180: Dr. Ratti Handa, DMD: How Hidden Tongue Ties Could Be Sabotaging Your Sleep (And How to Fix It!)

Welcome to the Sleep as a Skill podcast. My name is Mollie Eastman. I am the founder of Sleep as a Skill, a company that optimizes sleep through technology, accountability and behavioral change. As an ex sleep sufferer turned sleep course creator, I am on a mission to transform the way the world looks sleep.

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Each week I'll be interviewing world class experts ranging from researchers, doctors, innovators and thought leaders to give actionable tips and strategies that you can implement to become a more skillful sleeper. Ultimately, I believe that living a circadian aligned lifestyle is going to be one of the biggest trends in wellness.

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And I'm committed to keeping you up to date on all the things that you can do today to transform your circadian health and by extension, allowing you to sleep and live better than ever before.

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Welcome to the sleep is a skilled podcast. My guest today is Dr. Ratty Handa. And I am really excited to share this podcast with you because it's all on the topic of tongue ties. And I actually just had my own tongue tie released about a week ago. And as you can hear, I'm actually quite relieved that I'm not speaking in a crazy manner because that was part of my fear.

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But we talk about why we are discussing tongue ties at such length on a podcast sleep. So you will be learning all that and more. And if you are someone, if you were an adult who suspects that you might have a tongue tie, this is definitely the conversation for you. Or if you know you're with a tongue tie and you want to see what some of the steps might be to potentially rectify that situation.

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If you're looking to go the direction of surgery. And then if you also have a child or if you're looking at This topic of kids and tongue ties. This is also an important conversation because all ages are impacted by tongue ties and sleep. So we're going to get into how they intersect. But first a little bit about our guest.

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Dr. Rati Handa is an internationally renowned airway TMJ and cosmetic doctor. Dentist. Dr. Handa is the dentist in Acton, Massachusetts, who has worked with some of the most prestigious specialty practices in Massachusetts. Dr. Handa has been specially trained in the areas of bio rejuvenation, dentistry, sleep and airway dentistry, and myofunctional therapy.

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Since completing dental school in 1998, Dr. Handa has been working with. It's been a continuous learner attending some of the most prestigious higher education dental programs, including the Panky Institute, the Spear Institute and the Stewart Center, Vivos Education and the Breathe Institute. Dr. Handa has spent hundreds of hours training in state of the art dental technology.

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And in this episode, we discuss what you need to know about tongue ties, the airway and how it all impacts your sleep and health. So let's get into the podcast. But first, a few words from our sponsors. If you're listening to this podcast, you're likely looking to improve your sleep. And one of the first places that many people begin when they talk to me about sleep is they want to know what's the supplement I can take.

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You're investing in your health, wellbeing, and quality of life. So again, go to you block out spelled the letter U block out, and use code sleep as a skill for a discount  and welcome to the sleep as a skill podcast. Thank you so much for taking the time to be here. I know you, we have a mutual friend in the sleep world, Morgan Adams, who connected us and I'm very excited to learn more about the work that you do and to have you introduce us to this topic of tongue ties and how they can absolutely in the situation in for many people can really impact their sleep results, and they might have no idea it might be literally under their nose. So let's jump into it. Thank you for taking the time to be here.

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Yeah, thank you for having me. I think I've been in the world of sleep medicine now for the last six, seven years. And for me, the linchpin really was the understanding of tongue ties.

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Yeah.

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So doing all of these different things. Um, combining worlds of dentistry and then sleep and coaching and functional medicine, but really understanding of like the true why for most sleep issues, not all sleep issues.  Eye opening about what is loosely called tongue ties.

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Yeah.  

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And I say loosely because it really refers to tethered oral tissues.

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It's called TOTS. And most of us If we had no idea about this world would say, well, we're not tongue tied because we can talk,  you know, we can swallow, um, our tongue can move around in ways of sticking it out, which, which was the traditional medical test to see if you had a tongue tie, if you could stick your tongue out.

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Um, way, way, way back. And so for that  person who's not done this deep dive into tongue ties and airway centered dentistry, you're not going to know that you have a tongue tie. Yeah.  So,  and within the world of ties, I think it's important to understand that we are all meant to have a tongue tie. a connective tissue called the frenulum under our tongue.

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So for people listening to this podcast, if you took a second and just actually put your tongue up to your palate, just the tip of your tongue up to your palate and open wide, you'll feel a little string. to your finger under your tongue.  And if you went a step further and tried to suction your tongue up to the roof of your mouth, almost like if you're clicking your tongue, like,  and you catch that tongue on the top of the click and suction it up to the palate, you'll be then able to take your finger and.

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feel that piece of connective tissue almost like a thread between your tongue and the floor of your mouth.  So depending on how loose or tight that is,  or whether you can do what I asked you to do or not, And if you are the measurements, you can actually gauge what grade you're tie in, tie in.  And I think the world is still trying to come up with a universal classification or what grade of tie and the best.

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person, people who've come close to getting universal is Dr. Zaghi of the Breed Institute in defining that. And I know like a lot of their work, they keep trying to get better and better and get more data. Um, but in that world, we've learned to classify it as grade one to grade four. There's also Kotlow's method, but no matter what the premise of all of this is, does that tethered tongue tissue  impact your airway?

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So a few things which I think make up a big part of a dental checkup are of course, you know, gums, gum health and cavity health and oral cancer screening, but also is does your tongue rest and live up on the roof of your mouth?  Are your lips relaxed in a closed mouth posture?  Is your TMJ relaxed in the right place?

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And do you have an appropriate swallow?  Because even just that appropriate swallow is the very first part of your digestion after chewing.  So, I mean, there's just so much indirect,  you know, contributing factors because just say that we're not chewing or swallowing appropriately, that food doesn't get digested appropriately.

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And even that stuff can keep us up at night. Right. Absolutely.  So there's many other functional ways besides the physiological aspect of having a tight finalum or tongue tie, tethered oral tissue, whatever may have you. Absolutely.

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So for anyone listening that maybe is unsure if they are dealing with a tongue tie.

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You walked us through some of those components of being able to hopefully get a sense of potentially what that we might be dealing with this and that there's different grades of tongue tie. What would be the best steps for someone if they suspect that they are dealing with this? Maybe they're a little unsure about this specific grade.

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How do they even begin to navigate this? And then naturally to knowing that there's two buckets that people might be thinking of this often in for children and then for adults. So I wonder if you can help guide us on those questions.

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Oh, I think the first thing to do is, I would say, in order to get a better diagnosis, uh, first find an airway centered provider.

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So find an airway centered dentist or a myofunctional therapist. Or a, um, ENT who really understands the importance of tongue ties. Um, Who can, who can help you understand, I do think that the world is growing into pediatricians and GPs and other people, but as such, try to find somebody who can help you identify, but if you took, if you actually went to Dr.

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Zaghi's website on the Breed Institute, he's got a great patient resource on classifying tongue ties, tongue space, and I'll touch on tongue space too in a minute,  where you can look at and try to take similar pictures.  Okay. It's also really great  to take a tip as if you suspect your child to have a tongue tie or a breathing issue, just take a little video of them sleeping.

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You don't really have to think about a fancy sleep test in a hospital first. Just do a little 30 seconds, 60 minute video of a snoring partner, a child, or have somebody tape you if you suspect you're having a sleep issue at night.  And then take those tongue pictures, you may, you may actually not even classify yourself as having a tongue tie.

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But if you have, say, if you get frequent headaches, or you have jaw pain, or you, you know, you have a history of cracked teeth or bad breath or insomnia or anxiety or high blood pressure, literally anything, you may have a tongue tie.  

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Yeah, and that's what's so tricky about it, too, because it's so interesting, the rabbit hole that it can be the symptoms can be so surprising, right, like, and then on the plus side of if people are getting the tendency to be overwhelmed, or Oh, no, this is a whole new world to navigate on the bright side of it once we deal with this, which is a couple steps to navigate.

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But once that's handled, I get this, and especially I looked at your social media. You do a great job of kind of sharing some of the benefits that come on the other side once people really delve into this handle that's and surprising benefits possibly like the release of neck pain and the dropping of some of those headaches and just some of these things that you might not initially connect could be linked up with something that could feel so small but turns out to be so immense.

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No, it is. And I had that own experience for my own self. When I had mine released, I felt like I had these, like these shards in my cheeks, like I was in prison that I didn't know I was in.

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Wow.

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That started in my face, down my torso, and then it went down my legs. And I definitely had an emotional release afterwards because the way my nervous system responded.

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And having said all this,  because All of this information, if taken within like a little, you know, tunnel vision approach is, if, you know, if somebody says, hey, I want all of this, so I'm getting a tongue tie release, um, I think be warned, beware, because you may or may not achieve all of this.

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Yeah.  Wise. Important.

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And, and in my experience now, I've seen people who are, who either become more body away or are body away, also do a lot of collateral therapies like body work. And we can talk about that in a minute.

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Yeah.

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Um, but just generally are also doing their homework that they're supposed to do before and after a Tantai release in terms of those exercises.

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Um, Those sort of things help  get you that outcome. And once you have a Thai release, that's the beginning of the next step in the journey. Because now the body has to relearn what to do with this freed up tongue. Because it's very, very important for us to understand and wrap our mind around.  That, that frenulum under the tongue is the very tip of something called the deep front fascia line, which is one big fascia line

that, that researchers have seen in anatomical dissection.

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There's a lot of research out there, pictures, videos in humans. When you dissect the fascia around that tongue, it actually goes all the way around your neck, TMJ, um, middle part of your body, pelvis,  down your knee to your toe. So I have had at least a handful of patients who have told me that their toes straightened out.

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Wow.  

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Oh my gosh. It's so interesting because this deep front fascia line can't really access it from the outside. Sure. Wow.  So you are really respecting that when you are being body aware,  getting the appropriate body work, appropriate myofunctional therapy work. And, uh,  also, also seeing the tongue as this beautiful organ that  You know, when you go to the dentist, we usually typically take a dental mirror and take it out of the way so we can see the teeth and the gums.

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But instead of just taking it away, actually looking at it and saying, Oh my gosh, this is  at least eight muscles,  at least five nerves, five of the 12 cranial nerves, and it has a direct link all the way down to my toes. And it's the very first part in my digestion.  Wow. That's amazing.

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Yeah. Wow. Well, to use myself as an example, I am gonna, I was sharing with you before we hit record that I am about to be undertaking the process, I'm in the process of kind of the prep to get a tongue tie release with Zagi in LA.

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And for me, I share this because I have had these hesitations when going down the rabbit hole of concerns around how much, you know, I might be getting myself into now some people so you know, maybe you can help break this down for us and myself. So some of my concerns have been here are these amazing stories of some people just like one and done and then it's a relatively easy breezy experience and then they get all these benefits.

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A couple of things that I'm hopeful that I might benefit from include, I tend to get still more headaches than I would like, given how much I do for health and well being and all the kind of biohacking and sleep optimization, all the things, more headaches. And then particularly this neck pain, this like intense ness going down the neck.

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So my hope is that that will be beneficial. But then you go down the rabbit hole of different forums and conversations with people. And then you can also see how this sometimes begins this whole next step of the journey of needing to deal with potentially pallet expansion and marpy and all these other steps that might come to play.

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And so I've been kind of dragging my feet on how long is this going to be, especially since I talk for a living and will this kind of interrupt some of the things that I do forward facing anyway. So. I'm wondering if you hear things like this, or if for you, given what you see, you feel like those are unfounded concerns, what your take might be?

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Well, I think first of all, I, I think that because we have all of this out there, right? Like there's people with these aha stories or me even telling you my own story.  I think the first thing to, to understand is it doesn't, nothing gets completed with one step.  This is a part of a bigger. bigger thing because you've been living with these compensations that you've built in now for a dysfunctional tongue for your whole life.

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Absolutely. However,  as you learn the information, it may feel like a lot, but if you have the right team of providers, it's, it's just simply following the step by step by step, the next step.  And, um,  You know, your speech might get affected. Like, so when you have a Tantai release, you're probably not going to want to.

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Yes. Or maybe the next day. Okay.  By the third day. And  I really think it's an invitation for people to slow down  because the instrument tongue tie release is you have an opportunity for your sympathetic nervous system to shift towards parasympathetic  as that tight fascia starts to release around our nerves and stimulates vagus nerve.

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So when you can actually put the back of your tongue up on your palate with a good suction hold after release, you actually stimulate the vagus nerve. And we all know vagus nerve is like magical king.  Totally. Yeah. Yeah. And, and so  I think understanding that, um, it may seem very new to somebody listening to this, but for people who've been doing it now, it feels like, yep, we've got a plan.

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We know how to execute it. And yet, I will caution every patient, just because your dentist has a plan, your ENT has a plan, your myotherapist has a plan. It still may not be the right thing for you. Mmm. Interesting. So, so how to walk your talk and limit and not have to buy into  the Kool Aid so as to speak.

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Yeah. That's well said. Have you seen that often where you would have people come in and you might advise them against then having the tongue tie release or?

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Not often. Okay. Because I have a great, um, discernment process and. Sure. By the time someone gets to that stage with me, but especially in the beginning, when I didn't have that, I have at least had two or three experiences where I felt like I couldn't just go in and do.

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What they were asking me to do, like a tongue tie release, because I could feel some other factors which are my pillars of health for somebody was so off.  So the person that I'm thinking about was the mental pillar and the emotional pillar of health were screaming of needing help. Yeah. So I, tongue tie release would not fix that right away.

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It would in subtler ways, but,  um, so, you know, you, as a provider, you've got to choose when is the right time just because you have the knowledge.  It doesn't, you have to be wise enough to know when to execute that. Absolutely. So when I do my tongue tie releases. It is a beautiful procedure. It is. Um,  I tell my team, I tell my kids I'm like hermit, surgeon mode.

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Nobody talk to me, bother me. It's me, my patient, my assistant. And we're almost in this spiritual zone with the surgery and  do some hands on craniosacral fascia work in between steps and checking on where that fascia is releasing in the rest of the body,  more non invasive and we're also soothing the nervous system.

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So we put like a weighted blanket on so that we're also monitoring the heart rate. So, you know, those variables that, um, you want to see objective data,  um, To, to kind of see what's happening to the heart rate, what's the oxygen level, and just generally there's, there's usually a tone shift, even in conversation, you know, it, at some points, a lot of my patients go still and you can see there.

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Nervous systems unwinding  and sorting itself out and we're just there to support them through it.

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Is that all part of your specific protocol or is that a standard protocol? I'm just curious if that is what most providers, so if someone's listening and they're in Iowa and then they get that.

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I think that if you are associated with Breathe Institute, and I know you're going to see Dr.

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Zaghi, so I'm in affiliates, I've done a more extensive training with him. I think he really gives you the, and there are other people who teach great work, it's just, I've gone to him. He gives, he gives the clinical ground rules of what to do, which I think form the basis for providers like me. To put their own take.

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Okay. So my take is I'm, I'm a little bit more, um, conservative. I am also, I like to be in tune with the body. I like to look at mind, body, soul approach. That's my approach. I'm all about feeling the fascia and feeling the person. And so that's become my approach, but in the approach, any approach that you have is.

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As a provider, I think the things you want to ask for when you call to say, hey, do you release tongue ties? You want to ask things like, what is your procedure? How do you screen?  Um, what kind of instruments do you use? Are you using a CO2 laser, hand instruments, a combination? Do you use suture?  Do you, do you use suture?

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Do you use glue? Uh, what's your post op like? So you want to ask those questions because the more we learn  is that we want to suture and we want to use glue or one or the other to the best we can because we want what we lovingly call the wound to find a different meaning in tongue ties. It's this loving wound under your tongue that will heal the best if the two sides of that wound come together and it forms the least scar tissue.

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And because this is connective tissue that we're releasing under your tongue, it has this tendency to want to attach back at some level.  So you want to make sure that you understand your stretching protocols with your myofunctional therapist before and after that you lined up some great body work, whether it be a good myofunctional therapist.

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Um, good craniosacral therapy. I love craniosacral therapy as an adjunct for before and after, or a good, good, good massage,  osteopathy, chiro. You want some of these visits lined up before and after. Okay. As well as following through with your myofunctional therapist, uh, post op healing stretches. So in my practice, I also use something called a Summus laser.

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So it's an infrared laser that does photobiomodulation  before, during, and after the release. So that's helping the wound healing be optimal, least painful, least severe. Less than claim, but you want to ask your providers those

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kinds of intelligent questions. Sure.  If you've tuned into the show or followed any of our content here at Sleep as a Skill, you may have heard that everyone that we work with wears the Oura Ring.

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Sleep. So head on over to Beam Minerals, spelled BEAM today, and use the code Sleep as a Skill, all one word at checkout to get a special discount on your order, your body and your sleep well. Thank you.  And what you said about the photobiomodulation, that's interesting. I don't know that I've heard about that.

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So could someone listening that we've got all kind of a lot of biohackers, if you will, and they might have red lights, red light therapy. Is that something that they could use on their own or is that not? Is it a different conversation?

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We can touch on it. I think that no red light is bad. You don't even like little handheld ones that you get on Amazon.

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This is a, uh,  It's a different animal, it's four lights, it's got different wavelengths, it's doing four different kinds of things, it's a medical grade laser, but I do think that you can harm yourself by using something at home for red light healing.  

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Okay, that's perfect. And as far as, and I think you touched on this, but just to make sure I heard you, for the Myofunctional therapy prep work, what would people expect for the length of time that you would like to see people kind of engaging in that?

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Or is it case by case? What does that look like?

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I think that's a good question because I think that as we all grow and learn from each other, we realize that it can't just be the length of time to get the patients so called ready. of time to Yeah, it really depends upon if they're able to accomplish the things they need to do  in order to hold a certain posture during the procedure, um, or being, or have that, and now, if you're a grade four, for example, you're very severely tied, you really can't do a ton of pre op myofunctional therapy.

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You really, you really got to do more.  So it's a conversation between the  myotherapist, the patient and the dentist to really decide when is this person ready and being ready could also be contributed by, you know, the patient might have done six sessions, but doesn't do the exercises. So while they're technically ready, because by six sessions you should be ready, they're not ready.

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Or someone just, just gets it that Thai is not, maybe it's a grade three, bordering on grade two, they've been doing other things to help that tongue, um, release. So there are other modalities that can help treat tongue better. Um, they might be ready in two sessions.  I think the best thing to do is, um, in my opinion, is Kind of almost  work towards getting ready and then schedule your release.

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Smart. Okay. You also don't want to not schedule it because you don't want to keep doing these, you know, we're all human. Yeah. We're not going to do these additional things for you. a time span that has no end to it. Yes. A time span with an end to it is a good thing.

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That's so wise. The, uh, maybe Parkinson's law component.

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Very good. So then how about, I have heard some of those cautionary tales of some people speaking to that they got a tongue tie release and then they dealt with new issues as far as blocked airway as a result of the tongue tie release. Have you seen that often or would you hear that and think potentially that's more to do with the lack of preparation or the aftercare?

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Any thoughts there? I think that I personally haven't seen it,

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but I do think I've been trained well. Yeah. One of the things that we got trained to do is patient selection. Yeah, right. So if someone's airway, and I want to, I want to talk a little bit about getting that CBCT scan done, which is  actually of your head and neck area.

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I think that's a really awesome thing to do before you do this procedure, because you and your doctor and your provider team has a better idea of the architecture.  So if you have like a coffee stirrer, narrow airway, And you release your tongue all the way, for example, could that block that airway more and cause more snoring?

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Yes, it might,  um, but wouldn't have been great to have seen all of this before releasing it. Yeah, definitely. And the other thing is, some of the other things, like, maybe you weren't doing, or you,  Your tongue was just not toned enough to actually get the release done, or you just don't have enough tongue space, like you're really, really narrow and in your situation, it doesn't make sense to release you a little bit, let the talk come up and I want to talk a little bit about that.

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Tongue up and what it does to nasal breathing and expansion. Um, but those are all discussions to have as a team. This is a team approach.  It is not a, you know, I'm calling getting in tomorrow and getting my release.  This is definitely a team approach. It's a, it's also,  it's not like as hardcore as like getting a filling done or your gums cleaned.

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It's, it's a little bit,  It's a little bit in the, when you have fascia stuff, a lot of things can be subtle,  but sometimes it can be really dramatic. Like  we just had a patient this week who said that, um, as she was driving back, she could hear better, her, her space behind her right lung opened up, her neck was loose.

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So some people can have  a lot of crazy things. amazing things happen.

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Absolutely. Wow. Okay. And I know you mentioned to the component of some of the benefits of the posturing of the tongue and nasal breathing, any things that we want to underscore for people before we switch over to how you're managing your own sleep or any final things that you want to make sure that we address in general around tongue tie and sleep.

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Sure. I think that

understanding that, again, just going back to saying how  magnificent the tongue is,

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it's,

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it's almost as magnificent as the heart in terms of the, the muscular and, and the job it does. Yeah. But if you can imagine this whole tongue sitting up on the roof of your mouth that actually stimulates palatal cells to grow in children, for sure.

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But it stimulates any of these appliance therapies, orthotropic approaches, epigenetic approaches, for that palate to settle into the cranium,  for the sphenoid bone to start to move, for the temporal bones, all of these bones around. the maxilla or the upper jaw.  There's a shift in everything.  And as we're doing that, when we do have bowel expansion of some sorts or movement,  the floor of our nose expands.

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Because this, if you didn't walk away with anything, walk away with this. The roof of your mouth is the floor of your nose.  So the more internal space your nose has doesn't mean your nose is going to get bigger, but the more internal space your nostrils have, the better job your nose will do in breathing.

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And the premise of great sleep is nasal breathing.

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Ah, so well said. Beautiful. Well, actually, real quick, I'm curious if you do have any thoughts about this. I'm about to be speaking at an event in LA coming up called Biohack Your Beauty, and they want to touch on Tongue tie and how this could affect your physical looks any thoughts on that that you would kind of point to I know that's a big topic, but

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Yeah, well, in a big broad way, because it starts to lend itself to facial symmetry.

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Yeah, you see, because it's because of the time and the complication ramifications in the skull and the way the eyes are,  it contributes to facial symmetry, which is beauty.

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Yeah.

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So the left and the right sides matching, you know, most of us. don't have that matching. Yeah. And the other way it contributes to beauty is it relaxes your upper lip.

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Say you have an upper lip tie. Sure. Um, if you have like that area relaxed now, so now you don't have such a gummy smile. Sometimes you have a more  That's what I have.

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Yeah. So it's like, hello, all that gumminess. So I'm, I'm happy to hear you say that. Cause that's been part of my research is finding that that there's likely some ties there.

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No pun intended. Yeah. Sure. Oh, interesting. Okay. So it's funny. far reaching. We've spoken of the many different kind of maybe unexpected symptoms that you might have if you are dealing with the tongue tie. And on the plus side, the potentials that could await you if you set yourself up powerfully, find that informed provider, go through the steps thoughtfully.

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And then on the other side of this, there could be some real benefits, maybe surprising benefits for such would feel like a small procedure. I mean, how long does it take? Not very long, right?  

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Very long. And I think also, I think that if we can start to think of it, because when we don't know enough and we think of a tie, we think of a knot, right?

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Yes. You think that your tongue is not tied in a knot, but I want you to start to think of it as tension.  

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So

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no tissues in our body. Have tension, but when there's tension underneath, you'll see a blanched look or a whitish look or just a pulling under your neck or wherever back of your head. Sure. So almost like start the mind shift from not imagining it like a tie, like a knot,  but looking for tension.

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That's so interesting. It's funny. One of the books that I read on this, I don't know if you would recommend it or not, but it's called Tongue Tied. Yes. Right? Dr. Baxter. Yeah, Dr. Baxter. And, uh, on the front of it is a big tie. And I almost wish that it was more to what you were pointing to. Somehow we could kind of demonstrate a little less of the tie, a little more of the tension, but so well said.

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Because most of us will think we don't have that knot. Yeah. Yeah. I was like,

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that's not me.

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Yeah. Yeah, exactly. Which is the same thing when you ask somebody, are you mouth breathing? Most people will say, are you crazy? Like, cause when you think of someone mouth breathing, yes, you think of like, just this, you know,  like mouth open saliva dribbling, but really mouth breathing.

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You, the way to ask somebody is, do you ever catch yourself breathing with your lips apart? So well said. And you'll lift that one part and then you might get more information.

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Ugh, and if anyone, one of my favorite places to spot this is on a plane and you just see so many people with the part, you know, the parted lips immediately, like very close after takeoff.

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So many people are sleep deprived, they fall right asleep and then boop, that Chin goes down. But I like how you're saying that too, because then it's maybe a little less of a judgment or something for people. Oh, well, I'm not. You feel a lot is judged just the snorer and you know, your wife or husband tells you, Oh my God, you snored so much.

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Sure. So  you know, in my opinion, there's like this snorer and there's the snoree, and they both have complete different experiences. Yeah. And it's just how do you communicate around those things that can feel like a judgment that shut down further evolution.

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Absolutely. No, I love that. The communication, the languaging of all this, because for many people, this is a whole new concept and they might have some identity preservation concerns around this.

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So I appreciate that languaging. So for every person that we do bring on the podcast, we do ask them four questions around how they're managing their own sleep. Clearly, you've thought deeply about this topic. You're in the weeds on this topic and you even have dealt with this yourself, which is a unique component as well.

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So curious. Our first question that we always ask everyone is what is your nightly sleep routine looking like right now?

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So my nightly sleep routine is obviously brush and floss my teeth. But I make sure that no matter what I'm doing, I have my tape on my lips. So I like to put it on like 30 minutes or so before I actually fall asleep.

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Um,  the only times I don't tape is if I have a cold or sinus infection,  but I tape even on that plane, on like my long plane journeys back to India. I am the one who's taped,  um, all the whole flight. So tape Oh, I love that.  Um, I have a relaxing, uh, Valerian routine, not too close to bedtime,  just so I don't have to keep getting up to pee, but about an hour, an hour and a half before I go to bed, relaxing tea, I, in my mind, I have this quick meditation where I take everything from the day and I put it in a imaginary trash can.

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Ah!  Two seconds to do. It's not fancy. Sure. But I take everything from my day and I put it in a trash can.  And, um, so then I tape,  put my dental appliance, I tape, and then I also, is that your question?

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Yeah, absolutely. Anything that might be relevant of how you manage your evenings to support your sleep and surprising the things that we can learn because I've never heard anyone say that.

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So that's great.

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And then I. Just recently, about a month ago, I got the Eight Sleep Mattress Cover. So good. And going through menopause right now, that mattress cover is a friggin game changer. Like, it's my best friend. It knows me now. It's totally done.  I'm going through a lot of big team change at my office.

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Life is crazy sometimes. But when I wake up, I'm like, Oh my gosh, my sleep's great.  So um, I just think that is an amazing investment to make. And I just, Thanks. I am so grateful that my menopausal self has met that mattress right now.

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I'm so happy to hear that. You know, so over the many years that we've been working with hundreds and hundreds of people all wearing the Oura ring in particular, so we've got a very large data set of information around how people can improve and optimize their sleep outside of the research realm.

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And what's been so fascinating is there's a couple things reliably that we can point to that will assist. almost overnight, literally change, you know, the other things can be longer, take some more time, but those cooling mattress toppers, the chili sleep, the eight sleep for some people's sleep number makes such a difference.

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It is so important. So I'm so glad you pointed to that. Yeah.  Amazing. So good. Okay. So we've got a sense of your evening. I love the meditative process too. And to your point, it's like quick. It doesn't have to be arduous. It's sort of just a mental process. Because I think in our world, you know, um,  and anybody listening to a podcast is somebody who wants to self improve, right?

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Yeah. You're already like a go getter. Like you want to do that next best thing.

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Yeah.

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And I just find like adding on like lots of different things is where we fail. Absolutely.

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Absolutely. So.

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First of all, that's why I like habit stacking, like stack,  trash can, like take everything out and put it in a trash can.

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When you're sipping your tea, like try to do a few things.

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I love that. It's so good. Okay, amazing. And to your point, you can habit stack this and maybe you have it all lined up with in alignment with when you brush your teeth, floss and put on the mouth tape and then you know that then you're also dealing, putting away all the worries or whatever of the day.

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When I put my mouth tape, for me, it's

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It's, it's like my binky. That's how a little, little toddler must feel or a baby in their crib. It's like, okay, it's time to, that's what I associated with.

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I love that. So good. And I also love that you said how you do that on these long flights, that you'll do that throughout the whole time.

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Cause I haven't done that an entire flight. I might do that when, uh, for the kind of sleep.  But I like what you're pointing to because I have a flight coming up to Singapore and it's the world's longest flight, like almost 19 hours or something and say, so I will be practicing that. So thank you for that reminder.

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So what might we see on your morning sleep routine? And we say that with the thinking that how you start your day can impact your sleep.

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Sure. I always look at the sun. Always. I open my eyes. I mean, even in non, non sunny day, you know, you look outside for the, for your, cause that first hour that you wake up, your melatonin and cortisol is trying to stabilize.

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Yes.

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So I don't eat or drink anything in that first hour. And I look at the sun  and I, Get out of bed and go about and do my own normal stuff. But that's, that's just like the very first thing is look at the sun or look outside.

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So important, so important, especially in the northern latitude locations. I know you were, we were chatting about how I also was grew up in Maine, lived in near where you are around Boston, New York, what have you.

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And during some of these stretches of time where the sun isn't as powerful over the winter months, it's even more important for us to prioritize light exposure. So that's great. And even if we can get a 10 minute walk in outside, whether it's, even if it's like cloudy or cold, just actually that sets that circadian rhythm for, for the evening.

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Um, and it gets you out of your head, I think. Yes.

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Oh, totally. I like to think of that as kind of a walking meditation or, you know, that environmental meditation. And then what might we visually see on your nightstand? So in your environment, and maybe if you're traveling, proverbial nightstand, you know, kind of things in your space to support sleep.

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I've got some essential oils that I love. I love lavender. I have just, my lamp is a yellow light lamp. So it's like one of these salt, you get these salt bulbs, Himalayan salt bulbs that you can get on Amazon. Sure. So my night's just really soothing. There's no Sharpness. And I try actually to have my nightstand butter free because if there's too much, like even if there's too many soothing things, it's too much.

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Yeah. Have just a water, my tape. The oil and the lamp.

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Love it. Yeah. There's been a theme over the years of, um, kind of the peaceful nature that seems to come from a minimalistic approach, uh, for the things in your space. So really important. And lastly, what might we see in your life that's made sort of the biggest change to your management of your sleep?

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Or maybe said another way, maybe biggest aha moment in managing your sleep. That's a tough one.

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There's so many. Totally.

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I guess, you know, obviously I've spent so much time learning about  the jaw, the size of  our jaws and our tongue and all of that, but on a behavioral aspect, maybe eating three hours before I go to bed,

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like, like,  stopping consumption three hours before probably has  been the simplest and the most impactful behavior change.

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Absolutely. I mean, pointing to what we see with all of these data points, that is right. One of the next ones that I can share that we reliably see. C makes some of the biggest difference measurably. And so on different metrics, particularly things like lowering of heart rate, improvement of HRV, for some people, things like deep sleep, although those are a little less accurate to sleep stage classifications, but we can very often see that make a difference.

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And for some people even starting to creep even more once they get comfortable with three hours than as they might play even with the day. four hours or five hours whoop is about to be releasing a big study where they found some real benefits of four hours. So playing with that last, you know, kind of bite of food and the timeline of that and making it circadian aligned.

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So we're aligning that with the rhythms of nature we think about historically, it's very unlikely that we would have been eating far into the night. far past when the sun is set, because you just wouldn't have the pantry, the refrigerator, you just, it just wouldn't have really happened most likely as our understanding.

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So love that. And then how can people learn more about the work you're doing follow kind of very clear to me that you've thought deeply about this area that you're passionate about sharing on this topic in the many, many benefits that can come by walking down this path and this journey and how much transformation can be available.

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So how can they best follow you or

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work with you as well? You can follow me on Instagram or come visit my practice or call us or we do virtual consults. Um, but we also have, I also have great colleagues that I can, I can direct you to. I think the biggest shift for me when I entered the airway world. And then within that, the tongue tie world was that I don't have to do this alone,  which was different from when I was doing regular dentistry within my office  where we still work with specialists, but this is a whole different level of.

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Playing on a collective level, because I find that my colleagues are very generous with sharing and we share cases, lots of forums, people who are down this path and really committed to learning and  teaching and doing it. So I just think it's a very rich community. environment of growth within this world of airway dentistry.

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Um, so if you reached out to me and I couldn't help you, I think I would have pretty good resources to support you.

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So great. Well, I am grateful for the work you do, for the information that you share and for you taking the time today. It really makes a difference and so important and just really illuminates potential solution for people and they might not even realize they were dealing with this.

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So it's It's really, really impactful. Appreciate the time and more to come. Thank you, Mollie. Thank you for what you do. Oh, well, thank you so much.  You've been listening to the sleep as a skill podcast, the top podcast for people who want to take their sleep skills to the next level. Every Monday I send out the sleep obsessions newsletter, which aims to be one of the most obsessive newsletters on the planet.

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Fun facts. I've never missed a Monday for over 40 years. Five years and counting and it contains everything that you need to know in the fascinating world of sleep. Head on over to sleep as a skill. com forward slash newsletter to sign up.