Sleep Apnea and the Reason for Facial Wrinkles

One of the main reasons why sleep apnea is so common these days is that modern human's facial skeleton and jaws are much smaller than what they used to be hundreds of years ago. Dentists are saying that people didn't get impacted molars hundreds of years ago, since they had much more room inside their mouths. Dr. Weston Price, in his classic book, Nutrition and Physical Degeneration, describes how due to a radical change in our diets from natural, organic foods to highly processed and sugary foods, our jaws are getting smaller and smaller. 


Think about your facial skeleton as the walls of a house. The soft tissues are the furniture. As you move the walls inward, there's less space for the furniture and less space for you to walk through the room. To improve the situation, you either have to widen the walls or remove some furniture. This is what's done with the various sleep apnea treatment options that involve surgery. With CPAP, picture yourself navigating through the crowded furniture a bit faster to get to the other side.


A very important concept that many forward-thinking physicians and dentists point out is that the soft tissues (your facial skin, and internal structures like your tongue or septal cartilage) grow to its' genetically predetermined size. If you have smaller jaws, then you'll have crowding in your mouth, with partial obstruction of the breathing passageways behind the tongue. This is why many modern humans can't sleep on our backs. With gravity, the tongue falls back, and when you add deep sleep with additional muscle relaxation, you'll stop breathing and keep waking up.


The same process applies with the nasal septum. If your jaws are more narrow, the roof of your mouth gets pushed up into your nasal cavity. Then one of two things can occur: the septum (which sits on the floor of your nose, which is also the roof of your mouth), buckles to one side or the other, of the septum stays in place, but causes the maxillary bone underneath to splay apart, leading to the symmetric right and left maxillary bone spurs that you'll often see. Sometimes, due to the constant stimulation of the septum on the roof of your mouth, a midline bony bulge can occur in your mouth (called a torus palatini). 


If you upper jaw is underdeveloped from a front and back perspective, then your upper lip and lower nose will be pulled down and in, leading to the appearance of a nasal hump. This is one of the most common reasons for a traditional rhinoplasty. Furthermore, underdevelopment of the lower jaw creates the classic weak chin, which is traditionally treated with chin implants. Cheek bones are also underdeveloped, leading to a lowering of the lower eyelid and flattening of the face under the eyes. Since the facial skeleton is smaller, the skin that drapes the bony structures are more lax, and with aging, tends to sag and wrinkle easier. An excellent, more thorough review of these concepts can be found here.


When I first read about this process, my eyes were opened as to why there's so many sinus problems, nasal congestion, headaches, TMJ, and various sleep-breathing problems. This is also why when one specialty treats one particular problem (ENTs treating the sinus problem, dentists treating the TMJ problem, the neurologist treating the headache, and the dermatologist treating the wrinkles, etc.), these problems always tend to come back.


What do you think about what I'm describing? Is it academic hype, or should we be afraid of our very future? Please enter your comments in the comments box below.

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2 thoughts on “Sleep Apnea and the Reason for Facial Wrinkles

    I've been paying a lot of attention to people's facial proportions the past few months (and trying to not get caught staring!) and I think this perspective has some merit. It's too late to do much about my sags, bags, and wrinkles though, ;-:(  
    Invariably, the most attractive people I see daily (no matter what ethnicity & especially the ones who are aging well naturally) have wide dental arches, their noses aren't pinched, and their chin and jawlines are well developed.  Their profiles do not show the lips and chin behind the brow line, in fact, both are usually at least even with or even sometimes slightly forward of the brow line when viewed from the side.

    I've especially noticed that mothers from foreign countries (particularly Asian and South American countries that would provide less exposure to westernized food during development) generally have well developed facial bone structure, but their kids have narrow longer faces and narrow jaws/pointed chins.  The kids either are going to need orthodontic treatment or are already in braces.  The last time I was at Costco I counted at least 3 mother/child sets who fit this pattern in just a few minutes (all appeared to be prosperous & middle class).

    I'd read the Dr. Silkman article earlier when it was published in the WAPF journal but forgot about it.  It's a very good article.  I wish more dentists were as enlightened.  I didn't do a consult with him because I thought he was a general dentist, not an orthodontist.  We're quite happy with our son's treatment with Dr. Hang (started in December).  

  2. Thanks, Anna for your thoughts on this post. I've noticed that same thing on our subway system. Asians and South Americans who have recently immigrated have broader faces with well developed jaws, but their children have very narrow jaws. I have gotten caught a few times staring :)