There are 3 methods to treat obstructive sleep apnea non-invasively. Two methods have been traditional. The earliest method was CPAP which continues to be effective especially for the treatment of severe sleep apnea. Many patients, however, cannot tolerate CPAP for many different reasons. The second traditional method has been a custom-made, intra-oral sleep apnea appliance. Recently, a third method for the treatment of sleep apnea has been developed. It is called the Einstein Method.
The beauty of the Einstein Method is that it can be used as a stand-alone technique, or used with either CPAP, the intra-oral appliance, or when CPAP, and he intra-oral appliance are used together. It is important that you understand how the Einstein Method works. This understanding can motivate you to easily incorporate the Einstein Method into your daily schedule. Doing so will improve your sleep and give you more daytime energy.
The most common cause of obstructive sleep apnea is when the base of your tongue falls posteriorly to the back of your throat, thus blocking the airway. Figure 1 shows the back of the tongue obstructing the airway in the area of the throat between the soft palate and the epiglottis.
Keeping your tongue forward will be helpful to prevent this posterior collapse. There is only one muscle that can keep your tongue forward. It is called the genioglossus muscle. Forward tongue position is accomplished by strengthening the genioglossus muscle. The Einstein method is designed to strength the genioglossus muscle. The stronger the muscle, the more forward will the tongue rest, thus keeping your airway open.
Figure 1 shows the genioglossus muscle. This muscle is the only muscle that connects your tongue to the lower jaw. It is the only muscle that moves your tongue forward. By virtue of the anatomical connection of the genioglossus muscle to your lower jaw, the tip of your tongue can move forward, completely out of your mouth. The genioglossus muscle is fully contracted only when the tip of your tongue is sticking completely out of your mouth. In order to strengthen the genioglossus muscle to its full potential, full contraction of the muscle is necessary. However, we as human beings seldom stick the tongue out of the mouth. The common activities of the tongue - talking, singing, eating, swallowing - keep the tongue inside the mouth. Thus, the genioglossus muscle is almost never fully contracted, and so, it is never fully strengthened. Moreover, with age, muscles get weaker including the genioglossus muscle. As the genioglossus muscle gets weaker, the more apt it is to fall posteriorly to the back of your throat and block your airway.
Strengthening the genioglossus muscle will tend to hold your tongue in a more forward position in your mouth while sleeping. When you are sleeping on your back, gravity tends to force your tongue back and narrow the airway or temporarily completely block the airway as shown in Figure 1. Note that in Figure 2 the airway is open and airflow is normalized. When the genioglossus muscle is strengthened and toned to a maximum degree, the tongue works against the force of gravity to keep the airway open.
The single page instruction sheet for the Einstein Method is attached. Follow the step-by-step instructions. It is important to remember to begin the Einstein Method gradually. Your genioglossus muscle is, at present, very weak. It has been weak for a long time. If when you start the Method and begin by fully contracting the genioglossus muscle by sticking the tongue out to its maximum extent, you can injure the muscle. For the first 3 months of performing the Einstein Method, you must gradually protrude the tongue. Figure 3 shows the tongue position for each successive month.
The Einstein Method
A daily Method for people with sleep disordered breathing.
It is important to gradually protrude (stick out) your tongue keeping your upper and lower lips around your tongue. Do not open your mouth wide. Protrude only ½ inch for the first month, and for each successive month another ½ inch reaching its greatest protrusion in 3 months.
1. Protrude your tongue for 30 seconds, then relax your tongue for 30 seconds.
2. Repeat 5 times
3. Perform this method 3 times per day
This Method may appear unusual, and for some patients embarrassing even when performed alone. Therefore, perform this Method during non-social occasions, such as driving alone in your car or in the shower. As a beginner, do not perform this Method when lying on your back.
Strengthening the genioglossus muscle is extremely important to help hold your tongue forward during sleep. As adults, we rarely fully use this muscle. Thus, make this Method a part of your daily routine.
Brian D. Fuselier, DDS and Barry A. Loughner, DDS, MS, PhD, are members of the American Dental Association. Dr. Fuselier and Dr. Loughner are in private practice at Central Florida Oral and Maxillofacial Surgery in Orlando. For contact information visit www.cforalsurgery.com