google the Bohr effect, B-O-H-O-R. So this was discovered back in 1904, 355 00:30:32,080 --> 00:30:36,800 that the functions of carbon dioxide are well written in any medical textbook with a section 356 00:30:36,800 --> 00:30:42,320 on respiratory physiology. It's the primary regulator of blood pH. It's a vasodilator, 357 00:30:42,320 --> 00:30:47,600 tapping to open the blood vessels. It's a bronchodilator, taps to open up the airways. 358 00:30:48,480 --> 00:30:54,880 And it also assists in the release of oxygen from the red blood cells to the tissues and organs. 359 00:30:55,600 --> 00:30:59,840 You know, so the idea of telling a child if they're stressed to take a big deep breath, 360 00:31:00,480 --> 00:31:07,680 well, that may be in essence the absolute wrong thing to do. We should be teaching children how 361 00:31:07,680 --> 00:31:13,600 to regulate their states. We should be teaching kids who are going in to do exams. And again, 362 00:31:13,600 --> 00:31:18,560 it's been documented, children who are going to do exams, how does their breathing change? 363 00:31:19,280 --> 00:31:23,760 Those children with the most anxiety, their breathing gets faster, harder, upper chest and 364 00:31:23,760 --> 00:31:30,400 irregular. And there's a correlation between the change in breathing and anxiety. But the one thing 365 00:31:30,400 --> 00:31:35,520 about the breath is that you've got some degree of control over it. So if we had a child who is 366 00:31:35,520 --> 00:31:41,600 predisposed to anxiety, if that child knew that by changing and controlling their breathing pattern, 367 00:31:43,200 --> 00:31:49,760 they can help to minimize, to reduce, to control their anxiety. It's a great tool. 368 00:31:50,320 --> 00:31:56,080 It's not happening, not yet, but I think it will. And you know, we use breathing techniques. We use 369 00:31:56,080 --> 00:32:02,880 them with the military. I used them with police. I used them with top fighters, Olympic athletes. 370 00:32:02,880 --> 00:32:09,200 We use them with all walks of life. So breathing is something now that is getting out there because 371 00:32:09,200 --> 00:32:14,560 this isn't about taking the deep breath or taking the full breath. This is about knowing how do you 372 00:32:14,560 --> 00:32:18,960 breathe when you want to upregulate, when you want to downregulate, when you want to improve your 373 00:32:18,960 --> 00:32:26,000 sleep quality, when you want to change your state of mind. And really, we have to be thinking of 374 00:32:26,000 --> 00:32:31,680 it this way that breathing does need the attention. Now, in terms of children, the breathing exercise 375 00:32:31,680 --> 00:32:37,600 for kids are all free. We've put them up there. They're all up on YouTube. If any parent goes 376 00:32:37,600 --> 00:32:43,280 into our YouTube channel or even downloads the butyco clinic app, which is free, all of the 377 00:32:43,280 --> 00:32:49,200 exercise for kids are there. So, you know, we, there's different videos, why does the child breathe 378 00:32:49,200 --> 00:32:55,040 through the nose? Because the child's, it looks natural. You're better at your sports, it helps 379 00:32:55,040 --> 00:33:00,560 with your dental health. You know, is there a connection between children who are mouth breathing, 380 00:33:00,560 --> 00:33:06,800 which is causing a dry mouth, which in turn is increasing the instance of bacteria in the mouth, 381 00:33:07,440 --> 00:33:10,560 which in turn is contributing to dental cavities and gum disease? 382 00:33:11,440 --> 00:33:18,160 Children with chap lips, do children with mouth breathing get chap lips more than nasal breathing? 383 00:33:18,160 --> 00:33:23,440 And of course, the answer is yes. Is there a connection between mouth breathing and 384 00:33:23,440 --> 00:33:28,640 halitosis, bad breath? Is there a connection between mouth breathing and speech, 385 00:33:28,640 --> 00:33:33,280 speech and speech problems? Is there a connection between mouth breathing and 386 00:33:33,280 --> 00:33:39,280 eustachian tube? We already spoke about development, you know, so that connection is there. I think 387 00:33:39,280 --> 00:33:44,400 the parents are very important, but this information is readily accessible. And, you know, 388 00:33:45,040 --> 00:33:50,320 that's why when I was writing the books, I always wanted to try and reference as best we can and 389 00:33:50,320 --> 00:33:56,800 support that the information, there is nothing new about this. This has been here for decades, 390 00:33:56,800 --> 00:34:04,160 but yet parents, it's almost as if it has been hidden from parents. Yeah. Yeah, no one talks 391 00:34:04,160 --> 00:34:09,760 about it. And the other part to me that is so astounding is not just parents aren't talking 392 00:34:09,760 --> 00:34:18,240 about it. What we're finding with cath is doctors, pediatrician, dentists, they weren't talking about 393 00:34:18,240 --> 00:34:26,800 it. They weren't taught it. And that's mind boggling to me personally, just something so simple. 394 00:34:27,920 --> 00:34:35,280 But I think that's the problem. I think, you know, there's very much in medicine that if you're 395 00:34:35,280 --> 00:34:43,120 doing research that you have to be doing research of what's trendy, what's cutting edge, what's at 396 00:34:43,120 --> 00:34:49,360 the top of the game. Very few doctors are going to tell their peers, what are you doing research on? 397 00:34:49,360 --> 00:34:54,640 I am researching the importance of nose breathing. They will be laughed out of the park. There is no 398 00:34:54,640 --> 00:35:00,640 incentive to do research and breathing, because it's seen as so simple, so mundane. Why would you 399 00:35:00,640 --> 00:35:06,000 be doing anything research or not? And the other aspect of, of course, it doesn't promise profit. 400 00:35:06,880 --> 00:35:11,520 And that's a problem too. I was about to say that's the other unfortunate thing that I have heard 401 00:35:11,520 --> 00:35:22,240 from other dentists that you're hearing is we're telling people don't do braces. Don't pull teeth. 402 00:35:24,400 --> 00:35:28,400 And for a lot of dentists, I mean, we'll just call it what it is. It's the bread and butter. And 403 00:35:28,400 --> 00:35:34,480 we're saying don't do it, because it's dangerous. So right, it's definitely, 404 00:35:34,480 --> 00:35:40,800 definitely a hot topic. So with regard to breathing, and I will absolutely put, 405 00:35:42,000 --> 00:35:46,400 we have, and I'll put links in here, but we do have several of your links already on our website 406 00:35:46,400 --> 00:35:52,160 and our YouTube channel as references for parents. But maybe we could just do something quick that 407 00:35:52,160 --> 00:35:59,280 parents could do. You have a child, you have a teenager, they're stressed for a game, like you 408 00:35:59,280 --> 00:36:06,320 said, maybe before an exam. It means just a hard day. What's an easy exercise that maybe we could 409 00:36:06,320 --> 00:36:12,800 help bring them back into focus and help them regulate? There's two exercises that are pretty 410 00:36:12,800 --> 00:36:17,520 good for that. Now, what I would say is don't introduce the exercise when the child is stressed. 411 00:36:18,880 --> 00:36:25,760 Introduce the exercise to the child when the child isn't stressed. Okay. And have the child 412 00:36:25,760 --> 00:36:32,960 practice it when things are going okay. And always explain to the child, if things are not going your 413 00:36:32,960 --> 00:36:38,240 way, this is your friend to fall back on is your breathing. Because if you control your breathing, 414 00:36:38,240 --> 00:36:43,760 you can have to control your mind. The first exercise is small breath holes. Take a normal 415 00:36:43,760 --> 00:36:48,640 breath in through the nose, out through the nose, should be silent. So it's a normal silent breath 416 00:36:48,640 --> 00:36:53,840 in through the nose, a normal silent breath out through the nose, pinch the nose and hold five, 417 00:36:53,840 --> 00:36:59,280 four, three, two, one, let go. And just breathe now for about three four breaths. 418 00:37:00,080 --> 00:37:03,920 And then again, take a normal breath in through the nose, an out through the nose and pinch 419 00:37:03,920 --> 00:37:11,120 the nose and hold five, four, three, two, one, let go. I'm breathing normally now for about 420 00:37:11,120 --> 00:37:16,660 three to four breaths. And again, take a normal breath, Inter 421 00:37:16,660 --> 00:37:24,500 to nose and hold, five, four, three, two, one, let go and breathe normally for about three to four 422 00:37:24,500 --> 00:37:30,340 breaths. If the child has small little breath pauses, it helps to keep their breathing more 423 00:37:31,140 --> 00:37:38,820 regular. It helps to reduce the risk of hyperventilation. That's one way to do it. The second way is 424 00:37:38,820 --> 00:37:45,620 anytime, and I would say to parents actually, practice this yourself first. Okay. Do it when 425 00:37:45,620 --> 00:37:51,700 things are going well and fall back in it when things are going not so well. Anytime that we 426 00:37:51,700 --> 00:37:55,380 get into a difficult situation, the most important thing is not the hyperventilation. 427 00:37:56,740 --> 00:38:00,580 And if we start breathing hard and fast, of course, the body is telling the brain that things are not 428 00:38:00,580 --> 00:38:06,260 good. The brain is here to protect us. And the brain will want us to get out of the situation, 429 00:38:06,260 --> 00:38:11,220 launch us into a fight or flight response. Whenever we get into a difficult situation, 430 00:38:11,220 --> 00:38:17,300 as best as you can, bring your attention onto your breathing might be a minute or two afterwards. 431 00:38:18,180 --> 00:38:22,180 You may not be able to do it there and then because the situation sometimes can take over. 432 00:38:22,820 --> 00:38:27,780 But after a minute or two to step back and just bring your attention onto the breath, 433 00:38:27,780 --> 00:38:33,300 nobody will even know that you're doing it. Take a soft breath in through your nose and have a 434 00:38:33,300 --> 00:38:38,180 really relaxed and slow gentle breath out. So even though you might want to feel that you're 435 00:38:38,180 --> 00:38:43,380 breathing hard and faster, you might want to feel that this is the way to breathe. Always remember 436 00:38:43,380 --> 00:38:48,180 if you're breathing this way, it's only going to feed into your stress response. How do you tell 437 00:38:48,180 --> 00:38:53,700 the brain that the body is safe? Slow down the exhalation. Take a soft breath in through the 438 00:38:53,700 --> 00:39:00,020 nose and a really relaxed and slow gentle breath out. So when we have that very soft and slow gentle 439 00:39:00,020 --> 00:39:05,940 breath out through the nose, we're stimulating the vagus nerve, which secretes a neurotransmitter 440 00:39:05,940 --> 00:39:11,460 called acetylcholine, which causes the heart rate to slow down. And when the heart rate is slowing 441 00:39:11,460 --> 00:39:17,700 down, the brain interprets that the body is safe. So the child that's about to go into an exam, 442 00:39:17,700 --> 00:39:22,420 and their breathing is getting hard and fast, and they start sighing and taking these big breaths, 443 00:39:22,980 --> 00:39:28,340 that is going to affect the child's ability to do well in that exam. And it has nothing got to do 444 00:39:28,340 --> 00:39:34,420 with the child's intelligence. It's just that the child didn't have the tools to self-regulate there. 445 00:39:34,420 --> 00:39:39,620 You say to the child, whenever you feel that your breathing is getting a little bit off, 446 00:39:40,820 --> 00:39:46,740 focus on slowing down the exhalation. Don't wait until the exam. Start doing it with small things 447 00:39:46,740 --> 00:39:51,060 first. See, the one thing about breathing is that if you bring it into your everyday life, 448 00:39:51,060 --> 00:39:57,140 it's there for you anyway. And things will always happen. Something happens, you could even have a 449 00:39:57,140 --> 00:40:02,020 patient who's giving out, and the patient is giving out, they're opening and closing their 450 00:40:02,020 --> 00:40:06,340 mouth, and there's noise coming out of their mouth, and you have your attention on the breath. 451 00:40:07,140 --> 00:40:10,980 You're taking a soft breath into the nose, and a relaxing slow gentle breath out. 452 00:40:11,540 --> 00:40:17,860 You're still listening to the patient, but you're going to be remaining calm. And what you'll find 453 00:40:17,860 --> 00:40:22,660 now is that the patient will start coming down. You're in a better situation to deal with this 454 00:40:22,660 --> 00:40:28,900 situation. You're not going to be, you know, almost being consumed by the mood, because 455 00:40:28,900 --> 00:40:33,060 of course, every now and again, people are in a bad mood, and they're going to take it out on 456 00:40:33,060 --> 00:40:39,620 somebody, and that's normal. That's human nature. Right. So these are the tools that we should be 457 00:40:39,620 --> 00:40:45,060 able to use. Every one of us is always something that'll happen. If it hasn't happened, don't worry 458 00:40:45,060 --> 00:40:51,060 it soon. Well, it will. And it's interesting, because one of the things I've heard you mention, 459 00:40:51,060 --> 00:40:59,860 and I've pulled into my daily life, aside from, I actually, I can't tell you how many times a day 460 00:40:59,860 --> 00:41:06,180 now I actually monitor and notice my breathing, which is funny. Somebody with an airway issue 461 00:41:06,820 --> 00:41:13,060 never thought about it before, but I do now. I notice it, and these tools have helped me. 462 00:41:14,020 --> 00:41:19,140 But watching other people, you know, I was always taught to watch body language, 463 00:41:19,140 --> 00:41:24,100 and watch their head, watch their shoulders, watch what they're doing. Never occurred to me, 464 00:41:24,100 --> 00:41:28,740 watch their breathing. And I heard you say this, I think it was in the TED Talk one time. 465 00:41:31,060 --> 00:41:37,620 Wow. And I'm noticing now when I engage with people, I do watch for that, and especially even 466 00:41:37,620 --> 00:41:45,860 with my children, because such a subtle nuance. Child looks just fine. And I started watching 467 00:41:45,860 --> 00:41:50,500 her breathing, and I'm thinking, wow, she's a heavy breathing moment right here. Something's 468 00:41:50,500 --> 00:41:56,180 going on in its nose breathing, but had it not been attuned to it, completely would have missed it. 469 00:41:57,220 --> 00:42:01,780 So just another great tip for parents, you know, as you're thinking something so simple, 470 00:42:03,220 --> 00:42:06,500 watch their breathing patterns, watch what they're doing when they're awake, because even if they 471 00:42:06,500 --> 00:42:12,740 look okay, you know, and this is an example, I'm thinking of my child was in fight or flight, 472 00:42:12,740 --> 00:42:17,060 she was in complete freak out mode, and I had, I would have, there was no other way I would have 473 00:42:17,060 --> 00:42:22,580 known it. Yeah, yeah. And it can be a very important tool because kids now, you know, they spend a lot 474 00:42:22,580 --> 00:42:28,020 of time on social media, they spend a lot of time on mobile phones, we've, we will not always know 475 00:42:28,020 --> 00:42:34,980 what's going on there. That's just the way it is. Nope. Nope. So typically at the end of a podcast, 476 00:42:35,540 --> 00:42:42,420 I like to completely turn the floor back over to our guests for final thoughts, be it for parents, 477 00:42:42,420 --> 00:42:48,020 or medical professionals, or both. So I would like to give that, give the floor totally over to you 478 00:42:48,020 --> 00:42:55,940 now. You know, I think the most important thing is for the individual to be informed and to do your 479 00:42:55,940 --> 00:43:03,700 own digging on this one. There's questions that are unanswered. And we, but we still have to ask 480 00:43:03,700 --> 00:43:10,100 the common sense of it on the logic of it. You know, I think the more we observe and the interesting 481 00:43:10,100 --> 00:43:16,340 thing from the medical health point of view is most medical professionals who were into airway, 482 00:43:16,340 --> 00:43:21,700 when I actually asked them what brought you into this, they came across it because when they were 483 00:43:21,700 --> 00:43:27,460 working with their own children. And that's a very interesting one, you know, they're working with 484 00:43:27,460 --> 00:43:31,860 their patients, but they don't see their patients when the patient goes home. Right. When you're 485 00:43:31,860 --> 00:43:38,340 working with your child, you're seeing the child during, of course, the treatment, but you're also 486 00:43:38,340 --> 00:43:45,780 seeing the child during sleep during their normal every day. And this is when then some people will 487 00:43:45,780 --> 00:43:52,260 just ask the question, just something is off here. And breathing could be very that one thing. 488 00:43:53,140 --> 00:43:58,340 I'm not going to say it's a cure all not a lot, but it is a fundamental function that influences 489 00:43:58,340 --> 00:44:04,180 all of the major disciplines of medicine. 75% of individuals with panic disorder and anxiety of 490 00:44:04,180 --> 00:44:11,700 dysfunctional breathing 75%. Now, we could say that it's the anxiety and the panic that's causing 491 00:44:11,700 --> 00:44:17,460 breathing to be faster and harder and upper chest and irregular. But we also have to realize that 492 00:44:17,460 --> 00:44:23,700 that faster and harder and upper chest breathing is feeding back into the stress response. So we 493 00:44:23,700 --> 00:44:30,260 do have those tools. And I think it starts with us, like it starts with me, it starts with you, 494 00:44:30,260 --> 00:44:35,860 it starts with the person listening, you bring it into your own way of life. If I'm on the treadmill 495 00:44:35,860 --> 00:44:42,100 behind me here, I will do it with breathing in and out to the nose. When I'm asleep, my mind is 496 00:44:42,100 --> 00:44:48,260 closed. If I get into a difficult situation as best I can, I bring my attention onto my breath, 497 00:44:48,260 --> 00:44:54,260 I slow down the exhalation. I do breath holding during the day. I take my attention out of the 498 00:44:54,260 --> 00:45:00,180 mind and I connect with my breath with many, many times throughout the day. And it's a tremendous 499 00:45:00,180 --> 00:45:06,500 capacity to help to bring a stillness to the mind, a quietness to the mind, but also a connection 500 00:45:06,500 --> 00:45:10,980 with everything that's going on around you. And ultimately, it helps with energy levels, 501 00:45:10,980 --> 00:45:19,940 concentration, creativity, intuition, and above all, happiness. Because I remember when I was that 502 00:45:19,940 --> 00:45:27,220 kid, even into my early 20s, and having spent 16 years in formal education, I come out of it not 503 00:45:27,220 --> 00:45:32,900 knowing how to concentrate. I come out of it not knowing how to regulate states. I come out of it 504 00:45:32,900 --> 00:45:37,540 not knowing how to deal with the stress and the challenges of when you first go into the workforce. 505 00:45:38,500 --> 00:45:45,540 So it didn't teach me the very tools that I needed to learn to be able to go out there in society. 506 00:45:45,540 --> 00:45:51,300 And I was very stressed in my early 20s in the workforce. And it wasn't necessarily the company 507 00:45:51,300 --> 00:45:58,660 that was causing it. But it was my physiology. Because ultimately, our resilience and our ability 508 00:45:58,660 --> 00:46:05,460 to cope with the daily, you know, ups and downs of life. You know, anybody listening to this will 509 00:46:05,460 --> 00:46:11,700 identify with this, you know, something happens, one person can take it in their stride, and the 510 00:46:11,700 --> 00:46:21,220 other person, it's a total drama that consumes the individual. So stuff happens. Do you 511 00:46:21,220 --> 00:46:28,900 we want to be at the mercy of every small little situation that happens because all that's doing 512 00:46:28,900 --> 00:46:35,300 is going to throw us into a state of chaos. So life is a bit softer when you have a connection 513 00:46:35,300 --> 00:46:40,100 with your breath because you can regulate your states. And your breathing is also influencing 514 00:46:40,100 --> 00:46:44,420 your sleep. Your sleep is influencing your emotions, your emotions are influencing your 515 00:46:44,420 --> 00:46:50,740 breathing, your emotions are influencing your sleep. Your breathing influences your sleep as 516 00:46:50,740 --> 00:46:56,100 well. So there's a three way connection there, you can't disentangle the emotions from sleep 517 00:46:56,100 --> 00:47:01,060 and breathing. One is feeding into the other. So there's that bi-directional relationship 518 00:47:01,060 --> 00:47:05,540 always there. Start with the breath, even just start breathing through your nose during rest, 519 00:47:06,180 --> 00:47:10,580 during physical exercise, never wake up at a dry match in the morning. I just came across an 520 00:47:10,580 --> 00:47:19,700 article there, but three days ago, that adults who wake up at a dry matter at a greater risk of 521 00:47:19,700 --> 00:47:24,820 snoring and obstructive sleep apnea, we've been talking about this for 20 years. This was the 522 00:47:24,820 --> 00:47:30,340 first paper that I've seen it being studied. If you have a dry mouth in the morning, you're at a 523 00:47:30,340 --> 00:47:35,140 greater risk of snoring and sleep apnea. The very fact that the dry mouth is mouth breathing. 524 00:47:35,140 --> 00:47:39,300 It's mouth breathing that's increasing the risk of snoring and sleep apnea and the dry 525 00:47:39,300 --> 00:47:48,900 mouth is the result of that. Right. It's a sign. That's it. Well, I cannot thank you enough for 526 00:47:48,900 --> 00:47:53,380 taking the time to come on and speak with me today. I really appreciate it. It's a pleasure. 527 00:47:53,380 --> 00:47:59,380 Thanks very much, Rebecca. Thank you. Thanks again to today's guest, Patrick McKeown, 528 00:47:59,380 --> 00:48:03,780 for sharing his political insight and to each of you for listening to today's episode. 529 00:48:04,580 --> 00:48:09,460 If you're new to our podcast, please don't forget to subscribe. And if you enjoyed today's episode, 530 00:48:09,460 --> 00:48:12,740 leave us a review or comment telling us about what you enjoyed most. 531 00:48:12,740 --> 00:48:17,620 You can stay connected with the Children's Airway First Foundation by following us on Instagram, 532 00:48:17,620 --> 00:48:23,780 Facebook, Twitter, LinkedIn, or our YouTube channel. Parents can also join us via our 533 00:48:23,780 --> 00:48:30,660 Facebook Parents Support Group, the airwayheadle, at facebook.com backslashgroups backslashairwayheadle. 534 00:48:31,460 --> 00:48:35,940 If you'd like to be a guest or have an idea for an upcoming episode, shoot us a note via the 535 00:48:35,940 --> 00:48:42,820 contacts page on our website or send us an email directly at info at childrensairwayfirst.org. 536 00:48:43,220 --> 00:48:47,380 And finally, as always, thanks to all the parents and medical professionals out there that are 537 00:48:47,380 --> 00:48:51,620 working hard to help make the lives of kids around the globe just a little bit better. 538 00:48:51,620 --> 00:49:07,300 Take care, stay safe, and happy breathing, everyone. 539 00:49:21,620 --> 00:49:27,300 Bye.