Dog Sniffing, Sleep Apnea, & Facial Profiling

Someone just emailed me a link to an article showing that dogs can be trained to detect colon cancer in breath and stool samples, even in its’ early stages. He asked if this could be applied to sleep apnea. I though long and hard about this. There are so many metabolites in urine, stools, sweat, saliva, and even cerumen from untreated sleep apnea that could possibly be detected by dogs, but not any one of these substances would be specific, like cancer cells.

However, there’s an even easier way: Look at the person’s facial features. Look for narrow and/or recessed jaws, flat cheekbones, narrow nasal width, mouth breathing, or forward head lean. Inside the mouth, the classic findings would be multiple missing teeth, dental crowding, a high arched high palate, narrow and crowded dental arches, tongue scalloping, and a relatively large tongue that prevents you from seeing the uvula. Tongue scalloping alone has been found to predict apneas in 89%, oxygen desaturation in 89%, and abnormal AHI is 67%.

If you combine these exam findings which can take just a few minutes to observe, along with simple screening questionnaires such as the Epworth Sleepiness Scale or the STOP-BANG, you could probably screen for and pick out from 1/2 to 2/3 of all sleep apnea patients. Currently, it’s estimated that only about 10% of sleep apnea is diagnosed. Notice I didn’t mention being overweight, being male, or even the fact that you have to snore.

These days, I play an informal game with myself whenever I see patients. Just by looking at the medical history and external facial appearances, I try to guess who has sleep apnea versus who doesn’t. It’s scary, but I’m close to being about 95 to 98% accurate.

I know this may sound dangerously like facial profiling, but since I’m able to help many of these people breathe better and sleep better, I’ll continue to engage in this practice. Try it on yourself and then on your family members, and then on your friends. With some practice, you can be just a good as me.

Please note: I reserve the right to delete comments that are offensive or off-topic.

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6 thoughts on “Dog Sniffing, Sleep Apnea, & Facial Profiling

  1. Hi Dr. Park!

    I have started my own new “facial profiling” experiment. In efforts to improve my own health I started walking a lot. I developed some stress fractures in my feet. These did a bit discourage me but I have continued. My daughter has become a personal trainer.

    I noticed that my own lower jaw seems a bit bigger. I also noticed that my daughter’s lower jaw is now better developed than when she was young. I have started looking at athletes and have not found many if any with receded jaw structure.

    I know that when we exercise we cause micro-fractures in our bones which signal our system to make our bones more dense and strong. So, is it possible that constant exercise over time tends to re-structure our skeletal system not only for strength but also better air flow? I wonder.

    Thanks for all the posts and webcasts and all!


  2. Muscle tone firming up in the air ways will help one to breath better besides…in this case exercise helps…besides losing weight? What is the optimal solutions?

  3. My fiance is 26 years old. He has a very high and narrow palate, which doesn’t allow his tongue to fit properly in the roof of his mouth. He has many issues that an 80 year old man would have. He is 6’3 and 180lbs… clearly being overweight isn’t the issue here when it comes to the sleep apnea that we guess he has. There have been many times in the middle of the night that I have noticed him stop breathing for several seconds and then gasp for air. On top of absent breaths, he SNORES horribly. I have told him that I believe getting his palate expanded and teeth realigned would help his issues when it comes to his breathing difficulty. Due to his age, his palate is fused and doctors have told him that this would require breaking of his palate versus using a simple spacer. My fiance shyed away from this because he’s afraid the recovery period would interfere with his work. Just recently, my fiance developed a sore throat, annoying cough, the feeling that something is stuck in his throat, and sometimes difficulty swallowing food. He has a long history of heartburn, that can only be treated with Nexium. This has us both worried due to having a family history of esphageal cancer. I was wondering if the high arched palate could possibly contribute to heartburn and any types of esophageal issues. I know it may be far fetched, but insurance company’s refuse to help an individual pay for mouth reconstruction due to the excuse of it being for cosmetic reasons. My fiance has good insurance and we need help proving that his high narrow palate is contributing to health problems at a very young age. Any feedback?

  4. Mary Jo,

    Having a high, narrow palate with dental crowding leaves less room for the tongue. It sounds like he may have obstructive sleep apnea. Obstructions in the throat causes a vacuum effect that suctions up stomach juices into the esophagus and the throat. If he undergoes a formal sleep study showing that he has obstructive sleep apnea, then any type of treatment can be covered. He would have to go through the standard treatment options first, which would then make him a candidate for surgery. Many dentists are also saying that the hard palate does not fuse and can be expanded until your 60s and 70s. Take a look at Homeoblock and DNA Appliance. Theses are dental appliances that can significantly expand both upper and lower jaws in three dimensions, even in adults.