The Seattle Protocol: Dealing With Sleep Apnea

Dr. Carlos A. Alonso, DDS

The Seattle Protocol was developed by two dentists in the Seattle, Washington, area. It is a six-step process which helps patients who struggle with obstructive sleep apnea or other sleep disordered breathing conditions like upper airway resistance syndrome. Sleep apnea is a condition where the soft area at the back of the throat or the tongue relaxes during sleep, obstructing the airway. Upper airway resistance syndrome is a condition in which your body is working so hard to keep your airway open, it creates an incredible amount of stress and releases high amounts of cortisol, creating excessive amounts of inflammation.

Often when one thinks of sleep apnea, you may envision a CPAP machine. Although some patients may require a CPAP machine, the Seattle Protocol may still help these patients. Sleep disordered breathing can lead to dental conditions such as grinding and wearing of the teeth, thus making them weaker. We use sleep screening tools and the Seattle Protocol to help determine how to best restore your mouth to optimal health.

Step 1: Nose Breathing and Mouth Taping

The first step in the Seattle Protocol is to gently train your body to breathe through your nose, not your mouth. Breathing through your mouth during sleep can lead to snoring and dry mouth. The Seattle Protocol encourages nose breathing by adding a strip of paper tape vertically across the center of your lips. The light adhesive of the tape keeps your lips together but is easy and painless to remove.

Step 2: Temporary Splint for Lower Jaw and Mouth Taping

Once you’ve adjusted to the mouth taping, the second step of the protocol adds a temporary splint for your lower jaw while you sleep. Adding this splint increases the vertical dimension of your bite and allows more airway space.

Step 3: Temporary Splint for Lower Jaw with Lower Jaw Pulled Forward and Mouth Taping

If adding the lower splint only isn’t giving you the restful sleep you deserve, we move onto the next stage of the protocol. In this step, we add an element that pulls your lower jaw forward slightly. This realigns your jaw and increases your airway space not only vertically, but horizontally as well. This also can give your tongue more of the space it requires.

Step 4: Temporary Splint for Lower and Upper Jaw with Mouth Taping

With all steps of the Seattle Protocol, if you aren’t getting relief from the previous step, we move on. In this step, we remove the forward jaw posturing component and add a splint for your upper jaw. You then go to sleep with splints on your upper and lower teeth and your jaw is free to move. This stage allows for additional vertical height, opening up your airway, but without restricting the jaw muscles into any one strict position.

Step 5: Temporary Splint for Lower and Upper Jaw with Lower Jaw Pulled Forward and Mouth Taping

If you need to continue in the protocol, step five again adds a horizontal component by linking the upper and lower splints together and moving the lower jaw forward. The intent, as always, is to continue to open your airway more and more.

Step 6: Temporary Splint for Lower and Upper Jaw with Lower Jaw Progressively Pulled Forward and Mouth Taping

If you still aren’t getting that good night’s sleep, we move to the final stage of the Seattle Protocol. In this stage, we keep moving your lower jaw forward, incrementally, until you feel well-rested.

While there are six steps in the Seattle Protocol, you may not necessarily go through the entire process. 40-50% of patients resolve in Step 1. The purpose of the protocol is to help us understand which step provides the best relief. Typically, the further you progress in the process, the more help your airway needs.

The Seattle Protocol is a gradual, gentle, and reversible process that helps us identify solutions for our patients with airway issues and how these airway issues affect our dental health. It not only can help you get a better night’s sleep, but it can lead to an excellent path to better overall health and wellness. If you snore, spend your nights tossing and turning, have anxiety or depression, have acid reflux, or just simply feel tired all the time, call our office to schedule a consultation, 281-778-8400. We may recommend starting with the Seattle Protocol to help improve your life!

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