"My Mighty Quinn" - From Tics, Turbulence, Distraction and Disconnection to Calm, Confident and Connected"

S3 Episode 3: Sleep Matters: Expert Tips for Restful Nights and Better Days with Natasha Duffin

• Lucia Silver / Natasha Duffin • Season 3 • Episode 3

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This episode is all about the life-changing power of sleep, particularly for children and families navigating neurodevelopmental challenges. I’m joined by Natasha Duffin, an incredible occupational therapist and founder of Whole Child Co., whose expertise in sleep, oral function, and airway health has helped countless families. Together, we’ll uncover how improving sleep quality can transform lives.

Episode Summary
Sleep is the golden thread tying health, growth, and emotional well-being together, but for many families, it’s the missing piece of the puzzle. In this episode, we explore why sleep quality matters far more than hours in bed. We dive into the root causes of poor sleep—such as allergies, oral dysfunction, and sensory issues—and reveal why behaviours like snoring or mouth breathing shouldn’t be ignored. 

Key Takeaways

  • Quality over quantity: Good sleep is about how restorative it is, not just hours slept.
  • Red flags to notice: Emotional dysregulation, snoring, mouth breathing, and frequent waking are signs worth investigating.
  • Solutions that work: Natasha’s expertise in oral function, breathing exercises, and allergy management has transformed lives.

Top Tips for Better Sleep

  1. Mind the screens: Switch off devices at least an hour before bed to support melatonin production.
  2. Check breathing habits: Nasal breathing is essential—mouth breathing may signal an issue.
  3. Create calming rituals: Simple, predictable routines signal safety to the nervous system.
  4. Address allergies: Unchecked allergies can disrupt sleep and trigger other health problems.
  5. Co-regulation matters: Children rely on parents for emotional regulation—stay present.

Resources and Further Reading

  • Connect with Natasha Duffin: Whole Child Co
  • Download our guide: Top Tips for Sleep Hygiene at The Brain Health Movement.
  • Books we love: The Invisible String by Patrice Karst for easing separation anxiety.

If this episode resonated with you, share it with friends or family, and don’t forget to subscribe, rate, and review My Mighty Quinn. Sleep well, and see you next time!

Resource Links:

[00:00:00] Lucia Silver: Hello and welcome to the Brain Health Movement's podcast, My Mighty Quinn. I'd like to open today with Thomas Decker's quote, sleep is the golden chain that ties health and our bodies together. This quote emphasizes the interconnectedness of sleep and health and highlights that sleep is a crucial link in maintaining overall health and well being.

[00:00:24] Lucia Silver: For those who have been following this podcast and our educational support platforms and courses for parents, you will know that at the Brain Health Movement, we are all about a whole child approach. And that means looking at the root cause of any symptoms. and struggles that present from a multidisciplinary point of view.

[00:00:43] Lucia Silver: It is also our view that whilst there are undeniable, and in many cases, universal, scientific, and metabolic explanations that underlie the whole roster of neurodevelopmental disorders and challenges our children are facing, each child is still very much an individual. With a unique expression, presentation, and pathway to healing.

[00:01:06] Lucia Silver: And we also, as you know, always look at the whole family, and not just the child. Remember, there is no such thing as a bad child, and only ever behaviours that are expressing an unmet need. And many of these challenges that we're dealing with, can be systemic, relevant to the whole system, the whole family at large.

[00:01:27] Lucia Silver: For example, diet, what are you all eating? And lifestyle, what are you all doing as a family day to day, vis a vis exercise, screen time, sleep connection, and so forth. And of course, then there's the state of the whole family's nervous system to consider. But before we are even able to begin our healing journey, we need to understand and address some of the big contributors to dysregulation and overwhelm.

[00:01:52] Lucia Silver: And I think we all agree that if we and our precious children are not sleeping, then we are not even in the starting gate. With lack of sleep, we are unable to engage in any further remedial rehabilitation or healing work. So to this end, we wanted to find a super experienced. Specialist in sleep. A practitioner who, like us, has a whole child approach to this hugely important area.

[00:02:21] Lucia Silver: We've traversed the continents, and we've found Natasha Duffin all the way in Perth, Australia. Tash is an occupational therapist trained in orofacial myofunctional therapy, pediatric feeding, and infant and early childhood sleep quality and infant reflux. She is a mother of three vivacious, exuberant children and the founder of Whole Child Co.

[00:02:46] Lucia Silver: What a perfect name. Her two youngest children are the inspiration and drive for her work. When trying to find help for their concerns around sleep, she wasn't satisfied with the normal, they'll grow out of it approach. Through this journey, she learned to trust her instinct and advocate for her children, and she now supports parents to do the same and trust their gut.

[00:03:08] Lucia Silver: Tash is passionate about sleep quality for our children during periods of early growth and critical brain development. She believes the wait and see approach does an injustice to the developing child and family unit, viewing good quality sleep as a pillar of health and a foundation for growth and development.

[00:03:25] Lucia Silver: And she's passionate about early intervention in the airway and oral function space specifically, in order to prevent the snowballing of issues that can arise. experiencing this firsthand with her two children. And her dream is that sleep quality and airway development become part of mainstream health care advice and intervention, to truly set up our children for the best start in life.

[00:03:50] Lucia Silver: So without further ado, hello Tash, we're delighted to welcome you to the Brain Health Movement's podcast, My Mighty Quinn. 

[00:03:58] Natasha Duffin: Thank you so much for having me. That's quite funny listening to a bio on yourself. It's oh, she sounds interesting.

[00:04:05] Natasha Duffin: So thank you for having me. An honor to be on such a wonderful, podcast yeah, something I'm very passionate about and close to my heart, the whole thing that you're looking at. 

[00:04:18] Lucia Silver: Yeah. Well, Tesh, thank you. Thank you for being here.

[00:04:20] Lucia Silver: And it seems that the best place that we could start really is the importance of sleep. That seems like a really good place to start. Why is it so important? So how much sleep Should, we don't like the famous word should, but should babies versus toddlers versus preteens, teens be getting ideally?

[00:04:38] Lucia Silver: How do we know we're in a context of good sleep or not? 

[00:04:42] Natasha Duffin: Yeah, so this is, I've, this is a really interesting question for lots of reasons, and particularly for babies and toddlers. I actually don't like giving numbers of hours and that the naps should be exactly like this because I remember being a first time mum and how much that stressed me out and thinking I'm doing all these things and she's not doing the shoulds.

[00:05:06] Natasha Duffin: And therefore, that is I felt like there's something wrong with me or something wrong with her. I think, there's a range and obviously the small babies sleep more in general. And then as they get older babies start to sleep a bit less naps are happening up until about two or three, two and a half for most kids.

[00:05:30] Natasha Duffin: If they hold onto them for much longer, or they give them up much less. Earlier, that's a bit of a flag for me, which we'll go on to talk about in terms of sleep quality. And I think the shoulds of if you're doing everything and you're allowing the sleep to happen in terms of having nice, Bedtime rituals and routines and not displacing the opportunity for sleep with a million activities or screen time or things like that.

[00:06:00] Natasha Duffin: And your child goes to bed at a reasonable time, wakes up at a reasonable time and seems refreshed. And not tired throughout the day, then that's really our biggest should. And I suppose the thing which we're going to get into more is that quality matters more than quantity. And unfortunately particularly in the kind of baby sleep world and toddler sleep world, where the kind of the overarching message is you should have this many hours, and this awake time and all that kind of stuff, where actually the quantity of sleep.

[00:06:38] Natasha Duffin: matters very little if the quality of your sleep is not there. You can sleep, a child can sleep 12 hours overnight and have a three hour nap and still not be getting good sleep. Yeah. 

[00:06:52] Lucia Silver: Quality over quantity. Absolutely. And that was a real epiphanal moment for me because, and we're talking about the collective unit sleep, the whole family unit sleep as well.

[00:07:04] Lucia Silver: Whenever I've been asked previously as a mum everyone's All the other mums exhausted because their babies weren't sleeping. Interestingly, Quinn did sleep as a baby really well. And I've always slept so I thought really well. I don't have trouble falling asleep and I wake up in the morning and I haven't woken up in the night.

[00:07:23] Lucia Silver: But I never understood why I was always so tired. And somebody said, just because you're Sleeping that long doesn't mean the quality, and it was completely epiphanal to me. So I'm really pleased that you brought that up. Quality and quantity are two completely different things. So, please talk to us a little bit more about that, about how we, how do we know that they're getting quality sleep?

[00:07:43] Lucia Silver: You talk about looking at their daytimes, don't you? As opposed to necessarily how many hours they've been in bed. 

[00:07:50] Natasha Duffin: Yep. And yeah, quality, quantity, totally different. So the daytime behavior is really our biggest indicator of how well a child is sleeping. And coming back to that, a similar quote that you mentioned at the very start kids do well when they can.

[00:08:07] Natasha Duffin: It's bigger than sleep, like emotional regulation and things like that. If your child really struggles with emotional regulation compared to their peers, that you start to think they're not a bad kid. There's no bad kids. There's kids that are struggling with an unmet need.

[00:08:24] Natasha Duffin: Okay, let's have a look at the quality of their sleep. Are they really restless? Are they waking frequently? Not that not the waking itself is a problem, but it's the frequency of the waking and the fragmentation of the sleep. So daytime behaviors in terms of ability to concentrate, sit still, pay attention, regulate, all those types of things are signs that I would probably, one of the first things I would look at for a kid is their sleep quality good?

[00:08:57] Natasha Duffin: Because Regardless of what else is going on for a child, if they're so neurodevelopmental challenges periods of just growth and development regardless of what's going on to them, if their sleep is no good, any other struggle that they're having is going to be exacerbated. Because you and I know that as adults with fully developed prefrontal cortexes, if we have a bad night's sleep, we're more ratty, we find it harder to emotionally regulate, and we've got brain power to do so our children that are a long way away from that in terms of the development of their brain, then of course they're going to struggle. Sorry. Yeah. Daytime behavior is one of the biggest things. And I guess during these particularly early childhood is where obviously I'm very passionate about sleep across the whole, childhood, across all of childhood, early childhood those first three years is that really critical period of brain development.

[00:10:02] Natasha Duffin: And if we're not getting optimal sleep in terms of the quality, not the quantity then we're starting a bit on the back foot. And because when we can identify things really early on and make small changes we can, set them on this path for so many, so much better things rather than this downward kind of spiral or snowball that can happen when things are, missed essentially.

[00:10:32] Natasha Duffin: And. I think one of the big things that I, which we'll get into more, but, I'm looking at the way kids breathe during sleep and things like that, and historically, the kind of thinking was that children with Obstructive sleep apnea, which in the medical community is a little bit more obvious than some of the more milder forms of sleep disordered breathing, but so children with obstructive sleep apnea, they were they were the, kids that you intervened with because we knew they were having airflow limitation, those kids that were that.

[00:11:11] Natasha Duffin: Having upper airway resistance syndrome or airflow limitation, but were more mild and didn't meet the criteria for obstructive sleep apnea. These kids were left alone and they're the kids that still unfortunately quite often get told they'll grow out of it. Don't worry about it.

[00:11:26] Natasha Duffin: Nothing to worry about. Doesn't matter about snoring. Doesn't matter about mouth breathing. But there is a very stringent study on 11, 000 children. So it's not a study to be sneezed at by any means on 11, 000 children that looks at these kids with those more mild forms of sleep disordered breathing. So that kind of open mouth breathing, snoring, that kind of stuff.

[00:11:50] Natasha Duffin: And the research is very, clear from this study, that those children, poor sleep quality, impacts their daytime behavior. And they broke the study into different groups of symptom onset, for the first year, and at different points, and symptom resolution, and then looked at the kids like at seven, eight, and like when they're much older, and found a very strong correlation between those early life sleep disordered breathing symptoms, and academic performance, behavioral problems, friendship, all these different things.

[00:12:28] Natasha Duffin: That quality early on is so important. Like it just can't be overstated. And that's why I'm here. That's why I'm so passionate about it. 

[00:12:38] Lucia Silver: Right. I mean, what a study and what a revelation to see the impact, I think. The quality of sleep is therefore what you're saying is that if you're not quite sure what's going on you can also look to their daytime expression, to their exhaustion, to their lack of emotional regulation and so forth.

[00:12:54] Lucia Silver: But you've also got some indicators within the bedroom itself with sleep acne or snoring or mouth breathing or so on and those are important indicators to look for for knowing that the quality of sleep, even if you haven't heard your baby crying or your child getting up in the middle of the night.

[00:13:12] Lucia Silver: Those are some of the indicators. So moving on from there, Tash, the infamous cry it out technique of the 80s, which still gets quoted today. And certainly when I was raising Quinn, was bandied around between mothers, I will say it, I know you don't want to be diplomacy, but Gina Ford wrote a book called The Contented Little Baby that was what I would call the best piece of self flagellation that was out there for parents who wanted to give themselves a good sort of hiding over, leave your child and let it cry itself to sleep and then it'll learn.

[00:13:48] Lucia Silver: then it'll learn that that's what, needs to happen. And parents are mothers particularly, lying in their beds as I was, tortured by leaving Quinn even for three minutes, which I never did. But just intuitively, it doesn't make sense. I wasn't an overly anxious parent raising Quinn at all, but it just didn't feel right at all that a child should cry at They're just manipulating you.

[00:14:13] Lucia Silver: Really? They haven't got a prefrontal cortex. They haven't got a developed brain yet. They haven't got systematized thinking yet. So why would they be manipulating anybody? Can we speak to this? Because I'd really like to exonerate any parents who are thinking that's a good idea and they're lying there weeping as their child is weeping 

[00:14:35] Natasha Duffin: I guess I would start with, I wish it was left in the 80s.

[00:14:38] Natasha Duffin: Unfortunately, it's not. And look, I understand where some parents turn to it out of desperation and, or they think that's the only option. It's not. And it's, whilst I do, sympathize with parents that need to, that make that decision, when we look at the neuroscience, it is. Definitely not teaching them anything.

[00:15:07] Natasha Duffin: So the way, like we don't even, we don't expect toddlers to regulate by themselves. We co regulate with them. We don't expect our school aged children to regulate by themselves. We co regulate. I don't, and I would argue even as adults, we don't, We have the capacity to self regulate, but we still co regulate a lot.

[00:15:27] Natasha Duffin: So how can a baby that is a few weeks old or a couple of months old they, can't, they are incapable, neurologically incapable of self regulation. Some babies can fall asleep by themselves, but not from an upset state. So there's two different things. So self, Falling to sleep by themselves and self soothing, are two different things.

[00:15:52] Natasha Duffin: They cannot soothe themselves from an upset state. They need to borrow our nervous system to do that for them. And their nervous system will learn to do that through an apprenticeship of doing it with us. Over and over and over and over and over. And how long does it take? Always longer than you wish.

[00:16:13] Natasha Duffin: And that's, that tends to be the thing with most sleep things that longer than you want it to, being responsive. and lending our nervous system and doing it over and over again, that's what teaches our babies to regulate and to set, to, to soothe, to fall asleep and to calm themselves down from an upset state.

[00:16:34] Lucia Silver: And as an adjunct to that, for me, the reason why the, Gina Ford, let your child cry themselves to sleep is what you are teaching the nervous system When it seeks to co regulate through social engagement, through the mother touch and neuroception of safety, teaching that it is safe, you are teaching your child that it is not safe.

[00:16:56] Lucia Silver: That there is no one out there when they are crying. So it's, not just that it's ineffective for getting them to sleep. What is the neural feedback that you are giving to that central nervous system by being absent? 

[00:17:11] Natasha Duffin: Yep. And so I talk a lot about in my practice with my clients about, The autonomic nervous system, the sympathetic nervous system, the parasympathetic nervous system, and obviously wanting the parasympathetic nervous system to be the one in control for sleep, rest, digest, restore, as the name suggests.

[00:17:29] Natasha Duffin: We want all those things, those to come from our sleep, get the nutrients out of our food transfer things to memory, learn, consolidation, all those types of things. That's what we want in control when we're asleep. When a baby is in distress and they have nobody to co regulate with them, then there is no way that leaving them or checking them at certain points, that we're going to get that parasympathetic nervous system on board.

[00:17:58] Natasha Duffin: We will 100%, they will, and us, will be in sympathetic nervous system. Fight, flight, freeze, fawn. So when they eventually stop crying, they haven't learned anything. They've gone into freeze or fawn. And their nervous system is shut down and they've gone, Huh, oh what's the point in that? No one's going to come.

[00:18:17] Natasha Duffin: Yeah, 

[00:18:19] Lucia Silver: Terrifying damage. Yeah, 

[00:18:21] Natasha Duffin: so it's not teaching anything. That's the big thing. It's not teaching 

[00:18:23] Lucia Silver: anything. And just as an adjunct, Tash, you'll be thrilled to hear, but we're soon going to be podcasting with Stephen Borges, and we've been speaking to him over the last days. He is the pioneer, really, of the polyvagal, of understanding these different senses.

[00:18:38] Lucia Silver: states that the nervous system enters into. And he's going to be doing a piece on our course, as are you, our child healing course. And interestingly, Stephen says co regulation is a biological imperative. And I always hold that in my mind. I think if you understand that, we are here as parents, as vehicles of co regulation it sets a very different context for our, the necessity of our role and our presence.

[00:19:10] Lucia Silver: But let's move on to these underlying, causes, Tash, because I really want to deep dive and steal your expertise in this area. Seeing the sleep issue really as the symptom, not the problem, is really where we're stepping towards here and you're trained in many of the reasons why we end up. with sleep issues, starting with breathing as a critically important factor.

[00:19:32] Lucia Silver: So, let's start there. Talk to us about breathing and how critical nose, not mouth breathing is, right? 

[00:19:38] Natasha Duffin: Yeah. And I guess that it feeds directly back to what we were talking about there with the parasympathetic nervous system, sympathetic nervous system. So when we nose breathe. That is what's going to activate our parasympathetic nervous system.

[00:19:53] Natasha Duffin: Our sympathetic nervous system is going to be the one that is and in the fight flight when we're mouth breathing because of the suboptimal oxygenation when we mouth breathe, which occurs because of, a difference in the chemical process. So when you nose breathe, you get nitric oxide, and that promotes optimal gas exchange.

[00:20:18] Natasha Duffin: And that means that all the systems in the body are working optimally, and the brain detects that homeostasis, that safety, and parasympathetic nervous system can Be the one that's leaving the shirt when we are mouth breathing, we don't get that nitric oxide. So essentially, I think of it as it's suboptimal oxygenation.

[00:20:39] Natasha Duffin: And because that, the threat detection center, the amygdala, that's scanning all the time for threat or safety. Obviously that's a primitive part of the brain. It's not sitting there. Oh, it's not sitting there ranking the threat. It just identifies the threat. There's a threat and we go into sympathetic nervous system.

[00:21:00] Natasha Duffin: So at the core, that's why. Nose breathing is so important. And then I guess, the way we use our body is the way it grows. And obviously, particularly in early childhood, when we're seeing so much skeletal growth, it's about growing into those airway problems rather than growing out of them because form follows function.

[00:21:25] Natasha Duffin: If I nose breathe all the time, if I have the capacity to nose breathe all the time, that's my motor plan, my motor pattern. That's what becomes my normal in my brain and my nose. and my nostrils and my nares stay nice and strong and I have the easy capacity to get airflow through with minimal resistance.

[00:21:46] Natasha Duffin: If I mouth breathe for whatever reason, but if that is starts out a little, now and then, but then the nose is the filter. So if I'm a little bit allergic to something or, if I'm around kids with germs, I then might get some more inflammation because of that. The nose is no longer filtering because I'm breathing through my mouth.

[00:22:08] Natasha Duffin: And that becomes more and more of a habit. And then we see craniofacial developmental changes that typical of a mouth breather, that kind of forward head posture, the chin goes back. We often will see like a crooked nose. We get that kind of drag through the face and then all of that. As, they, as we grow that vertical growth of the face, as we grow, that it becomes a self fulfilling prophecy.

[00:22:37] Natasha Duffin: That's that snore, snore, snowballing that I mentioned in terms of that creates more narrowness in the airways, which means it's hard, it gets harder and harder to do the right inverted commas thing to be able to nose breathe. And so we just, it's this spiral of. One little thing that, say an allergy, yeah, start with nasal congestion, we don't identify the allergy, the nose is just always blocked.

[00:23:06] Natasha Duffin: And then in those early years, we see those craniofacial developmental changes, because you, don't use it, you lose it. Yeah. So the nose gets weaker and we grow into that problem. 

[00:23:19] Lucia Silver: Wow. That's quite something. And the, in terms of growing into airway problems rather than growing out of them how, do you then begin to address that?

[00:23:31] Natasha Duffin: Yeah. So that the, and that's where a therapist like myself or a facial myofunctional therapist is key to helping you, the family, the child, understand where can we put a circuit breaker in there? What is the root cause of the presentation that we see? So I might see a baby or a child that has low tongue, rest posture, open mouth, and mouth breathing.

[00:24:00] Natasha Duffin: So that could be so many things. So you've got to look at the whole child and go, okay, so let's look at the birth history, the feeding history. Did we have feeding challenges early on? Are we struggling with eating now? Is there congestion? Are we always sick? What's nutritional deficiency history in the family?

[00:24:17] Natasha Duffin: Are there family history of allergies? All these types of things. So you're pulling little bits of information. from that whole system, that whole child, to go, Okay, this makes sense that this would be it. And you've got to find that circuit breaker to then open things up. So like an allergy, for example, is a really easy example to understand.

[00:24:39] Natasha Duffin: If a child has a dust mite allergy, And dust is a real problem for sleep because it doesn't matter how clean you are. Those dust mites are everywhere and they're terrifying. Never look them up. And so if you have a, if you have an allergy that a child has an allergy that no one's aware of and they get into bed and every night they're congested and they have to breathe through their mouth because they can't breathe through their nose because it's all congestive from an allergy.

[00:25:09] Natasha Duffin: And. Then their sleep quality is poor because they're mouth breathing and they get up in the morning. They have really puffy eyes. They might sneeze or they might cough a bit in the morning and then as the day goes on they're a little bit better and then that cycle starts again over every night. If we could identify that they have that allergy, do some nasal hygiene, reduce the allergy load in the environment, then that's the circuit breaker that we need.

[00:25:37] Natasha Duffin: I know you're a little bit chicken and 

[00:25:39] Lucia Silver: egg. Are you a little bit chicken and egg with that, Tash, in that, the fact that they were mouth breathing has exacerbated the problem or the fact that there were bed mites that the dust mites were there would have been much worse through the mouth breathing or have they been those breathing, they might have been it.

[00:25:59] Lucia Silver: So it's a little bit where do we look first? So first of all, it's to identify if your child is Nose breathing or mouth breathing. Then when you identify that they are mouth breathing, then you want to look at some of the areas that would be particularly critical for them if they are mouth breathing, like the dust mites and the allergies and so forth.

[00:26:18] Lucia Silver: So you work through that way. And what do you mean by oral function? What area is that parents should be looking out for? 

[00:26:26] Natasha Duffin: So that's the way, so breathing is part of that, but the way we use our tongue, our lips, our cheeks for eating, drinking, swallowing, and out of my scope, because I'm an OT, but also speech, if a speechy is also qualified.

[00:26:41] Lucia Silver: So a tongue tie, for example, would that come into it? Yes. A tongue tie. And so that again, you would look at that and say that's going to would that push them to be mouth breathers if that were the case or does that cause a different set of problems? 

[00:26:56] Natasha Duffin: It can do for sure. So if, depending on the degree of the restriction, if the tongue has limited mobility and it's unable to suction to the palate, so it has, it sits low, The muscle bulk that would normally be suctioned to the oral cavity is down low and can head back into that airway, and particularly when a child lies on their back in bed, if it's not suctioned, it can head back into that airway, increase resistance to nasal breathing, you might hear snoring, they might always want to sleep on their tummy with their bottom in the air to try and get the tongue out of the airway.

[00:27:31] Natasha Duffin: It can then also, like when their primary source of, nutrition is milk, they might be because of the way the tongue moves if they're swallowing air when they're feeding and that's causing reflux, then that reflux can cause inflammation back in that nasopharynx space and then that congestion and we see this kind of snowballing.

[00:27:57] Natasha Duffin: So you might say, oh, that kid's congested. How's that linked to a tongue tie? But yes, so you've got to cut, peel back the layers to look at 

[00:28:05] Lucia Silver: where 

[00:28:05] Natasha Duffin: it starts. 

[00:28:06] Lucia Silver: So this is we're in the sort of stage one here of nose breathing, mouth breathing, oral function. We're just doing a checklist here, pediatric, feeding, and the reflux.

[00:28:17] Lucia Silver: Within that, are these, obviously we can see it, categorically affecting babies. How much of this? Can still be affecting children through their toddlerhood and their preteens teens.

[00:28:29] Natasha Duffin: So heaps, because number one, like what happens form follows function, so we might be, then these things start exacerbating the feeding, say take tongue tie, for example.

[00:28:41] Natasha Duffin: The feeding challenges may not, but they, may also transfer to introduction of solids. So they may have trouble moving food around in their mouth to break it down. So they might choose not to eat red meat, for example because that requires a lot of nose breathing, lips together, chewing on both sides, using that tongue to move it around.

[00:29:05] Natasha Duffin: So if and a child doesn't know, Oh, I should eat red meat because that's maybe good for me. And it's got some good nutrients in it. They're just like. Too hard, no thanks, give me the beige break down meltables that I know are going to be the exact same time, same, every time. There's not going to be little gristly bits, there's not going to be harder bits, I'm not going to have to work at it.

[00:29:26] Natasha Duffin: Stop eating meat and then we have the impact on sleep on that. If we are then iron deficient, That has an impact on our sleep and our growth and development and immune function. So it all can tie back in. And there even looking at the kind of, which I touched on briefly there with the link with tongue ties and reflux.

[00:29:52] Natasha Duffin: So that term when it's, it's actually called aphasia or air induced reflux. So when the tongue's not functionally functioning optimally and they swallow air. The air then comes back up, brings the stomach contents, this area up here behind the nose and the throat is not meant to have stomach acid in it, so we'll become inflamed, produce mucus, that's our congestion, and it's actually a big cause of, adenoid and tonsil inflammation and things like that, and then those things can just carry on, because if the disease that if it's not identified and Stop gap find the cause early on, and then we start mouth breathing and then we get more exposure to germs and allergens and all those things.

[00:30:44] Natasha Duffin: Yes, it can. It's still very much a thing later on. Some kids can really compensate really well on the breast, for example, or mom goes, no, thanks. That's too hard. Like it hurts too much. And the, but we can get the milk in on a bottle. So that's better for mom because she's no longer in pain, baby's feeding, but that oral dysfunction transfers to the bottle, but it's just less obvious.

[00:31:11] Lucia Silver: It's an enormous rollercoaster of one thing impacting another. You can think that you're dealing with sleep as the issue, but actually the, how much time do we spend sleeping? A hell of a lot. And therefore, if we're not breathing correctly, which is fundamental to our wellbeing and our, state of homeostasis, then it's gonna impact so many other things as a result of not sleeping, but just coming back again to some of the reasons for the lack of sleep.

[00:31:40] Lucia Silver: Again, just working down the list of possibilities. You specialize in this, which will have to explain to us orofacial, myofunctional therapy. 

[00:31:48] Natasha Duffin: So we call it either Mayo or OMT for short, because it is a bit of a, which is based on what, like what it is.

[00:31:55] Natasha Duffin: But so essentially it's all those, that, that oral function, that breathing and airway stuff. So it's the goals of, OMT tongue to palate, lip seal, teeth slightly apart, so not clenched, and nose breathing. So those things and then how that obviously impacts our eating, our sleeping, our swallowing, our speech that they're the goals of, of Mayo.

[00:32:27] Natasha Duffin: And that's what it is. So it's looking at the identifying why we're seeing the presentation that we're seeing. That's the big, I would say the cornerstone because you can like some people think, oh, I'll come and I'll do some exercises. But. I could strengthen a tongue till the cows come home.

[00:32:44] Natasha Duffin: If you can't breathe through your nose, you're never going to have good oral function and you're never going to breathe properly because your nose is blocked. So identifying what the root cause is, what the barriers are, intervention there, and then going, okay, let's look at the functional deficits.

[00:32:59] Natasha Duffin: What can the tongue do? Are the lips really weak? What's the dentition like? For example lots of airway kids. Kids with enlarged adenoids or tonsils and things like that will thumb suck, for example, or really hang on to a dummy for years. And the way that, changes the dentition in terms of having like big overjets or open bites and that, so you have your top and bottom teeth misaligned and then actually trying The ability to get your lips over those teeth can be impossible depending on how strong the sucking has been.

[00:33:37] Natasha Duffin: So them going, okay we need to identify why they're thumb sucking, do that. Then we need to help them remove the thumb. And then we need to go, okay, those lips have no idea where they're meant to be. Neither does that tongue. That tongue has been thrusting while it's been sucking on the thumb for six years.

[00:33:55] Natasha Duffin: The tongue doesn't know to live up on the roof of the mouth and how that impacts your vagus, vagal tone. Because the thumb's been doing it and the lips don't know where to rest, the lips can't get there. So then going, okay, we're going to need to like look at strengthening, creating those new motor plans to get us to where we need to go.

[00:34:14] Natasha Duffin: So it's, identifying the barriers and specific, exercises and things to, and functional things as well, like removing things that may be hindering change like thumbs, dummies, different types of drinking cups that kind of stuff to optimize all of those things.

[00:34:34] Lucia Silver: So it's actually I'm going to say it again, orofacial myofunctional therapy is actually a fantastic diagnostic platform.

[00:34:42] Lucia Silver: Lots of ways of approaching them, but it's also interventional as well. It's a, it's then a roster of tools that you together with parents can step by step go through. And my goodness it's amazing to think that with all of this, parents might be thinking, Oh, I can just get my child to sleep. But actually, The positive outcomes are huge.

[00:35:05] Lucia Silver: They're way beyond just sleeping. We're talking about emotional regulation, concentration. We're talking about. Even metabolic the, functioning and getting the best out of the food that we're eating, it's energy levels, it's everything, isn't it? So it's absorbing the nutrients 

[00:35:19] Natasha Duffin: of the good 

[00:35:20] Lucia Silver: food you're eating.

[00:35:21] Lucia Silver: Absorbing the nutrients. And, then the biggie, which is the central nervous system, taking it out of this state of fight or flight, which many parents will be familiar with. They might not be familiar with all the other states, but we've all heard fight or flight. And goodness knows, most of us have.

[00:35:36] Lucia Silver: these days with all the stresses. If we can use those hours of sleep in bed. to help our bodies understand that it can return to a place of safety, then that's huge for when we wake up. Absolutely huge. We are looking at particularly children with neurodevelopmental challenges.

[00:35:57] Lucia Silver: So within that context, Tash, do you have the relating science to speak to some of the specifics of the symptoms of ADHD sensory processing and so forth. We are talking about them already, aren't we? Emotional dysregulation, we're talking about lack of ability to concentrate, prefrontal cortex not developing and so forth.

[00:36:16] Lucia Silver: But can we bring all this together a little bit for parents, particularly in that 

[00:36:21] Natasha Duffin: area? So I think it's a bit of a two way, maybe it's even more than two way street. But, A tired kid, a wired and tired kid, because remember, a tired child will often present very different to , a tired adult. So a tired adult might be like lethargic and taking things slow. A tired child might actually be powered by a motor because they've got tipped into that kind of tired and dysregulated kind of zone. And the only way I know to stop myself from falling asleep is to just keep moving.

[00:36:57] Natasha Duffin: And their research depending on where, you read, somewhere between 20 to 40 to 50 percent of, children diagnosed with ADHD either have a concurrent sleep disorder or don't have ADHD, but have a sleep disorder that is presenting with those symptoms because they're chronically sleep deprived.

[00:37:20] Natasha Duffin: And those children that, have ADHD as well, when you treat their sleep disorder, then their symptoms reduce and they need less medication, for example. So that's one way. Then if we think about children with neurodevelopmental challenges and the experiences they have, like they're very busy brains, anxiety, their sensory cups being very other, really small or very big, struggles with emotional regulation, struggles with impulse control.

[00:37:51] Natasha Duffin: If you are chronically sleep deprived, and remember in terms of quality not quantity, if every night you're getting a rubbish night's sleep, all those things are going to be heightened because you don't have the capacity, you can't be at your best if you're not sleeping well. And then there's the other things in terms of, like trying to get your child to sleep in inverted commas again, thinking okay if I've got those neurodevelopmental challenges and my child has a busy brain, they have anxiety, they, their sensory cup is too full or it's not full enough they're going to struggle to separate from me.

[00:38:30] Natasha Duffin: They don't have very good impulse control. Then falling asleep and separating, that's going to be really tricky. Sleep training or not that you sleep train kids, the, kind of Oh, you close the door and they can just bang on there, whatever, like there's horrific things, bits of advice that go around.

[00:38:49] Natasha Duffin: Like you've got to think come back to kids do well when they can. If we're struggling here. Why? And okay, if my sensory cup is for I need some more proprioceptive input and I can't, and I'm sitting there and I'm pushing against the walls, I'm kicking off mum and dad, like pushing against them.

[00:39:10] Natasha Duffin: My nervous system isn't in that state of safety, because my sensory cup isn't full yet. So we've got to go, okay, what are some signs we're seeing here? We're seeing that pushing, okay, maybe we need to increase that sensory input during the day, offer some opportunities for that sensory input on the way to bed.

[00:39:27] Natasha Duffin: If, things like when they've got, Maybe they're not great with their impulse control. Like a little toddler who just keeps coming out of bed because they're just like, Oh, I just want to see mom and dad. I don't know why, like why, I don't know why I shouldn't be doing that. So those types of things.

[00:39:43] Natasha Duffin: So it's yeah, very much a two way street there.

[00:39:47] Lucia Silver: Understanding what stimulation is needed in order for them to sleep well is a, big piece of the pie, especially with a dopamine sort of levels that often affect children that are not able to. Yeah for, lots of different reasons, find that state of rest before sleep.

[00:40:04] Lucia Silver: They once again need help to find that, whether that's through stimulation or 

[00:40:08] Natasha Duffin: interaction. Yeah. And think so like deep sleep.

[00:40:12] Natasha Duffin: So sleep is regenerative for th for neurotransmitters like dopamine. So it's only made when we're sleeping. So that's the fuel for our frontal lobe,

[00:40:19] Natasha Duffin: So it's frontal lobe responsible for concentration, planning, emotional regulation.

[00:40:23] Natasha Duffin: So when we lack that fuel, things are going to be harder. And again, later on, especially when the brain is still developing. So yeah, it's that it's a five way street. 

[00:40:38] Lucia Silver: Getting them to sleep, getting them to sleep and understanding what they need for that, and then understanding the impact of them not sleeping with those particular neurodevelopmental delays and so forth.

[00:40:49] Lucia Silver: So the, bits we love best, and I think that the most juicy and, digestible really for our parents and our listeners, educators, practitioners, and so forth, is to understand some of the case studies some real life examples, Tash, of if we were to take, if you were happy if you can take a baby maybe, and a preteen, and maybe a teenager and, choose three of those and look at, What it was that was presenting, what you found and what you were able to address.

[00:41:18] Lucia Silver: I think that would be really making it crystal clear what this looks like in real life. 

[00:41:24] Natasha Duffin: Yeah. So I guess something that a lot of people come with babies come to me say I'm bed sharing I'm breastfeeding, and I've been doing that for a long time and I've liked that, but now I'm ready to move on.

[00:41:39] Natasha Duffin: I don't know how. A lot of people will come to me and not actually know that there's any barriers to doing that. And they just, think it's a sleep problem. So I recently worked with a, it was about 18 months, I think. And yeah, breastfeeding every hour overnight.

[00:41:55] Natasha Duffin: So waking every hour, bed sharing and Mum was exhausted. So what we did is we actually identified, okay, there was some signs of sleep disordered breathing there, figured out what they were related to, so they were related to tongue function and some allergies. We improved the oral function through some exercises and bearing in mind, he's 18 months old, so it's not like you sit there and get him to do 10 reps of anything.

[00:42:22] Natasha Duffin: So it's modified with the pediatric feeding. That's where they meld together. So we did some exercises with food and functional things to improve that range of motion of his tongue, address those allergies from an environmental perspective. And we also used co regulation as we replaced breastfeeding.

[00:42:47] Natasha Duffin: So we didn't go, okay that's it. Goodbye. So we supported mum and the baby through that transition. And I can't remember the exact timeframe, but it would have been within three or four months that the baby was sleeping through completely. in their own bed. And mum, like at different points along the way, mum was contacting me, literally emailing me saying, I can't believe how few tears there are.

[00:43:20] Natasha Duffin: Like I just, I can't believe it. So we removed the barriers to the sleep and then we used her nervous system to regulate and we transitioned beautifully away from hourly wakings and feeding to dad being able to settle him. And. sleeping all night in his own bed. So that's a really beautiful example of and it's the, and in this instance, it wasn't like giant ENT issues like that needed adenoids or tonsils removed, or didn't need a tongue tie release.

[00:43:52] Natasha Duffin: We were able to improve the function by identifying the root, and that was enough in this case. It's not always, but that was enough in this case. Another one where, so I think they were about seven years old, and. Their whole life had been waking early and not just like three, four o'clock in the morning.

[00:44:18] Natasha Duffin: And the kid was so cluey and so followed all the rules and knew not to come and wake mom and dad up. But they were like, he's tired. Like he's so tired, but he just cannot sleep in past for or whatever it is in the morning which would be fine if you went to bed earlier and or, he felt actually good with that amount of sleep.

[00:44:42] Natasha Duffin: Did that ORF, OMT assessment. Again, it was allergies in this case as well. We did some breathing exercises. Treated the allergies straight away. Slept in. 

[00:44:56] Lucia Silver: Wow. 

[00:44:57] Natasha Duffin: What were the allergies out 

[00:44:58] Lucia Silver: of interest? 

[00:44:59] Natasha Duffin: So the first one was dust.

[00:45:01] Natasha Duffin: I think this kiddo might've been, More like maybe there might have been some dust in the bed, like pet dander, grass, pollen, that kind of thing.

[00:45:07] Lucia Silver: Are those easy tests to do Tash? Are they Yes. For parents, yeah. 

[00:45:12] Natasha Duffin: So you can see an immunologist for the skin print test or here in Australia at least we can see our GP and get a blood test for those.

[00:45:21] Lucia Silver: Okay. And any examples of the older roters. Yeah, 

[00:45:27] Natasha Duffin: so 

[00:45:28] Lucia Silver: I think 

[00:45:28] Natasha Duffin: she's about 13 and came to me for, so mum brought her to me for oral dysfunction was having some treatment on her, some dental treatment. And so they came to me for the oral function, but along the way mentioned, Oh, she still wakes up and comes into our bed every night.

[00:45:49] Natasha Duffin: And what we did was, strengthened those oral structures. So improved the tongue rest posture, lip seal, nose breathing. Her doctor also identified and he, they even said at the, time, it would be very strange unusual for a 13 year old to have this. But, maybe we're dealing with some reflux here.

[00:46:11] Natasha Duffin: Treated the reflux. So treating the reflux paired with the the oral motor work. And again, stopped waking, stopped coming into the parent's bed. And then that obviously meant, and she said to me, like she was saying, and obviously a 13 year old's a bit more clued in and can, Tell me, she said, yeah, I'm, I feel like I'm sleeping so much better and I feel better in the day because I'm sleeping better.

[00:46:38] Natasha Duffin: As you can see, particularly the last two, not a scratch, nothing behavioral. It's understanding why they are waking. That the mum the older two mum and dad had done every behavioral thing under the sun before, and. Nothing had changed the sleep presentation because the problem wasn't behavioral.

[00:46:59] Natasha Duffin: It was something else underneath. So coming back to that, one of the first comments you made like sleep is very often, and particularly with my client base it's, a symptom, and it's a very loud and very exhausting symptom, but rarely when you've got ongoing sleep difficulties, rarely is it the actual problem.

[00:47:20] Natasha Duffin: We've got to look at it's the canary in the coal mine. What is behind that difficult sleep presentation? Sleep is a biological process. If we can't do it, why can't we do it? 

[00:47:31] Lucia Silver: If we can't do it, there is a reason. Absolutely. I'm thinking these poor parents, on the one hand, they're like, this is amazing.

[00:47:37] Lucia Silver: Finally a night's sleep. And on the other hand, they're thinking, If only we'd found Tash seven years ago, or 13. It's great news, but at the same time, it's oh my goodness, why didn't someone this is what I live with daily with kids. Why didn't someone say, why didn't the GP, for goodness sake, and I can say this as a mom, just say, I don't know.

[00:48:02] Lucia Silver: But how about you? Stay curious and keep looking. Go, see a functional medical person. Go see a sleep expert, but don't try and medicate and don't tell someone it'll just go away. Go do more studying because there's always a reason. There's always a reason. So, Tash, just, yeah, I know. I think you and I could, stand on a soapbox for a long time on these ones.

[00:48:26] Lucia Silver: So Tash, finally it is a whole family thing, whether it's. The kid's not sleeping, therefore mom and dad not sleeping. Mom and dad also may have sleep issues. It's a universal something that we all relate to. If we don't personally struggle with sleep, we know someone who does.

[00:48:41] Lucia Silver: So finally, with parents and sleep and the whole family could you share some just top tips for the whole family? What's the sacred list for sleep hygiene? Just some of the, Really, I mean for me it's a epiphany as it will be for some parents. Just hearing if you're mouth breathing, that's a problem. 'cause they don't even know that you dunno what you don't know. No. Some there's a, and they've done it your whole life. 

[00:49:03] Natasha Duffin: It's normal. 

[00:49:05] Lucia Silver: Absolutely. But they wouldn't know to look for it in their child. And similarly with the screen, I think it's only in recent years we've understood don't be on a screen after a certain amount of time.

[00:49:15] Lucia Silver: That gives the wrong signals to your brain. It wakes it up instead of telling it to go shut eyes. But what's your sacred list here, Tash, to just give some parents some pointers as to what they could be doing. 

[00:49:28] Natasha Duffin: Yeah. So I think screen habits is a big thing. And particularly for our teens, preteens, keeping screens.

[00:49:35] Natasha Duffin: out of the bedroom having a time that they go off. And that it's to do with that melatonin production. And I always tell families, it's it comes back to when we were cavemen and the sun would set and the only light we would have was the campfire, our red campfire, all these LEDs, our computers, our screens, our TVs, our iPhones.

[00:49:57] Natasha Duffin: A blaring blue light into our eyes and we're not, we don't get the signal that it's time to wind down. We're not setting, our body's not starting that process to shut down for the night. So screens should be 

[00:50:09] Lucia Silver: off to be specific when the sun goes down, ideally. 

[00:50:13] Natasha Duffin: Yeah, so one, one to two hours before bed is the, and different kids will have different, and adults will have different sensitivities there.

[00:50:23] Natasha Duffin: But it can, and I'm thinking, in particular one client it can make a huge difference if, and I know it's hard if that's part of the bedtime routine and you've got a toddler who wants what the toddler wants, and sometimes you've really got to really change up that bedtime routine, but you could use things like a podcast or music or and, just get through that difficult period.

[00:50:48] Natasha Duffin: Cause it can make a really big difference. And I guess having a bedtime ritual and wind down for your kids and for you. Importantly for kids, thinking coming back to my OT base and sensory cups, if we've got movement seekers, sensory seekers, that might not actually look like a wind down just yet.

[00:51:09] Natasha Duffin: It might be a wind up before we wind down. Fill those sensory cups. Get that last little bit of proprioception, that deep pressure, that vestibular input that I need to calm my nervous system to get into that. I feel safe. Now I can wind down to go to sleep. Obviously you don't want to be like jumping.

[00:51:27] Natasha Duffin: jumping jumping, and then going straight to bed. But you might be doing 20 minutes of jumping and crashing and going through an obstacle course and squeezes. And then we go and read a book or something like that. Or we sit reading a book with a weighted blanket on our lap or something like that to just fill those sensory cups.

[00:51:44] Natasha Duffin: And the bedtime ritual again, for us as adults and children, it's about, The nervous system knowing what's coming next, helping us feel that sense of safety on that subconscious level. So that, yeah, for all of us. And I think with kids that really struggle with the separation it can be helpful to see sleep as a separation and therefore treating it as you would any other separation challenge.

[00:52:19] Natasha Duffin: So if your child is struggling to go to school hopefully we're saying, Oh, I know it's hard to be apart. We'll always come back together and come up with some little strategies like drawing a little heart or reading books like The Invisible String or something like that.

[00:52:33] Natasha Duffin: So going, acknowledging that, okay, this feels tricky for you. This is what we can do about it. And so carrying that over to that separation of sleep instead of, Oh you just got to stay in your room. And just get on with it. Like I've got to go, we've always got to do a hundred things. So it's a bit, but go, okay, they're struggling with this separation.

[00:52:54] Natasha Duffin: Can I leave them a piece of me? Can I have my my pajamas? Can I, we've got a little. button that I've got a voice recording on there with a mantra for my youngest, she likes to press that, reduces that separation alarm. So finding little ways we can connect if it's the separation. And I guess, The other thing is if a particular sleep setup with one parent sleeping in that bed with that kid, one kid sleeps on the floor, everybody sleeps in the one bed, if that setup works for you, it is fine.

[00:53:30] Natasha Duffin: If you're doing it safely, obviously with babies, but it is fine. And obviously I'm privy to lots of people's sleep setups and You would be surprised how many people sleep with their older kids. It's just it's no one wants to tell anyone, but they tell me. Yeah. So if that works, then it works.

[00:53:52] Natasha Duffin: Doesn't matter. Yeah. 

[00:53:54] Lucia Silver: And you can tell the world it's going on and it works as you say. So let's get rid of this. Let's get rid of this judgment. 

[00:54:01] Natasha Duffin: Very, important. And with obviously the caveat for babies, you've got to be able to do it safely, 

[00:54:07] Lucia Silver: Yes, of course. Those are some great tips, Tash.

[00:54:11] Lucia Silver: Thank you. Really incredibly enlightening. It's a huge subject and I feel so privileged to be sitting here hearing it first hand from you because it's so important. It's revelatory in many areas for us all, and I really want to thank you for joining us today and sharing your expertise and your personal stories with your clients, which are always so helpful to hear, and it's clear that your work is making an incredible impact not just for children with challenges around sleep and the related health issues that you've shown us this causes, but for the families and for communities as a whole.

[00:54:46] Lucia Silver: So thank you very much indeed. Thank you. For those listening, you might like to look again at the key takeouts of this incredible podcast with Tash. We've, we will be creating a top tips cheat sheet with practical tips for anyone struggling with sleep. And it will include all of Tash's actionable advice on improving sleep and where to look for wise sleep, which is the lack of.

[00:55:11] Lucia Silver: which is only a symptom of something else that needs addressing. Please remember that. And this can be found and it can be healed. We will share all of Tasha's, platforms and how you can reach her and deep dive further into her Incredible resources in the show notes and you can also download the cheat sheet in the show notes or by visiting our website at www.

[00:55:34] Lucia Silver: thebrainhealthmovement. com. I'm wishing you all a wonderful day ahead and a great sleep. Goodbye for now. Bye 

[00:55:46] Natasha Duffin: bye. Thanks for having me.