Airway Answers with Nicole Goldfarb: Expanding Your Breath of Knowledge

Psychiatry Meets Sleep Medicine: ADHD, Anxiety, Depression, Sleep Apnea & Beyond — with Dr. Nnamdi Orakpo

🧠 What if symptoms that look psychiatric are being influenced — or worsened — by poor sleep or an underlying sleep disorder?

ADHD. Anxiety. Depression. Irritability. Difficulty concentrating. Emotional dysregulation. Insomnia. PTSD.

In this episode of Airway Answers, Nicole Goldfarb sits down with Dr. Nnamdi Orakpo, MD, PhD — psychiatrist, sleep medicine physician, and Clinical Assistant Professor in the Division of Sleep Medicine at Stanford University School of Medicine — to explore the fascinating intersection of sleep, psychiatry, mental health, and airway health.

💡 What does a psychiatrist who specializes in sleep see that the rest of us may be missing?

We discuss why ADHD symptoms can overlap with poor-quality sleep and sleep-disordered breathing; why insomnia may sometimes be a clue to undiagnosed sleep apnea; and why asking “How is your sleep?” may not be enough.

Dr. Orakpo also explores the two-way relationship between sleep and mental health: poor sleep can contribute to or worsen psychiatric symptoms, while anxiety, depression, PTSD, bipolar disorder, trauma, and psychiatric medications can also affect sleep.

💡 IN THIS EPISODE:

🧠 ADHD or sleep apnea? Why symptoms can overlap
😴 Insomnia medications vs. undiagnosed sleep apnea
🫁 Sleep apnea, intermittent hypoxia & the brain
💊 Antidepressants, psychiatric medications & REM sleep
😰 Anxiety, depression, PTSD & sleep-disordered breathing
🌙 REM Sleep Behavior Disorder & Parkinson’s disease
🛌 Why psychiatrists need more sleep medicine training
🦷 Snoring, gasping, bruxism & other clues psychiatrists may miss
🏫 Teen sleep deprivation & early school start times
👩 Women, menopause, hormones & sleep apnea
👨‍⚕️ Why sleep education matters across medical specialties

⏱️ CHAPTERS

0:00 Welcome to Airway Answers
0:32 Meet Dr. Nnamdi Orakpo: Psychiatry & Sleep Medicine
4:13 From Professional Basketball to MD/PhD & Sleep Medicine
10:27 The Parkinson’s Patient Who Changed His Career
14:23 REM Sleep Behavior Disorder & Parkinson’s Disease Risk
17:35 Why Psychiatrists Need to Ask About Sleep
22:03 Insomnia Medications vs Undiagnosed Sleep Apnea
25:08 How Sleep Apnea Affects the Heart, Lungs & Brain
27:00 ADHD or Sleep Apnea? Symptoms That Can Overlap
36:04 Intermittent Hypoxia: How Sleep Apnea Affects the Brain
39:35 Teen Sleep Deprivation & Early School Start Times
46:34 Sleep Apnea Screening: Questions Psychiatrists Should Ask
49:47 Anxiety, Depression, PTSD & Sleep-Disordered Breathing
54:11 Antidepressants, REM Sleep & Sleep Architecture
1:01:22 Women’s Health, Menopause & Sleep Medicine

👨‍⚕️ ABOUT DR. NNAMDI ORAKPO

Nnamdi Orakpo, MD, PhD, is a psychiatrist, sleep medicine physician, and Clinical Assistant Professor in the Division of Sleep Medicine at Stanford University School of Medicine. His clinical interests span sleep-disordered breathing, insomnia, ADHD, mental health, chronic pain, sleep technology, and emerging treatments in sleep medicine.

Before becoming a physician, Dr. Orakpo pursued basketball internationally and later played Division I basketball in the United States. He earned a PhD in gerontology before attending medical school and later completed his sleep medicine fellowship at Stanford.

🎙️ ABOUT THE HOST

Nicole Goldfarb, M.A., CCC-SLP, COM®, is a speech-language pathologist and Certified Orofacial Myologist® specializing in orofacial myofunctional disorders, airway health, and sleep-disordered breathing. She is the owner of the San Diego Center for Speech & Myofunctional Therapy and host of Airway Answers with Nicole Goldfarb: Expanding Your Breath of Knowledge.

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#AirwayAnswers #SleepApnea #MentalHealth #Psychiatry #SleepMedicine #ADHD #Anxiety #Depression #SleepDisorderedBreathing #Insomnia #PTSD

🦷 Could the dental office be one of the most important places to identify children at risk for sleep-disordered breathing?
Pediatric obstructive sleep apnea is not simply a story of enlarged tonsils and adenoids — and removing them does not always resolve the problem. So what else should we be looking for?
In this episode of Airway Answers with Nicole Goldfarb, Nicole sits down with Dr. Rakesh Bhattacharjee, pediatric pulmonologist and sleep medicine specialist, to explore what decades of research have taught us about pediatric sleep-disordered breathing and obstructive sleep apnea (OSA) — including residual sleep apnea after adenotonsillectomy, craniofacial risk factors, obesity, insomnia, and the different phenotypes of pediatric OSA.
🔬 Dr. Bhattacharjee also discusses new 2026 research examining craniofacial risk factors for sleep-disordered breathing in dental and orthodontic practices and why the mouth and craniofacial structures may provide important clues that help dentists and orthodontists recognize children who need further evaluation.
💡 IN THIS EPISODE:
• Why tonsil and adenoid removal does not always resolve pediatric OSA
• The surprising rate of residual sleep apnea after adenotonsillectomy
• The fascinating brain-lung connection
• COMISA: when insomnia and sleep apnea coexist
• Craniofacial clues dentists and orthodontists can look for
• New 2026 research on pediatric sleep-disordered breathing screening
• Why pediatric sleep apnea has different phenotypes
• The importance of interdisciplinary airway care
⏱️ CHAPTERS
00:00 Pediatric Sleep-Disordered Breathing: Why Dentists Should Be Paying Attention
00:27 Meet Dr. Rakesh Bhattacharjee
02:39 Why Tonsil & Adenoid Removal Does Not Always Cure Pediatric Sleep Apnea
04:56 Dr. Bhattacharjee’s Research & Career
08:13 The Brain-Lung Connection: Sleep, Breathing & the Brain
11:49 COMISA: Insomnia + Sleep Apnea in Children
16:59 Residual Sleep Apnea After Adenotonsillectomy
22:09 Can Early Intervention Change Future Sleep Apnea Risk?
27:46 Obesity, Weight Loss & Tirzepatide in Sleep Apnea
33:05 New 2026 Research: Craniofacial Risk Factors for Pediatric SDB
38:21 Screening for Sleep-Disordered Breathing in Dental Practices
43:55 Why Sleep Physicians Need to Look Inside the Mouth
51:27 The Different Phenotypes of Pediatric Sleep Apnea
56:17 Final Thoughts & Takeaways
👨‍⚕️ ABOUT DR. RAKESH BHATTACHARJEE
Rakesh Bhattacharjee, MD, is Director of Pediatric Sleep Medicine at Rady Children’s Hospital–San Diego and Professor of Pediatrics at the University of California San Diego. A pediatric pulmonologist and sleep medicine specialist, his clinical and research work focuses on pediatric obstructive sleep apnea, sleep-disordered breathing, and related health outcomes.
His research has helped advance our understanding of residual OSA following adenotonsillectomy and the different factors contributing to sleep-disordered breathing in children. He is also a co-author of the 2026 study examining pediatric craniofacial risk factors for sleep-disordered breathing in dental and orthodontic practice settings.
🎙️ ABOUT THE HOST
Nicole Goldfarb, M.A., CCC-SLP, COM®, is a speech-language pathologist and Certified Orofacial Myologist® specializing in orofacial myofunctional disorders, airway health, and sleep-disordered breathing. She is the owner of the San Diego Center for Speech & Myofunctional Therapy and host of Airway Answers with Nicole Goldfarb: Expanding Your Breath of Knowledge.
Nicole lectures nationally and internationally on the relationship between orofacial function, airway health, sleep, speech, and interdisciplinary care and has presented more than 50 lectures to dental, medical, and allied-health audiences.
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#PediatricSleepApnea #SleepDisorderedBreathing #DentalSleepMedicine #PediatricDentistry #AirwayDentistry #PediatricOSA #AirwayAnswers

What should parents and healthcare professionals really know about tongue-tie? In this episode of Airway Answers, Nicole Goldfarb interviews Autumn Henning, MS, CCC-SLP, COM®, IBCLC, one of the leading educators in tethered oral tissues (TOTs), infant feeding, and orofacial myofunctional disorders.

Together, we explore how to evaluate tongue-tie across the lifespan, what makes an infant feeding evaluation unique, why function matters more than anatomy alone, and how thoughtful interdisciplinary care can improve outcomes for both children and adults. Autumn also shares her insights on therapeutic readiness before a frenectomy, post-release care, common misconceptions about tongue-tie, and what every parent and healthcare professional should know.

In this episode, we discuss: Tongue-tie • Tethered oral tissues (TOTs) • Infant feeding • Breastfeeding • IBCLC • Orofacial myofunctional disorders • Myofunctional therapy • Therapeutic readiness • Frenectomy • HOPE Healing Protocol • Airway health • Interdisciplinary care

⸻

CHAPTERS

0:00 Meet Autumn Henning, SLP, COM®, IBCLC

0:33 Autumn’s Background and Clinical Specialties

1:52 Autumn’s Bio and Areas of Expertise

4:35 How Autumn Became Passionate About Tethered Oral Tissues (TOTs)

9:45 The Oral Function Trifecta & Becoming an IBCLC

16:11 What Happens During an Infant Tongue-Tie Evaluation?

34:05 Jaw and Tongue Mechanics During Breastfeeding

37:00 Tongue-Tie vs. Other Breastfeeding Challenges

38:56 Why Lip Ties Rarely Exist Without Tongue-Ties

40:45 Evaluating Tongue-Tie Across the Lifespan

42:11 Preparing for a Successful Tongue-Tie Release

45:46 Aftercare and the HOPE Healing Protocol

1:02:13 Busting Common Tongue-Tie Myths

1:06:12 Autumn’s Courses & Where to Learn More

⸻

👍 If you enjoyed this episode, please Like, Subscribe, and share it with colleagues interested in airway health and orofacial myofunctional therapy.

💬 What surprised you most about this conversation? Leave a comment below—we would love to hear your thoughts and questions!

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⸻

About Autumn Henning

Autumn R. Henning, MS, CCC-SLP, COM®, IBCLC, is a Speech-Language Pathologist, Certified Orofacial Myologist®, International Board Certified Lactation Consultant, educator, and founder of Chrysalis Orofacial in Greenville, South Carolina. She specializes in evaluating and treating tethered oral tissues, infant feeding, swallowing, and orofacial myofunctional disorders across the lifespan.

Autumn also serves as a voluntary Assistant Professor in the Department of Communication Sciences and Disorders at the University of Kentucky College of Health Sciences and was a founding board member of the International Consortium for Oral Ankylofrenula Professionals (ICAP).

Through her internationally recognized continuing education programs—including TOTS® (Tethered Oral Tissues Specialty Training), Plot the TOT®, The STONES Approach®, and the E3 Model of Care®—she has educated thousands of healthcare professionals worldwide, emphasizing functional assessment, critical clinical reasoning, interdisciplinary collaboration, and evidence-informed care.

⸻

About Nicole Goldfarb

Nicole Goldfarb, M.A., CCC-SLP, COM®, is a Speech-Language Pathologist, Certified Orofacial Myologist, international speaker, educator, podcast host, and founder of the San Diego Center for Speech & Myofunctional Therapy.

⸻

🌐 Airway Answers:
www.AirwayAnswers.info

🏥 San Diego Center for Speech & Myofunctional Therapy:
www.SanDiegoCenterForSpeechTherapy.com

📩 Email:
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⸻

#TongueTie #InfantFeeding #AirwayHealth

#Breastfeeding #IBCLC #MyofunctionalTherapy #TetheredOralTissues #TOTs #Frenectomy #AirwayAnswers

⸻

⚠️ Disclaimer: This podcast is for educational and informational purposes only and is not medical or dental advice. Always consult a qualified healthcare professional regarding diagnosis or treatment. Reliance on the information presented is at your own risk. Mention of specific providers, products, or services does not constitute an endorsement.

What can an airway-educated pediatrician teach us about sleep, breathing, tongue-tie, and child development? In this episode of Airway Answers, Nicole Goldfarb interviews Dr. Erik Galindo about his journey from traditional pediatrics to an airway-informed approach to patient care.
Discover how airway health influences pediatric practice, why tongue-tie and sleep-disordered breathing are often overlooked, and what pediatricians, dentists, speech-language pathologists, myofunctional therapists, and parents should know to better recognize early signs of dysfunction.
Topics discussed: Pediatric airway • Airway health • Tongue-tie • Tethered oral tissues (TOTs) • Sleep-disordered breathing • Pediatric sleep • Infant feeding • Child development • Whole-child care • Myofunctional therapy • Interdisciplinary healthcare
CHAPTERS
0:00 Welcome to Airway Answers
0:28 Meet Dr. Erik Galindo, Airway-Focused Pediatrician
1:38 Dr. Erik’s Bio and Credentials
3:34 Why He’s Called “Dr. Erik”
6:33 From Traditional Pediatrics to Whole-Child Care
11:08 Suck-Swallow-Breathe: Why Infants Are Oral-Centric
12:45 Nicole’s Story: Airway Signs Missed From Infancy
16:38 Identifying Dysfunction Before It Becomes Pathology
20:26 Discovering Tongue-Ties and The Breathe Institute
24:57 Then vs. Now: How His Exams Have Evolved
32:18 Five Minutes That Matter: Sleep, Feeding & Daylight
39:13 Tongue-Tie Evaluation and the TRMR Debate
45:30 Practical Steps Pediatricians Can Use Tomorrow
56:48 Sleep-Disordered Breathing and Systemic Inflammation
59:58 Closing Thoughts and Final Advice
👍 If you enjoyed this episode, please Like, Subscribe, and share it with colleagues interested in airway health and orofacial myofunctional therapy.
🔔 Subscribe for future conversations with leading experts in airway health, sleep medicine, dentistry, orthodontics, speech-language pathology, and myofunctional therapy.
About Dr. Erik Galindo
Dr. Erik Galindo is a pediatrician with a special interest in airway health, pediatric sleep, infant feeding, tongue-tie, and whole-child development. His practice emphasizes identifying early dysfunction before it progresses to pathology, helping families and healthcare professionals better understand the connections between breathing, sleep, oral function, and long-term health.
About Nicole Goldfarb
Nicole Goldfarb, M.A., CCC-SLP, COM®, is a Speech-Language Pathologist, Certified Orofacial Myologist, international speaker, educator, podcast host, and founder of the San Diego Center for Speech & Myofunctional Therapy.
👁️ Watch the Video on YouTube & Subscribe: https://youtu.be/JajcMwmbpnc
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🌐 Airway Answers:
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📩 Email:
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#AirwayHealth #Pediatrics #TongueTie
#SleepDisorderedBreathing #ChildDevelopment #MyofunctionalTherapy #Pediatrician #InfantFeeding #AirwayAnswers
⚠️ Disclaimer: This podcast is for educational purposes only and is not medical or dental advice. Always consult a qualified healthcare professional regarding diagnosis or treatment. Reliance on the information presented is at your own risk. Mention of specific providers, products, or services does not constitute an endorsement.

Can tongue-tie contribute to cancer treatment complications, airway dysfunction, and sleep-disordered breathing? In this episode of **Airway Answers**, Nicole Goldfarb interviews **Dr. Hilary Pada** about the connection between tongue mobility, oral oncology, craniofacial development, and airway health.

Learn how the **Tongue Range of Motion Ratio (TRMR)**, obstructive sleep apnea (OSA), oral mucositis, infant feeding, craniofacial development, and interdisciplinary care may influence patient outcomes in both oncology and airway-focused practice.

**Topics discussed:** Tongue-tie • Tethered oral tissues (TOTs) • Airway health • Obstructive sleep apnea (OSA) • Oral oncology • Oral mucositis • Infant feeding • Craniofacial growth • Myofunctional therapy • Interdisciplinary healthcare

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**CHAPTERS**

0:00 Introduction to Airway Answers & Meet Dr. Hilary Pada
3:17 Dr. Hilary Pada's Background in Oral Oncology & Airway Health
10:48 Tongue-Tie and Cancer: Why This Research Matters
17:25 The "Episode Four" Analogy: Why We're Missing Early Signs
18:48 Case Study: Tongue-Tie in a Multiple Myeloma Patient
23:22 Obstructive Sleep Apnea (OSA), Oral Mucositis & Cancer
26:48 Tongue Range of Motion Ratio (TRMR): How to Assess Tongue Mobility
31:31 Before & After: Real Patient Tongue-Tie Treatment Results
35:07 The Seven Oral Frenula & Tongue-Tie Anatomy
41:20 Craniofacial Development: Midlines, Jaw Growth & Airway
51:58 Anterior vs. Posterior Tongue-Tie: What's the Difference?
1:05:23 Research Findings: Severe Tongue Restriction in Cancer Patients
1:20:32 Why Tongue-Tie Is Often Missed in Infants
1:29:18 Sleep, Cancer Risk & Long-Term Health
1:36:47 Infant Feeding, Tongue Function & Early Intervention
1:48:50 Key Takeaways & Closing Thoughts

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👍 **If you enjoyed this episode, please Like, Subscribe, and share it with colleagues interested in airway health and orofacial myofunctional therapy.**

🔔 **Subscribe for future conversations with leading experts in airway health, sleep medicine, dentistry, orthodontics, speech-language pathology, and myofunctional therapy.**

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**About Dr. Hilary Pada**

Dr. Hilary Pada is an oral oncology researcher whose work focuses on tongue mobility, airway health, craniofacial development, sleep-disordered breathing, and cancer care. She is passionate about advancing interdisciplinary collaboration to improve patient outcomes.

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**About Nicole Goldfarb**

Nicole Goldfarb, M.A., CCC-SLP, COM®, is a Speech-Language Pathologist, Certified Orofacial Myologist, international speaker, educator, podcast host, and founder of the San Diego Center for Speech & Myofunctional Therapy.

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[www.AirwayAnswers.info](http://www.AirwayAnswers.info)

🏥 **San Diego Center for Speech & Myofunctional Therapy:**
[www.SanDiegoCenterForSpeechTherapy.com](http://www.SanDiegoCenterForSpeechTherapy.com)

📩 **Email:**
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#TongueTie #AirwayHealth #MyofunctionalTherapy

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⚠️ **Disclaimer:** This podcast is for educational purposes only and is not medical or dental advice. Always consult a qualified healthcare professional regarding diagnosis or treatment. Reliance on the information presented is at your own risk. Mention of specific providers, products, or services does not constitute an endorsement.