S4 E4 - Dr Shereen Lim Reveals Why Many of us Have Trouble Breathing: BREATHE, SLEEP, THRIVE

Did you know that the way a child breathes will impact every aspect of their development including their sleep quality, learning, behaviour, jaw and facial development, speech, and future health?
Dr, Sherren Lim wrote Breathe, Sleep, Thrive to connect the dots to help you identify the important developmental milestones for good airway health development and breathing, the red flags that indicate things are off track, and what can be done about it to help your child not just survive, but thrive.
I found this quite a bit intriguing as it affected my own health from youth into adulthood. This book is an excellent resource for parents whose children may be experiencing the same issues. Their lives could be changed for the better

Pick up Dr. Lim's book here: Breathe, Sleep, Thrive: Discover how airway health can unlock your child’s greater health, learning, and potential : Lim, Shereen: Amazon.com.au: Books

Dr Shereen Lim is a Perth based dentist with a post graduate diploma in dental sleep medicine from the University of Western Australia.She has been involved in the team management of snoring and obstructive sleep apnoea for over a decade.Dr Lim is dedicated to promoting airway health from infancy as an alternative approach to minimize the development of these problems, and is author of the book “Breathe, Sleep, Thrive: Discover How Airway Health Can Unlock Your Child’s Greater Health, Learning and Potential.”Her work in private practice is restricted to tongue tie management from infancy to adulthood, early interceptive orthodontics and myofunctional therapy.

Episode Transcript

(00:05):
Welcome to book Spandrum. I'm yourhost, Chris Cordani. This is the
show where I bring you authors andwriters, but they aren't necessarily seasoned in
that field. They're from other occupationsacross the spectrum. With me, I
have a doctor as someone who hashad problems with his own airways when I
was younger, my own airways,however, you want to put that.

(00:29):
This book I'm going to discuss todayis extremely helpful for parents to understand more
about not only what their afflicted childis going through, but the potential overall
health problems and how to fix them. You might remember maybe you suffered this
as a kid, had some littletrouble breathing, a little extra sniffing,
or you woke up with a littleextra stuffiness. There were reasons for that,

(00:51):
but we didn't know back then.Heck, did you have a lot
of ear infections when you were akid? I did. I had tubes
put in my ears. But thereare other reasons and we are going to
find out about those today and thiscould change a lot of young people's lives.
With me on book Spectrum, missdoctor Scherene Limb. She wrote the
book Breathe, Sleep and thrive.It's about this particular this particular affliction.

(01:17):
And really I'm happy to have youhere, doctor Limb, because we're going
to be talking about a lot ofvery interesting things here. Welcome to book
Spenttrum, doctor Limb. Fantastic,Thanks for having me. The book is
Breathe, Sleep and Thrive, andwe're talking on opposite ends of the world
here because you're in Australia. You'realso a dentist. How did you notice

(01:37):
these problems in young people and figureout a way to solve them? Yeah,
so I originally became interested in breathingthrough my husband snoring. So my
husband snoring was driving me pretty crazy, got me up one night, decided
that I was going to look athow I could help resolve this issue.
I knew that gentle appliances that repositionthe jaws forward during sleep could help to
open up the airway and reduce snoring, and so I decided I was going

(02:01):
to enroll in a postgraduate course tolearn all about that. But yeah,
learning more and more about those problems, I started to understand that snoring can
be a symptom of a more seriousbreathing sort called obstructive sleep. ATNA Now,
these are not problems that occur suddenlywith age or putting on weight.
They have their developmental origins in earlychildhood, and so they develop when mouth

(02:28):
breathing begins and when our airway structuresdon't form properly. And a lot of
this has to do with how ourjaws are forming. Explain that mouth breathing
thing, because you'll see some youngpeople who are having trouble breathing through their
noses and you think, hey,well, maybe their noses are stuffed.
Parents were probably thinking, hey,maybe it's just a little bit of interference.
They can still breathe a little,but they'll grow out of it for

(02:51):
sure. So with our nose especiallydesigned for breathing, when we breathe through
our nose, it filters and warmsand humidifies the air before it goes in
to our lungs, and it alsoallows us to get the most RESTful sleep.
So if we close our mouth andwe try to snore, we'll find
that it's much harder than when weclose our mouth when we open our mouth
and try, and so we havemore instability of the airway, and that's

(03:14):
when we have more problems like snoringand obstructive breathing. But we need to
pay special attention to mouth breathing inchildhood because mouth breathing also affects the way
that our jaws and facial structures grow. Our face will tend to grow in
a forward, a downward, andbackward direction, and so we tend to
have more high, narrow palettes andreceded lower jaws when we mouth breathe.

(03:36):
And how did you find that out? This is incredible because I've never heard
of anything like this. I'm alayman. I'm not a doctor. I
get that. I just interview people. I'm a radio producer and radio host.
I get it. I'm not supposedto know all this. But I
had ear infections in playing them whenI was a kid. I had trouble
breathing when I was a kid.You're seeing that me and a lot of

(03:57):
other people could could have It wouldhave been a little bit better for us.
Now if that was the case.Is that what you're saying? Yeah,
for sure. So you know whenwe have a lot of ear infections,
well, part of that reason isthat when we don't breathe well through
our nerves, we're not actually filteringthat air with gems and bacteria, and

(04:18):
so we're going to tend to getmore infections of our middle ear. But
middle ear infections I also think area symptom of poorse swallowing, and so
when we don't swallow well, EUstation tubes don't work really well. And
to swallow well, we really needgood tongue elevation and soft palette elevation.
And when we have narrow jaws,we know that it reduces the support for

(04:41):
our soft palette and we don't getthat proper attention during swallowing. So there's
a lot of research to support thatpalette expansion in children can actually improve your
station tear function and address this chronicgluya and improve hearing thresholds. I'm here
with doctor Sharene Limb on book spectrum. Her book is called Breathe, Sleep

(05:06):
and Thrive, And this is important. You're a dentist, and we mentioned
it earlier, but you're a dentistand what puts you in that position as
a dentist to notice this and figurethis out that to a point where maybe
another medical doctor, even even anE and T may not have figured this

(05:27):
out. Well, we know thatnarrow palettes and receided jaws are really well
recognized risk factors for the development ofobstructive sleep out there, and we can
actually as dentists be the best peopleto identify when jaw development is off track.
So, for instance, when wehave crooked teeth, it usually is
a symptom for jaw development. Andso we can recognize those children that come

(05:51):
to us for their regular preventive care, those children that have problems like lack
of spacing between their baby teeth orcrossbites, or different orthodontic problems that reflect
poor development. And if we recognizethat the stimulus from jaw development comes from
the way that our mouth muscles work, we need to pay special attention to

(06:12):
the way that the muscles of themouth are working during sucking, swallowing,
and breathing in the early years oflife, when the jaws are developing most
rapidly. So we can look atthings like how the tongue is functioning.
You know, how well children arechewing, the tone of those muscles.
We can recognize a lot of cluesinside the mouth. Looking back, I
would have hoped to have this kindof knowledge when I was younger. And

(06:33):
again it's not easy to figure thesethings out. Because you're thinking, well,
the kids just making noises when he'sbreathing, the kids just clearing his
throat too much, or the kid'sgoing to a couple of your infections.
We can clear those up with adoctor. However, the good idea is
this book will help parents from hereon forward talk about the breathing complications that
we can have as adults. Ifthis is not discovered in one's youth anymore,

(06:58):
well, I think very important.One thing that we need to touch
on is really that when children don'tbreathe well, it affects their whole sleep,
and we need the most pastored asleepduring those earliest years of life when
our brains are developing most rapidly.So we know that problems like mouth breathing
and snoring are linked to increased riskof behavioral and learning problems and ADHD type

(07:20):
of symptoms in childhood. But foradults that develop more serious problems over their
life, they're going to have morefragmented sleep. Sometimes they can have drops
in oxygenation, and these can createchronic stress and information and increase risk of
virtually every health condition from depression,dementia, heart problems, you know,

(07:46):
cancers, every single chronic health diseasecan almost be linked back to poor sleep
and the quality of our sleep thatcomes from our breathing. I keep watching
commercials about junk sleep. Of whatthis is one bed company sleep in our
you won't have that junk sleep anymore. I'm sure to what extent people need
that extra comfort. But it's thebreathing. It seems like it's the breathing.
This book is in lightening in thatrespect because you're gonna and I said

(08:09):
it before, you're going to changea lot of young people's lives. You're
going to open up a lot ofparents eize. However, there are a
lot of people, again like myself, who kind of are stuck with these
breathing problems. Is there are waywe can maybe? I know we can't.
Okay, I'm guessing we can't fullyrepair this now, but is there
a way we can kind of flightback a little bit at least? Yeah?
If we recognize that these breathing problemsare actually a reflection of poor airway

(08:33):
development and poor airway function, whatwe can do is we can try to
restore the airway structures and restore theway that their airway muscles work. And
so when it comes to structures,we can basically look inside the airway.
Well, there are symptomatic improvements thatcan be gained by things like seapap or

(08:54):
dental devices that move the lower jawfor it. When these open up the
airway, they help people achieve morerestorative sleep. However, they're not particularly
targeted people rely on them, andthey really only band aid the nighttime problem.
So if we want to restore airwayhealth, which is good breathing and
good airway structure, we need tolook inside the airway for things like enlarged

(09:18):
tonsils, adenoids, problems inside thenose, deviated septums, those type of
things. But we also need toconsider the outer framework of the airway,
which is really formed by those jaws. And so when it comes to the
jaws, they really are the floorof the nasal passages, the space for
the tongue, and the framework forthe collapsible upper airway muscles. And so

(09:39):
there are adult interventions to restore thejaw structures. For instance, we can
do palette widening and adults it's alittle bit more complicated, but that really
can get to the root of theproblem for people that don't want to rely
on band aid solutions. So weknow, for example, a lot of
people that have nasal surgery when itfails, there's persistent nasal obstruction. What

(10:01):
is the common risk factor. It'sa poor palette or a high and narrow
palette, and so we can actuallyintervene with that. In adults. We
can also do double jaw advancement surgery. So that's generally regarded as one of
the most successful surgeries for obstructed sleepapnia. And what that involves is bring
those jaws forward. Because when webring those jaw forward, jaws forward,

(10:24):
it opens up the back of ourthroat, so it really allows the air
to flow more more freely between oursoft palette it behind our selt palette and
our tongue. Here's something interesting.You're in Australia. As I mentioned before,
I host another show called the OuthouseLounge. Right, I had a
didgerido player named hits Quatroni, andhe was telling me that playing the digerido

(10:48):
could actually help cure sleep apnea.And it made sense because you move your
mouth in very strange ways, indifferent ways where it does kind of give
it a workout and change the patha little. But since I have a
doctor here, What are your thoughtson that? Yeah, absolutely, so
I talked before with the different thingsthat we can do to improve the airway

(11:09):
structure, but we also need toimprove airway function, and so the ultimate
goal is achieving nasal breathing daytime andnighttime, but also the throat is a
collapsible airway and we need to improvethe tone of those throat muscles to have
a more stable airway. So wedo know that jijury do plane can actually

(11:31):
increase the tone of those muscles,and it's not really a frontline option,
but it can definitely help in supportwith other interventions to improve the way that
the muscles are working. We alsoknow that there's a thing called my functional
therapy, so this is really exercisesof the muscles of our mouth, including

(11:52):
our tongue and our throat muscles.And this was really there's been more attention
to that ever since that evidence forthe effectiveness of digitido playing, and so
we know that these type of exercisescan actually be a missing link to help
restore proper breathing after we have interventionslike orthodontic treatment and surgery. You're hearing

(12:16):
this from a real doctor, adoctor Scherene Limb. She's the author of
Breathe, Sleep, and Thrive,and she knows where she's speaking. I
guess I'm gonna have to get mea DIGERI do. That just has to
happen. Maybe maybe kids should getone prescribe a did we do to get
all sorts of kids? But Iwill say that this can get a lot
more serious. What are the what'sthe range of for lack of a better

(12:39):
term, since I said the wordjust a few moments ago, seriousness in
breathing problems as a child and wherethey lead to later on. Well,
if I can touch back to theidea that children should get a digity do
well, when we look at thosemuscles of the throat, really they are
those muscles that are involved in sucking, during breast feeding, swallowing, and

(13:01):
breathing, So we want to optimizeall those functions and even during speech.
And the next question was really aboutwhat is the impact on change. Well,
when I see children that are nothaving good sleep, that's a large
part of my practice, and I'mseeing children that are actually really not functioning
well. They have problems with emotionalregulation, They're having meltdowns, and parents

(13:28):
are feeling that they're working on eggshellsbecause they've got poor attention and concentration,
or children are just you know,very sensitive or difficult to manage in their
behaviors, and it has an impacton the child's whole family. So we
do know that when we have disturbedbreathing, it does impact the brain development

(13:48):
during those really critical windows. Anothervery important point in your book, you're
stress that these issues as a childcan also cause problems with intelligence memory.
Yeah. Correct, there's actually researchto support that there are changes that go
on inside the brain. We haveless gray matter in certain sections that are

(14:11):
involved with executive functioning and so on. But even when I see adults that
have disturbed breathing, one of themost common presentations is brain fog and memory
concerns. How does that work Thoughit's just breathing. Parents are going to
tell you, and kids are goingto tell you it's just breathing. How
would it affect the brain? Howwould affect one's intelligence? A couple of

(14:31):
different ways. So when we don'tsleep well, we have a lot of
sleep fragmentation and we're going to havepoor attention, and so that can affect
our learning. But also there isa direct impact because when we have oxygen
deprivation, it actually one of themost important things that will be affected is
our brain, and so that's howwe get the structural changes that are occurring

(14:54):
in our brain. Doctor Lim,you make sure that your patient find ways
to breathe better. But what makesyou decide to sit down and write a
book about this and share your thoughtswith the whole world. I think healthcare
is very compartmentalized. So one patientmight go to several different physicians, you
know, one for depression, onefor heart disease, one for diabetes,

(15:18):
one for you know, all theirreflux, different conditions, but no one's
really putting it all together. Noone's really addressing the quality of the sleep
and how is that being impacted bythe way that we breathe And when we
come to breathing difficulties, we're sofocused on diagnosing obstructive sleep out there,
and eighty five percent of people thathave this condition undiagnosed. But the bigger

(15:43):
picture is that we're missing all theprecursor forms. We're missing all those more
subtle breathing disturbances that occur during childhoodor premenopause or in those thinner individuals.
And so I think that when Isee the adult that come in that has
the brain fog and has had decadeswell for poor quality of life, it

(16:04):
really despaires me because I can seethe clues inside the mouth, I can
see the poor jaw development, andI can see that perhaps they have a
tongue tie which has restrict their normalor function. And we could have actually
intervened with this much much earlier,and we could have actually helped them achieve
a better trajectory of life. Andso as a dentist and with someone with

(16:26):
sleep medicine training, I'm able toreally bridge those professions and I feel that
I'm in a position to be ableto connect those dots, and I think
that it's really important for me toget the message out so that we can
ensure more people have a better qualityof life and also impact future generations as
well. As a professional doctor,lim you can figure these things out when

(16:48):
you see them in your patients.Parents, however, they might not be
so sure. What are some earlystage symptoms, if you will, or
things that parents can watch their childrendo that might alarm them and might say
might make them say, hey,let's go to a doctor. Let's talk
to doctor Limb or somebody who knowswhat they're doing about us. Yeah.
I can really discuss this in twoparts. Firstly, we need to let

(17:15):
parents know that it's worthwhile paying closeattention to how a child is sleeping.
A lot of parents, if theirchild sleeps through the night, they think
that their child's are really great sleepback because they haven't come in and disturbed
them. However, we need tomake sure that children are breathing with their
mouth closed and through their nose,and they're looking pretty still and peaceful.

(17:37):
And so parents can recognize red flagslike mouth breathing, snoring, any gasping
during sleep, any restlessness, sleepingwith their neck hyper extended, bed wedding,
teeth grinding, unexplained awakenings, feelingunrefreshed on waking. These are all
symptoms of poor breathing during sleep.And so if if we recognize also that

(18:00):
the jaws play an important structural contributionto the way that we breathe, and
the stimulus for good jaw development isgood our function, we need to be
able to recognize those earliest, oldestfunctions. For instance, if we have
breastfeeding problems or we have difficulties chewingand swallowing or sometimes picky eating can be

(18:21):
because of difficulties with these issues.If we have ear infections which are related
to poor swallowing a new station tofunction, and those type of problems like
nasal congestion or allergies, we needto be ablet that these are the earliest
warning signs. Doctor Scheren Limm iswith me on book a Spectrum. You

(18:41):
also formed a Facebook group for professionalsand other members to discuss certain ideas and
exchange them to help young people moveforward and get over what's happening, or
at least get the help they need. It's called it's called the Airway Health
for Kids. Facebook grew up AirwayHealth four Kids. The number four not

(19:02):
spelled out. Fo R tell usabout that. Yeah, well, it's
interesting. I just reflected that thatwas established seven years ago. And you
know, at the time when Ifirst became involved in speaking on these type
of topics, there was some oppositionfrom certain dental professionals that really didn't want
me to propose that dental treatment couldactually help with the child's breathing and sleep.

(19:25):
But I actually really wanted to beable to promote the research to support
this and why we need to bepaying more attention to it. And so
it just started off as a localgroup trying to disseminate information and it just
became much bigger over time. Sonow we have international professionals from all different
disciplines because I think that it involvesa team approach. All different childcare professionals

(19:48):
need to be on board with theimportance of healthy breathing through the nose and
good sleep. And I really wantedto promote more cross talk the medical industry
and also emphasize this in the book, that the medical industry tends to be
reactive when they see problems or seethe symptoms they can they can try to

(20:10):
cure them or try to work withthem, but it's very difficult to be
proactive. And again that what Iwas considered made up from the nineties on
wherever. That's a different story fora different day. But the idea is,
are there ways for parents to tryto prevent this from happening with their
young children beforehand, or or theirconditions you can give them and so they

(20:32):
don't develop something like this. Weneed to recognize that our very earliest warning
signs are what we call my functionaldisorders, which is problems with how the
mouth is working and it is functioningduring sucking, swallowing and breathing and chewing.
So when we have these issues likethose breastfeeding issues or dummy use or

(20:56):
taught swallowing, we need to recognizethe bigger picture that these are affecting the
way that our jaw structures grow.And when our jaw structures don't grow well,
our airway doesn't grow well, andwe're going to have some limitation of
airflow. And we need to promotenasal breathing because nasal breathing is a way
that we're designed to breathe and weneed to develop this as early as possible.

(21:21):
Once again, Doctor Sharene Limb iswith me on book Spectrum. The
title of her book is Breathe,Sleep, and Thrive. I want to
thank you for being with me here, but a couple of things that I
guess i'll rephrase it a little bitbetter. What would you like our listeners
who will read the book and anybodyreading the book to come out with the

(21:41):
most What would you want them tolearn from the book itself, and of
course to understand while after reading it. I would like people to recognize that
breathing our disturbances. We actually dohave quite a bit of control over developing
healthy breathing, healthy sleep, healthyairways if only we know what to look
out for. And so a lotof common issues that children experience are really

(22:07):
dismissed as things that they will growout of. Things like those ear infections
that we talked about, or teethprining or bedwedding and difficulties with their eating.
We need to recognize that they maynot necessarily be growing out of it.
It could actually be affecting the wherethey're sleeping and the way that they're
growing, and this could lead toa downhill trajectory of airway development and breathing

(22:30):
down the track. Doctor Limb,thank you very much for being with us
on book Spectrum. Thank you forhaving me once again. The book is
titled Breathe, Sleep and Thrive.Doctor Sharim Limb is the author. Doctor
Sharene Limb, thank you very muchfor being with us on book Spectrum.
Thanks for having me, Chris,once again, the book is Breathe,
Sleep and Thrive. If anyone wantsto find any more information about you,

(22:51):
if you have a website, andI do note that the Facebook page is
still there as well. That onceagain is I'm trying to get your say
that I'm sorry one more time.Okay, I'm going to say it one
more time. A right ready onceagain. The book is titled Breathe,
Sleep and Thrive by Dodtor Lim.If any of our listeners would like to
know a little more about you,if you have a website, they can
find you on. Yes, thewebsite is www dot doctor sharene Lim dot

(23:17):
com dot au. And I'm veryactive on social media, on Facebook in
particular, always sharing different cases anddifferent things that parents can look at for
as well, so that's another greatplace to find me. Exscelle find doctor
sharene Lim on her website and ofcourse on Facebook. Find the book on
Amazon and wherever you get your books, download, buy the hard copy,

(23:37):
whichever one makes you happy. I'mChris Cordani. Once again, thank you
for listening to Book Spectrum.