REMplenish: Simple Tool For Better Sleep & Health

Jennifer Rooney, BSDH

Thank you for having us. Dr. Wells. We’re very excited to share what we have to offer.

Audrey Wells, MD

As am I. You know, I’ve tried this product and so I know a little bit about how it works. But I wonder if you could start us off by just explaining what sort of product lineup you have and how it works to improve breathing and even sleep.

Jennifer Rooney, BSDH

Certainly. So REMastered Sleep, what it really is, is it’s a drinking nozzle that you drink water through. And as you do so, it makes you exercise and use your tongue. It provides some resistance to create exercise. So there’s a very small slit on the end. So it’s not like a regular straw that you suction in with your cheeks. You actually need to use your tongue in order to swallow correctly to get the water through the nozzle. We have both a version for adults and a version for children.

Audrey Wells, MD

Oh, that’s really important, because I know that a lot of the movement for sleep disorder breathing is starting to focus on earlier intervention. Even in the pediatric age group, to help the palate not be so high, arched, and narrow but actually allows enough space for proper tongue posture. Is that what the REMplenish straw is meant to do for kids?

Jennifer Rooney, BSDH

It really is. You know, the tongue is the proper, creates the proper form of our mouth. And if your tongue is not living up in the roof of the mouth where it should, that form is not going to flow, you know, not going to develop as kids are growing. And when kids are young, they are very malleable. You can get a lot of growth and development and shaping and forming and really setting people up for the right path their whole life through.

Audrey Wells, MD

You know, that makes a lot of sense. And for people who are struggling with obstructive sleep apnea or even persistent mouth breathing right now, I’m sure they’re kind of looking back and thinking, I wish this would have been available when I was a kid. But the truth is, there’s also an adult version of this nozzle. And can you explain more about how that works?

Jennifer Rooney, BSDH

Absolutely. So a big component of our breathing and sleep has to do with the tongue position, just as it is for kids. If the tongue is not living up in the roof of the mouth when we’re resting and we’re sleeping, it leads to an open mouth posture, which means we’re breathing through our mouths, which allows air to rush in and vibrate the tissues in the back of the mouth, leading to snoring and in very severe cases, as you know, if those tissues are very weak, they will collapse and block the airway, which is obstructive sleep apnea. So what the nozzle is really working on doing is strengthening those muscles in the back of the neck and the throat. So, number one, they’re stronger, so they’ll vibrate less. And then we’re hoping to prove in a study that we’re currently doing with the Mayo Clinic, that by using the nasal, it can reduce the risk of sleep apnea in kind of mild to moderate cases, similar to mild functional therapy, which is exercises of the mouth and neck and throat that can be done through a therapist that will show that has been shown to reduce the risk of sleep apnea by as much as 50%. So, we’re basically helping those exercises along by simply drinking water throughout the day.

Audrey Wells, MD

You know, I think that’s kind of killing two birds with one stone because I’m a big fan of staying hydrated. That helps you feel more energetic and less sleepy or tired during the day. And you’re also describing this workout for the tongue. It’s sort of a myofascial exercise in and of itself, meant to help the tongues stay in the roof of the mouth, which is what good tongue posture is. And I’m wondering if you can help me understand, you know, for kids, that middle suture in the roof of the mouth is not quite formed, which allows for more movement. But for adults that suture is in place in the bony palate. So how can the REMplenish straw help adults to have better tongue posture and better breathing? How long does that take?

Jennifer Rooney, BSDH

Well, for most people, they can notice a change in about a month, period of time. But I’ll share my own experience because I found a change in about three days. I started to notice a change. So being a hygienist for as long as I have been, I would have thought I would have known that my tongue should live in the roof of the mouth. But I didn’t know that until I was introduced to REMplenish. And so my tongue hung low most of the day. So as everyone’s listening to us, I would ask them to just think for a moment, where is your tongue in your mouth? Is it suctioned up to your roof or your mouth, or is it actually hanging kind of low? If it’s hanging kind of low then REMplenish might be a really good avenue for you. So within three days of using REMplenish, I started to be aware that my tongue was going up to the roof of my mouth and it was staying there more often. And what ensued was an improvement in my sleep. So I used to be the individual who would wake up at night, lay there, toss and turn for an hour, an hour and a half, and have a really hard time falling back to sleep. Once I started using REMplenish that actually started to go away. A secondary benefit would be when I would wake up, I would go to the bathroom. And so now I’ll wake up. If I do wake up, I’ll just roll over and I don’t wake up to go to the bathroom. So waking up in the middle of the night with a break in your breathing can actually stimulate the urgency or the need to use the bathroom when it’s just a chemical reaction in your body and it’s not truly a need to use the restroom in the middle of the night. So basically my quality of sleep improved, my awake time greatly decreased, and I would say I started to notice the change really in about a month’s time of regular use, drinking one or two bottles of water daily, where that really started to have an impact on my quality of sleep.

Audrey Wells, MD

That’s really great because I think a lot of people can kind of put it together how mouth breathing or not having your tongue up in the roof of your mouth can interfere with sleep. In fact, one of the consequences is dehydration. If you’re breathing through your mouth during sleep, you can actually lose up to a liter of water overnight and wake up really feeling parched in the morning. Now, I am a huge proponent of nasal breathing and the roof of the mouth is the same as the floor of the nose. And so I would imagine that people who are able to have that better tongue posture also see improvements in their ability to breathe through their nose.

Jennifer Rooney, BSDH

Absolutely. In fact, if you do a proper swallow or before you go to sleep, it actually opens that airway so that you can breathe better through your nose at night. And then the other aspect, at least what I found is that my tongue was still somewhat weak. So the middle of the night I would wake up and my tongue would fall and my mouth would be open again and I’d be snoring once again. So I personally incorporated some mouth taping to help hold my chin shut, so that if I did wake up and the tongue had fallen, I could then reposition my tongue to stay up there, to continue to breathe properly through my nose. And then, as my tongue strengthened with the continued use of REMplenish, that has happened less and less.

Audrey Wells, MD

Yeah, that that’s really encouraging. And I wonder if you can really make it help palpable for the people watching. What is it like to use this straw? And you mentioned you’re drinking about two bottles of water or you were to get your tongue up to the proper strength. What is it like to drink from the straw?

Jennifer Rooney, BSDH

Yeah. So let me kind of explain it first and then I will demonstrate it. So the nozzle goes entirely into the mouth and you think if you think of your tongue as being underneath the nozzle, you’re going to push that nozzle up against the roof of the mouth and you have a spot behind your front teeth where people start to swallow. So if you put the tip of the tongue right behind the front teeth, you should start your swallow there. And then your tongue should roll along the roof of your mouth to push water backward. So we call that the spot. So every time we push up with our tongue on the spot, it actually pulls a little water into the mouth and then we push up again to swallow. So we’re basically doing a push-up with our tongue each and every time that we swallow that water. So let me grab my large mug. I try and drink one of these a day and let me turn to the side so you can see the action that’s happening. So we want to see movement in the chin, which is showing movement in the tongue moving up and down.

Audrey Wells, MD

Yeah, I can really see that you’re pulling the swallow or the water back and there’s sort of a coordinated movement of the tongue this happening.

Jennifer Rooney, BSDH

Yeah. And some people will use this nozzle in conjunction with a mild functional therapist if they have swallows that aren’t functioning the correct way to improve that function. But I will say, for those people who have really weak muscles in their mouth, their tongues, especially when they start using this, they can have some soreness because we’re working a muscle that really hasn’t been worked before. So if we were doing, you know, bicep curls and we hadn’t been curling that much, that muscle’s going to get sore. So you need to start slowly and gradually increase that. So we would say a goal early on would be to drink like a 20 ounce, 20 ounces of water a day and then ultimately get yourself up to about 60 ounces a day for an adult.

Audrey Wells, MD

Oh, that makes sense. And I’m kind of hearing or reading between the lines that there is some type of maintenance involved as well.

Jennifer Rooney, BSDH

Well, actually, once the tongue has developed that muscle and tone, after about six months, things will kind of level off. And if that tone remains, there’s probably no need that you would have to continually use it. But we still want to stay hydrated. So I’ve been drinking out of this for 22 months. This is how I drink my water. But then throughout the day, I drink other beverages in a cup. You know, I don’t have to use this for all drinking. It’s just when I’m drinking that water.

Audrey Wells, MD

I guess what’s happening is that you’re getting the tongue, more strength, and also better coordination. And then your swallowing profile or your swallowing mechanism improves and sort of maintains itself. Do I have that right?

Jennifer Rooney, BSDH

You do. You’re basically creating habituation of that muscle. And so when you’ve used that proper swallow technique time after time after time, you will be able to take that proper swallow and do it elsewhere in other beverages that you drink out of a glass or another straw. So, for instance, I have another bottle in the other part of the house that about a month into using this, it was a regular straw, and about a month into using it, I went to take a drink out of it and I realized that I was using my tongue the same way that I would use my REMplenish nozzle and not suctioning in with my cheeks. You know, that creates suction and we’re we’re creating a vacuum to pull water in the mouth.

Audrey Wells, MD

Yes, I can see that. I mean, you’re basically having muscle memory.

Jennifer Rooney, BSDH

Correct.

Audrey Wells, MD

Yep. Fantastic. You know, one of the things that I noticed when I tried the REMplenish straw was that the amount of water that you get is less than what you could get before. And that sort of let me take several drinks in a row, and I would imagine that’s part of the workout is doing those reps.

Jennifer Rooney, BSDH

Exactly. I usually do. You saw me do it for five, six pumps of water because that gives me the amount of water that I would drink as if I were going to take a drink out of a glass. So to feel hydrated, that’s how often I would pump my tongue. Now, using this on the treadmill, maybe not the time to be working your tongue when you’re working the rest of the body. Maybe let’s just do regular hydration and save the tongue workout for other times of the day.

Audrey Wells, MD

Yeah. You know, you mentioned the soreness that you can notice if if this is new to you and you’re just getting started. And I really think it’s important that people are prepared for that so that they have perspective on what their treatment should look like and feel like. Are there any other things that people should be aware of if they want to try this?

Jennifer Rooney, BSDH

For some people who have, we would call them compensation or the inability to find that spot that I talked about where the tongue should go to the roof of the mouth. There’s more going on in the mouth with musculature that they might need additional guidance from a male functional therapist or a speech-language pathologist. So if you were to get REMplenish and try it and have struggles, we, of course, as a company can support you and coach you on those things. But we might at some point say, you know what, you need additional support and help and we might refer you to a mild functional therapist, but that’s not very common.

Audrey Wells, MD

Yeah, that makes sense. When I am counseling people who use CPAP treatment for obstructive sleep apnea, one of the more common problems is the mouth coming open, and I recommend this little exercise at the beginning of the night when someone’s just ready to get to sleep, put the tongue on the back of the upper front teeth and then swallow. And they should feel the tongue sort of come up in the roof of the mouth and seal. I wonder if those who have high-arched palates or trouble with tongue posture, would they get that same feeling or would that be a sign that they needed mild functional therapy?

Jennifer Rooney, BSDH

It might be a sign that they need mild functional therapy. It really depends upon the tongue’s ability to push up to the roof of the mouth. Like if you have a really strong tongue, you can reach a longer distance. If your tongue is tied to the floor of your mouth, something called a tongue tie that’s going to inhibit your ability to push your tongue up to the roof of the mouth. So I think sometimes it’s a 1 to 1 evaluation on whether or not someone can use that. You mentioned people who use CPAP machines. We have individuals who are on CPAP machines that incorporate REMplenish along with that therapy because we know there’s weakness in the back of the neck and the throat and that’s why the airways collapsing. This can only have a positive impact on that. If we can strengthen those muscles, it might reduce some of the dependency on the pressures. Maybe you don’t have to have as high of a pressure on your machine. Maybe it’s easier to wear your mask because you have to be tight as tight to your face. So there are definite benefits to use this along with other therapies that you’re doing. I also know that some people will have sleep appliances, and oral appliances that they wear. You know, this can be used in conjunction with that, strengthen the muscles during the day to make a better result at night.

Audrey Wells, MD

Yeah, I totally agree with that. And a lot of people are interested to know that even just the act of mouth breathing reduces sleep quality and can produce daytime tiredness. And once your mouth is closed, hydrated, and moist, then you’ll have a much better experience with your sleep. So it makes sense that this would be helpful. I wonder if there are other benefits or pros to using the REMplenish device.

Jennifer Rooney, BSDH

Well, we were just talking about mouth breathing. Let’s further the nasal breathing. So we know there are health benefits to nasal breathing. When we breathe through our nose, we will create something called nitric oxide. And nitric oxide is very important for our bodies because it’s antibacterial, antiviral, and anti-fungal and it filters and humidifies the air. So just by simply closing the mouth and getting that tongue up, we’re going to be able to better breathe through our noses, which is better for our overall health.

Audrey Wells, MD

Fantastic. I love the nasal breathing aspect. It’s really the way we were meant to breathe. And so having that option is super important. Now, you mentioned a study going on in the Mayo Clinic. I’m wondering if there are published peer-reviewed studies already out there about the effect of the REMplenish straws.

Jennifer Rooney, BSDH

So we have one small study that we did was a usability study back in 2020 where 93% of the respondents had an improvement in their snoring. They were using Snore Lab to track their results and then also that came out of that was 34% of those respondents said, gosh, I’m not as tired, I’m sleeping better. Well, obviously you’re not as tired because you’re not snoring. You’re getting that more restful sleep. You’re not waking up with the brain fog and the headaches and the dry mouth, probably because you’re you’re snoring less. So that’s the study that we have published at this point in time. And like I said, the Mayo Clinic study is ongoing and we hope to have some data from that hopefully early in 2024.

Audrey Wells, MD

That’s really exciting. You know, I love a good study that really looks at the effectiveness of devices like these. And I can say from experience that something is improving with tongue strength when you’re using that. So I’d love to see that borne out. And for those of you watching, Jennifer mentioned Snore Lab, which is a great app that you can download to survey for snoring, not only for you but potentially for your bed partner, families, or friends. I think that’s a really nice way to look for snoring.

Jennifer Rooney, BSDH

I will say, though, if you have a bed partner’s snoring, it’s hard to determine if it’s your snoring is recording or there’s snoring. So you might need to sleep in another room to see who truly is the snore in that case.

Audrey Wells, MD

That’s so true. I think that a lot of times when people wake up and they’ve kind of heard themselves snoring, they attribute it to their bed partner because they don’t want it to.

Jennifer Rooney, BSDH

They don’t want to own the fact that they snore.

Audrey Wells, MD

That’s right. Yeah, that’s right. That’s exactly right. Okay. So we talked about the Pedes straw, the pediatric straw a little bit. Can you explain how that’s different than the adult straw? And then is there an age limit to these things?

Jennifer Rooney, BSDH

Oh, yes and no. So the difference are the fact that the adult straw is about four millimeters longer than the the junior straw. So it’s made for a smaller mouth. In addition, there are these little nubs and bumps. They don’t show up very well on the video here, but those nubs and bumps do two things for us. They help, number one, children or users know where to put that tongue properly. But with kids, what we’re finding is that really helps with desensitizing your oral environment. So kids who have food aversions, and texture aversions, are gaggers just by getting that extra texture in the mouth is desensitizing the mouth. So with that being said, if you’re an adult and you have that problem, there’s no reason you couldn’t use the smaller version. If you’re also an adult with a smaller mouth, there’s no reason you couldn’t use this version as well. So it’s kind of a matter of personal preference. The main difference is how long the arches from the front to the back teeth and what might be the proper length for you. Generally, we would aim to see the children is for a 3 to 9-year-old. Once those second molars start coming in and then we would move you into an adult after that again unless there is a definite benefit for you to have those bumps or something smaller.

Audrey Wells, MD

You know, I’ve got little kids and it occurs to me that giving them this straw to drink from would save me some money on unorthodox shots in the future. They don’t snore, but I don’t see a downside, actually, to using it. Even in the absence of snoring.

Jennifer Rooney, BSDH

There really isn’t. In fact, I’ve got a case study of a little boy who was having speech and language delays, and his tongue was kind of pushing out the side of his mouth. We call it a lateral thrust and it was making his bite open and he was not really following along with the therapy that the speech-language pathologist was recommending. He had behavioral issues because he wasn’t sleeping well. And so she started him on this junior nozzle and he liked it. He got it. He just like automatically started using it and was really consistent with using it during their therapy sessions and then also at home consistently and about two and a half months later, after having infrequent sessions of therapy because of the holidays, he comes back and his arch is completely changed. He went from having two baby teeth, which were very small, that was in the process of coming out to having his permanent teeth come in, which were twice as wide as baby teeth, and having no room for them. So just by getting the tongue up, that arch is developing the way it is intended to be and letting the teeth have the space to come in correctly. So you really are setting your kids up for proper development and growth by letting their tongues do what they’re naturally intended to do. And it might reduce your orthodontic needs absolutely.

Audrey Wells, MD

Oh, my gosh. I think if anybody is hearing this and has any connection with little kids, that can be a big expense. So it’s great to know that.

Jennifer Rooney, BSDH

Let me also add that 190% of your skull is formed by the age of four. So you want that growth happening when they’re younger, when they’re malleable so that can happen, and then just supporting that as they continue to grow beyond that age.

Audrey Wells, MD

Man, I think that’s fantastic and it’s always nice to hear a story of success. For anyone listening, it’s really clear that sleep problems in children can look very different from that in adults. So kids oftentimes are hyperactive, inattentive, even getting a diagnosis of ADHD, sometimes on the autism spectrum. And, you know, sleep problems need to be investigated early so that other types of growth, like linear growth and academic growth, can happen on a backdrop of healthy sleep. So fantastic information about kids’ tongues and skull development.

Jennifer Rooney, BSDH

And another one, Dr. Wells, we should talk about bedwetting, because if you have a child that’s wetting the bed, that’s a telltale sign that they are having disrupted sleep.

Audrey Wells, MD

Yeah, that’s that’s often the case. And sometimes when they go to get a sleep study, it can be a little bit unsatisfying if the results are inconclusive. So yeah, if you have any kind of sleep issue for your child, it’s worthwhile to seek out care because sleep is absolutely foundational to good health, especially for kids. Now, I wonder, Jennifer, is there kind of a story about how REMplenish came to be? What was the motivation behind doing this type of work?

Jennifer Rooney, BSDH

Yeah, good question. So it was developed by a biomedical engineer and he was working on a master’s degree in health innovation and was looking for problems, health problems or what should I look at? And he went to a sleep clinic where he saw someone with moderate apnea, and said, I am not wearing a CPAP machine. And unfortunately, that’s the reality for a lot of people. They’ve heard horror stories. They don’t like how it fits. They don’t want to be tied to a machine. Now, we would never say that this is a replacement for that CPAP machine, but that person was going to do nothing. So he started thinking, well, is there something? Can I do something? What can I do? So he did some due diligence and some research and came across a couple of really interesting studies.

The first one is the didgeridoo. So didgeridoo for those that don’t know, is a long Australian instrument that makes that aboriginal sound that you’ve probably heard. When you think of Australia that sound. And in this study, they found that in people who use that device 20 minutes a day, five days a week after about four months, their apnea events, apnea being the breaks and breathing dropped from a moderate risk to a mild risk. So that was kind of clue number one. Clue number two I alluded to earlier, we talked about mild functional therapy, the exercises of the tongue, mouth, and throat, which had been shown to reduce APNIC events by as much as 50%. So two very obvious clues. Something’s going on with the mouth. And then the last one, which is actually the most fun one watching is Dog Comet. One day play with the peanut butter Kong. So the the toy that you stuffed the peanut butter in and the tongue is just working to get the peanut butter out. And he literally had this like brain-child moment. Oh, my gosh, the dog is playing, but it’s getting exercise. So what do people do every day? People drink water every day. So I got to find a way to get them to exercise with their mouths every day by drinking water. So that’s really how it all came about.

Audrey Wells, MD

Wow. That’s a great story. And it makes me think that I should be giving my little pug dogs more Kongs because they have that smooshed-up face. And one of them especially snores a lot. You know, it’s been really great to talk to you about this solution. And I’m sure a lot of people would be interested in knowing where they can find the REMplenish products. And if you’re offering any specials for the sleep summit.

Jennifer Rooney, BSDH

We absolutely are. So you can go to our website. It’s www.remasteredsleep.com. And go to the shop page. And then if you enter the code, doctor talks one five doctor talks 15. So DRTALKS15, you’ll get 15% off your total order.

Audrey Wells, MD

That’s great. I will be going to sign my kids up for these straws right away. And Jennifer, I wonder if you can leave us with any parting thoughts, what do you think the audience really needs to know and remember about remastered sleep?

Jennifer Rooney, BSDH

I think the best thing to remember is that it’s a low-risk, economical option to try. I mean, if you’ve got any interruptions in your sleep or any problems with your child’s sitting, why not try it? It really is. You’re only doing good. You’re only drinking more water and you’re helping yourself along the way. And like we’ve been mentioning, sleep is integral to everyone’s total health and we just need to get more and more sleep and not consider it a luxury. It’s a necessity.

Audrey Wells, MD

Oh, my gosh. You’re singing my tune. Thank you so much for being here and letting everybody know there is a new solution for better swallowing, better breathing, and better sleep. Thank you, Jennifer.

Jennifer Rooney, BSDH

Thank you, Dr. Wells.