The Hyoid Slump Hypothesis!

Recently, I read an article titled “Hyoid slump hypothesis” and it’s in reference to some thoughts on functional and anatomical causes of obstructive sleep apnea.

The Hypothesis:

Put simply, the paper discusses the hypothesis which proposes that “the vertical descent and positional instability of the hyoid bone as a biomechanical trigger of airway collapse”. While this does appear that they’re just looking at the mechanical position of the hyoid bone as a causative factor for poor airway patency, they do look at why the hyoid may be altered in its position- phew, thank goodness! They discuss mouth breathing, low tongue posture, altered craniofacial development (which all relate to one another), forward head posture, and genetic factors that may also be involved.

It’s wonderful that orthodontics and dentistry are starting to consider the body and how its structure and function relate to each other. Osteopathy always considers the body as a whole unit of function of course. While osteopathic treatment may be helpful for people who have obstructive sleep apnea to address some of the causative factors mentioned above, Orofacial Myology Therapy (OMT) is also a really useful tool. Think of OMT as rehab for not only the muscles, but the neurology that develops with their function.

The Hyoid bone in relation to the tongue and ears.

The Hyoid bone.. but what else?

I like the picture above because I can show this to a patient and it gives a really easy way to understand how tissues above and below are very literally connected. What it doesn’t show is function. Function is so important to the structure. It also doesn’t show the arteries, the veins, the lymphatic tissue, the fascia, the viscera and (other than the hyoid itself) the bones! These will all influence the function of the tissues in the body. You can think of every tissues having the ability to exert the butterfly effect in the body. Thankfully we are able to compensate beautifully most of the time.. until we can’t. So, for people who have obstructive sleep apnea, they have likely compensated for a long time before they reach the point where they are noticing symptoms. To this hypothesis, I would say that the hyoid bone doesn’t sudden appear in a different location, it will happen over time. This is why it’s idea to deal with mouth breathing, tongue position, head posture, allergies etc earlier rather than later in life.

Do you have any questions about sleep apnea or the study? I’d love to hear your thoughts.