EC Paediatrics

Perspective Volume 14 Issue 6 - 2025

The Connection Between Ankyloglossia (Tongue-Tie) and Airway-Related Conditions Such as Obstructive Sleep Apnea (OSA) and Sleep-Disordered Breathing (SDB) in Infants and Children

Lawrence Kotlow*

Board Certified Pediatric Dentist, Private Practice, Albany, NY, USA

*Corresponding Author: Lawrence Kotlow, Board Certified Pediatric Dentist, Private Practice, Albany, NY, USA.
Received: May 27, 2025; Published: June 04, 2025



Many children are referred to a pediatric dentist for issues such as: breastfeeding difficulty, speech delays, or eating disorders, yet their restricted tongue mobility (ankyloglossia) is often not considered in the context of breathing or sleep issues and how these comorbidities are all often related to ankyloglossia. Preventing OSA/SDB in newborn infants and toddlers requires immediate consideration and intervention, not a wait and see attitude, when the tongue is unable to move forward and blocks the infant's airway.

  1. Guilleminault C., et al. “Upper airway resistance syndrome in children: A precursor to obstructive sleep apnea”. Pediatric Pulmonology (2016).
  2. Rachel R Markwald and Anne Germain. “Preface: Waking Up to the Impacts of Sleep Health on Human Performance”. Sleep Medicine Clinics1 (2020): xi.
  3. Villa MP., et al. “Efficacy of adenotonsillectomy in children with obstructive sleep apnea and short lingual frenulum”. Sleep and Breathing (2012).
  4. Zaghi S., et al. “Assessment of tethered oral tissues (TOTs) and the impact of frenectomy on sleep, speech, and feeding”. Journal of Craniofacial Surgery (2019).
  5. Khan U., et al. “Effect of frenotomy on breastfeeding and related outcomes: A systematic review”. International Journal of Pediatric Otorhinolaryngology (2018).
  6. Dominic Holland. “Structural growth trajectories and rates of change in the first 3 months of infant brain development”. JAMA Neurology10 (2014): 1266-1274.
  7. Yoon AJ., et al. “Ankyloglossia as a risk factor for maxillary hypoplasia and soft palate elongation: A functional - morphological study”. Orthodontics and Craniofacial Research 4 (2017): 237-244.
  8. Kotlow Lawrence. “Laser ankyloglossia release: implications for maxillomandibular growth”. Seminars in Orthodontics2 (2020): 96-101.
  9. Harper RM., et al. “Sleep-disordered breathing: effects on brain structure and function”. Respiratory Physiology and Neurobiology 3 (2013): 383-391.
  10. Oscar Sans Capdevila., et al. “Increased morning brain natriuretic peptide levels in children with nocturnal enuresis and sleep-disordered breathing: a community-based study”. Pediatrics5 (2008): e1208-e1214.
  11. Weider DJ., et al. “Nocturnal enuresis in children with upper airway obstruction”. Otolaryngology–Head and Neck Surgery 3 (1991): 427-432.
  12. Messner AH and Pelayo R. “Pediatric sleep-related breathing disorders”. American Journal of Otolaryngology 2 (2000): 98-107.
  13. Kotlow Lawrence A. “Tethered oral tissues as a differential diagnostic tool in infants and toddlers presenting with obstructive sleep apnea and air induced reflux”. Australasian Medical Journal5 (2019): 131-137.
  14. Chervin RD., et al. “Inattention, hyperactivity, and symptoms of sleep-disordered breathing”. Pediatrics3 (2002): 449-456.
  15. Yu-Shu Huang., et al. “Short lingual frenulum and obstructive sleep apnea in children”. International Journal of Pediatric Research 1 (2015): 1.
  16. Hui-Leng Tan., et al. “Obstructive sleep apnea in children: a critical update”. Nature and Science of Sleep 5 (2013): 109-123.
  17. David Gozal. “Obstructive sleep apnea in children: Implications for the developing central nervous system”. Seminars in Pediatric Neurology2 (2008): 100-106.
  18. Guilleminault Christian., et al. “A frequent phenotype for paediatric sleep apnoea: Short lingual frenulum”. ERJ Open Research 2 (2016): 00043-2016.
  19. Christian Guilleminault and Farah Akhtar. “Pediatric sleep-disordered breathing: New evidence on its development”. Sleep Medicine Reviews 24 (2015): 46-56.

Lawrence Kotlow. "The Connection Between Ankyloglossia (Tongue-Tie) and Airway-Related Conditions Such as Obstructive Sleep Apnea (OSA) and Sleep-Disordered Breathing (SDB) in Infants and Children". EC Paediatrics 14.6 (2025): 01-04.