Autonomic Nervous System Balance Through Breathing And Appliance Therapy

• Heart rate variability (HRV) is a non-invasive window into autonomic nervous system balance

• Autonomic nervous system balance is a key component to overall general health

• When we breathe we regulate, increase and decrease in arterial pressure; this is the cardiopulmonary connection

• Breathing combined with Facialblock™ appliance therapy can generate improved autonomic nervous system balance as demonstrated through improved (HRV)

• The Facialblock ™ appliance therapy with tongue and jaw muscle action and controlled breathing can enhance sympathetic and parasympathetic response generating greater heart rate variability, which equates to greater autonomic nervous system balance (coherence).


For some time now I have been promoting Facialblock™ (Orthoblock) treatment and breathing exercises for patients with sleep bruxism and sleep and breathing disorders. I postulate that appliance therapy and breathing can balance the autonomic nervous system, reduce stress, reduce inflammation, and tone the airway to reduce sleep bruxism.

Scientists now recognize the positive health implications of achieving autonomic nervous system balance, the state where sympathetic and parasympathetic functions are of equal emphasis, through heart rate variability (HRV).1 Utilizing heart rate variability and respiratory oscillations to generate a sleep spectrogram , scientists are now categorizing sleep as stable (high frequency coupling) or unstable (low frequency coupling).2 This is a departure from the traditional use of PSG (polysomnography) to measure RDI (Respiratory disturbance index) and AHI (Apnea hypopnea index).


We can look at heart rate variability using an algorithm. This is a non-invasive window into the status and operation of the autonomic nervous system. – EmWave ll Heartmath, Inc.

What is the cardiopulmonary connection, cardiopulmonary coupling?

Upon inhalation, thoracic pressure becomes negative (a vacuum) the magnitude of this pressure depends upon the extent of the inhalation. Blood vessels in the chest expand storing increased blood. Due to the storage of the blood in the chest arterial pressure, as measured in the extremities falls. However, heart rate increases consistent with respiratory sinus arrhythmia (The pacemaker of the heart, innervated by the vagus nerve). Arterial walls constrict as heart rate increases, thereby limiting the decrease in peripheral arterial pressure. This is a sympathetic response and is represented by the upper portion of the sine wave.

Upon exhalation thoracic pressure becomes positive, the magnitude of this pressure dependent upon the extent of exhalation. Due to increased pressure, blood vessels in the chest shrink increasing blood flow to the heart, however, heart rate decreases consistent with RSA. Arterial walls relax as the heart rate decreases thereby limiting the increase in peripheral arterial pressure. This is the parasympathetic response and is represented by the bottom half of the sine wave. This is how breathing pattern modulates heart rate.

With a balance of the parasympathetic and sympathetic system we reduce the strain on the heart considerably.

Facialblock™ Protocol For Improved Autonomic Nervous System Balance

When the appliance is worn the patient is instructed to bite down on the bite block and press the tongue against the acrylic on the palate while inhaling. This will accentuate the sympathetic response and will immediately alter heart rate variability. After breathing in for six seconds and applying tongue pressure against the palate the patient is advised to relax the tongue and slowly exhale for six seconds, which accentuates the parasympathetic response, and will also alter Heart rate variability; increasing the amplitude in the HRV graph.

Heart rate variability is determined by subtracting the lowest component beats per minute from the highest component beats per minute. The greater the heart rate variability the better the coherence or autonomic nervous system balance. The six second interval is extremely important. We generally breathe in and out about 15-20 times a minute, i.e. at 3-4 second intervals. This is too fast and too shallow. Slowing breathing to five breaths per minute, six inhales and six exhales at six seconds each, results in deeper breathing.

The goal is to increase coherence. The significance of the appliance is it acts as a trainer. After conditioning when you place the appliance in the mouth you will immediately slow your breathing and take deeper breaths. Just practice for at least eight minutes each day. After 30 to 45 days you can generate a conditioned response. Furthermore, the appliance provides more room for the tongue, discludes the mandible, distracts the jaw joint and tones the genioglossus at the base of the tongue.

The increased coherence with appliance therapy is ideal for alternating supply of oxygen and removal of carbon dioxide from body tissues as well as delicate maintenance of arterial pressure and blood ph. Furthermore, it is the efficient removal of carbon dioxide that reduces the sleep bruxism response, instigated by the sleep center in the brain, as a response to carbon dioxide buildup. It takes only eight minutes a day to train the body to use the appliance with breathing exercises to improve coherence during sleep.

How does the Facialblock™ appliance therapy work to generate coherence?

In short, the appliance can accentuate the sympathetic response while inhaling and support the parasympathetic response while exhaling.

First time Heart Rate Variability graph without appliance and breathing

First time Heart Rate Variability graph with appliance and jaw muscle contraction and tongue pressure and six second inhale and release the pressure and 6 seconds exhale