Can Sleep Apnea Cause Celiac Disease?
December 30, 2009
I know that the topic of this post may inflame a lot of readers out there, but please hear me out.
Celiac disease is a well-defined autoimmune condition that was originally described in children with chronic, severe gastrointestinal symptoms (diarrhea, cramping, abdominal pain and bloating). It’s known to exist in around 1/100 people in this country (97% don’t know they have it), and it’s responsible for various non-gastrointestinal symptoms, including a specific skin rash called dermatitis herpetiformis, migraines, ADHD, numbness, depression, chronic fatigue, and seizures. Others have reported a link between celiac disease and migraines, PCOS, and infertility. Only 1 out of 6 people have classic abdominal and gastrointestinal symptoms. For unexplainable reasons, the incidence has been reported to have increased 4x in the past 50 years.
The theory behind this widespread condition is that the in susceptible people, antibodies in the small intestines attack gluten, a common protein in wheat-based food. Humans don’t have the enzyme to digest gluten, so it passes harmlessly, but in people with celiac, an immune response is created which causes severe inflammation in the small intestines, leading to the classic symptoms. The only known effective cure is to avoid eating anything that contains wheat, in favor of alternatives such as rice, flax, oats, quinoa, teff, and buckwheat.
People who are eventually diagnosed and who go gluten free have remarkable success stories, with more awareness within the medical community and the lay public. One proposed explanation as to why this condition is so underdiagnosed in the US compared to other developed countries is that there’s no pharmaceutical drug that treats this condition, and that in other countries with centralized medical systems, prevention is stressed, rather than just treating the symptoms.
So far, pretty basic information, right?
Here’s my take on celiac disease: For the past few years, whenever I see patients with known celiac disease who come to see me for various ear, nose and throat symptoms, they all have various degrees of sleep-breathing problems. Almost invariably, they have small jaws, cold hands, can’t sleep on their backs, are tired all the time, and have at least one parent that snores heavily. If you look at the space behind the tongue, the airway is extremely narrow. I’ve always suspected that there’s a link between celiac disease and a sleep-breathing disorder such as upper airway resistance syndrome, but I’ve been waiting to accumulate enough studies and evidence before adding celiac disease to my sleep-breathing paradigm.
Various other gastrointestinal conditions have been linked to sleep-breathing problems such as irritable bowel syndrome, Chron’s and ulcerative colitis, so why not celiac? Remember that with upper airway resistance syndrome (UARS), repeated micro-obstructions and arousals prevents deep sleep, which causes a chronic low-grade physiologic stress response. Stress shuts down blood flow to the intestines, which leads to the food just sitting in your intestines without proper digestion and nutrient absorption. After a while, the food becomes an irritant, which causes an inflammatory reaction, creating antibodies in the process, and food being rapidly expelled in the form of diarrhea. Chronic low-grade stress heightens your nervous system and immune system, where your body tends to over-react to normal stimulants or irritants. Just like in the nose, not only will you have an allergic reaction, you’ll also have a nervous system reaction (since your gut has a lot of nerves).
It’s no surprise that every symptom that you see with celiac disease is also seen with upper airway resistance syndrome, including hypothyroidism, migraines, PCOS, dizziness, low blood pressure, and cold hands. There’s even anecdotal evidence that breastfeeding lessens the chance that you’ll develop celiac, which is consistent with what I’ve been saying about how bottlefeeding can increase your risk of upper airway resistance syndrome and obstructive sleep apnea.
I’m not discounting the significant strides made in celiac disease research. There needs to be more awareness and more screening to treat this all-too-common condition. However, even when people go on completely gluten-free diets, they continue to have many of the various other non-gastrointestinal symptoms, including chronic fatigue, migraines, and poor sleep. The way I see celiac is that it’s kind of like a bad allergy, where your main reaction occurs in the intestines. Removing gluten definitely can help, similar to removing a cat from your house if you’re strongly allergic. But ultimately, you’re not treating what’s making you allergic in the first place. Celiac is possibly one of the early signs of an underlying sleep-breathing disorder, just like hypertension, ADHD, depression and heart disease. In modern medicine, we only tend to treat the end result, rather than the cause.
If you have celiac disease, ask yourself the following:
1. Do you prefer to sleep on your side or stomach?
2. Are you tired, no matter how long you sleep?
3. Do you have cold hands or feet?
4. Do you get frequent sinus headaches or nasal congestion?
5. Do either of your parents snore heavily?
What’s your take on my theory? Please enter your feedback in the comments box below.
48 Responses to “Can Sleep Apnea Cause Celiac Disease?”
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This is very interesting. I think there may be something to it. Eliminating gluten has “saved” my life–that is, I’m feeling back to normal now–but I’ve wondered why, after over 50 years, gluten suddenly started being a problem. I did the genetic test and it confirmed that I have two copies of the gene. I read that in order for celiac to occur, you have to have the genetic factor, be ingesting gluten (which everyone in the U.S. does) and also reach a certain stress factor. Maybe the sleep factor IS the stress factor that triggers the response, as noted in the article. Thanks for posting this information!
This is, indeed, interesting.
I’ve been diagnosed as having obstructive sleep apnea which is currently being treated with cpap. I’ve been on cpap for 90 days and feel a LOT better than previously.
My doctor feels I also have celiac and I’ll be tested for that in the next few weeks. ‘m not sure I’m interested in a bowel biopsy since the treatment is to eliminateluten, though. I’ll be more likely to just move to eliminate gluten and see if that resolves my digestive problems.
Though I’ve already been diagnosed with OSA, my answers to your list of questions are (before OSA treatment):
1. Do you prefer to sleep on your side or stomach? I always slept on my side because my snoring would wake even me when I slept on my back.
2. Are you tired, no matter how long you sleep? I was so tired I would need a nap or I’d fall asleep at my desk or fear falling asleep when driving.
3. Do you have cold hands or feet? My hands and feet were always cold (they still are actually).
4. Do you get frequent sinus headaches or nasal congestion? I would get a daily headache, usually sinus but sometimes migraine. My nose was always congested.
5. Do either of your parents snore heavily? Both my parents snored heavily.
Maura,
One option for you is to wait about 4-6 months and then reassess your gastrointestinal issues. Most likely, it’ll be better, but if not completely, go ahead and get tested.
I think it likely that there is a connection between apnea and gut issues. I have both. I would strongly recommend to anyone interested in the subject, the works of Dr. Sidney Valentine Haas, who received honors in 1951 for his pioneering efforts in the connection between diet and gut issues. His diet was superceded for celiac by the gluten-free diet by the simple expedient of defining as celiac only those who reacted specifically to gluten. Those with gut issues who did not respond to gluten-free were simply left in limbo. Diet is also a factor in many other issues — one has only to look at the adulteration of our food supply over the past fifty years to understand some of that.
Thanks for the feedback, Dr. Park. I told her I'd go ahead and do the blood test because that's not a big deal to me but I'll hold off on the biopsy unless she really feels we need it. I've also heard of a stool test that can be done. The blood test, if positive for celiac, would tell me something concrete to warn my children and siblings about, though. Add to that a husband who thinks it's all in my head.
Even if the blood test is negative for celiac, I'll operate under the assumption I have a gluten intolerance and see what happens with 6 months of a gluten-free diet. If it solves the problems, I'll continue the diet and enjoy my "cure". :)
No offense to the medical field but endoscopy doesn't sound like a while lot of fun :)
I am very interested in your celiac disease connection theory. I have 4 of your symptoms. I wanted to let you know that even though I have not been diagnosed with celiac, the gluten and starch things that I occasionally eat cause the most problems with my digestion. I've been doing the SCD diet 11 months now and I'm mostly symptom free. I was officially diagnosed 10 years ago with sleep apnea but after a month with the cpap machine, I thought the cure was worse than the disease. I have also had Migrains since I was 12 years old (under control with accupuncture), And most recently I am being treated for adrenal fatigue by my alternative MD. Adrenal fatigue is my biggest challenge these past 10 years. If you are interested in doing any studies, I would be more than willing to participate or answer questions. Oh yes, I was also a bottle fed baby!
Dr. Parks, I found this article very interesting. You definitely gave me something to think about. I have been gluten free for 9 1/2 years, and still have so many issues. I have finally came to the conclusion that I am super sensitive to gluten. We all know that "gluten free" labeled food, actually is not gluten free, it's gluten lite. 20ppm may be safe for some celiac's, but not for me, even 5ppm gets me.
I was diagnosed with moderate sleep apnea in Aug of 08, and have been using a CPAP since then.
1. Do you prefer to sleep on your side or stomach? I always prefer sleeping on my side, not sure of the reasoning, I do have hip pain, so sometimes side sleeping is more difficult, but much prefered.
2. Are you tired, no matter how long you sleep? ALWAYS! For the last month or so, I am exhausted all the time. I do have a diagnosis of CFS because of Epstein Barr flares too.
3. Do you have cold hands or feet? Want to feel them!!! My daughter was visiting me in December, and one night when my feet were especially cold, she wrapped them in a quilt..an hour later she asked if they had warmed up and I let her see for herself…still freezing cold….but, I also have neuropathy, which can be the villian.
4. Do you get frequent sinus headaches or nasal congestion? I have a headache, every hour of every day…it's never gone, sometimes not as bad, sometimes horrific, but always there.
5. Do either of your parents snore heavily? My dad was always a heavy snorer.
I do feel that most of my diagnosis were caused by years and years of eating gluten, not knowing it was poison for me.
Thank you for this article.
Deb
Interesting… my sister has sleep apnea. After I was diagnosed with cilac disease she had the blood test and the results were negative.
After having Mono/Epstein Barr in my late teens… I felt I never recovered. After a miscarriage in my 20s my doctor hospitalized me for a series of tests… he was convinced I had diabetes… all my results showed… low blood sugar rather than high. My ‘old country’ doctor recommended a high protein diet… That diet helped me to function for 50 years….( and I am hyper-thyroid)
I went in for a cancer screening at age 67… my gastro guy found that my small intestiine had no villia; then I had my blood test just to make the insurance company happy…
I have now been ‘gluten free” 20 months.. I am 69 years old.
1. I always fall asleep on my side, however, I often wake up on my back or stomach..
2. Before going gluten free… I often slept 10 or more hours a day… Now I sleep about 71/2 ot 8 hours.
3. In the winter my feet can be cold. However, in summer I sometimes awake in the middle of the night and soak my feet in cool water. I can not wear closed in shoes… else my feet will ‘cook”… I wear sandals year round.
4. No to headaches..(except thosse due to dehydration … I live in a very dry climate ; if I have a headache … I drink water and it goes away. . After my case of mono… my nose ran … I carried a box of tissue all the time. Then I experimented with cigarettes… the sinus dryed up and Naturally I became very addicted to cigarettes… when I finally was able to quit at age 55 … the sinus infections started up again… and over the years I had become very senstive to perfumes and additivies in cleaners and soaps and shampoos…. I have had no sinus infections since being gluten fee.
I also use fragrance free products …
5. My parent are dead.. My father snored loud enough to wake the dead. He and his mother both probably had dermatitis herpetiformis, They had this rash on their arms and lower limbs that never cleared up…. My mother had a very bad reaction to malt. . Two of my great aunts died young of intestinal cancer and each had at least 3 pregnancy that did not go to term… My great grandmother letters discriber her ‘gut problems’ in detail… I am convinced that she had undiagnosed celiac disease… as did her mother-in-law… you say there is more celiac disease now…. I DOUBT that… it was just called my different names and people like my great grandmother did very well when she stuck to her own routince lots of beans, potatoes, corn pone and fresh and canned veggies and fruit from herown garden and neighboring orchards… When she ‘wintered’ with her children and ate cake and store bought bread… she got sick.
So my reaction to your ideas are that it will take a great deal of research to determine cause or effect… A great many celiacs have arthritis and osteoporosis are we going to say that osteoporosis cause celiac … …
I have another little worm to throw at you… I know only personally 4 people with celiac disease… in my tiny town… 3 of us worked in the same office for years… Any read on celiac disease being contagious. ????
Note to Maura, Let me tell you what is NOT a whole lot of fun. After being gluten free for a little less than a year I accidentally ingested some gluten. My husband felt I needed to go to the emergency room and I agreed, however, I could not leave the bathroom. I had violent cramps and chills and after drinking about a quart of V8 and a lot of water I was finally able to curl up in bed for 12 hours of pain and nausea… Now I have just discribed a gluten chanllenge… I would not wish that on my worst enemy…
On the other had I have also put off having a scoping until age 67 because I feared the procedure.
The procedure is a walk in the park.. You need to have your driver with you … You are anesthesized… you do not feel a thing… during the whole process. You will be too groggy to drive after the procedure and hungry… My husband took me out for breakfast after the procedure and then drove me home.
It is no biggy…
For pete's sake, do some research, sleep apnea does NOT cause celiac disease! However, if you have celiac disease, or non-celiac gluten intolerance, you might also have sleep apnea as one of the many entities that can be associated with celiac disease. Please don't think you need to have a positive biopsy in order to be gluten intolerant or to have celiac disease. Just go on the gluten-free diet and see if you improve. But make sure it's gluten free and not just semi-gluten free – even a smidgen of gluten can keep the inflammatory process going for weeks. I suggest you read Healthier Without Wheat by Dr. Stephen Wagnan.
DE…Dr. Parks didn't say it causes it, he said there may be a connection. He also said that celiac is more of an allergy, not so much an intolerance…which is somewhat true too. Try thinking outside the box a little. I have dealt with gluten intolerance/celiac disease for my entire adult life, and yes, I have sleep apnea too. He makes some sense, and he didnt' say anything definite…at least he is thinking this through…too many scientists aren't doing enough research on gluten…they think they have found the answer with celiac, but let me tell you, gluten intolerance is much bigger than celiac, and every bit as dangerous. Keep at it Dr. Parks!
This is very interesting.
I am gluten intolerant, though never went for testing or an official Celiac diagnosis because I learned after I had been gluten free for a while that I would have needed to be tested before going gluten free. I didn't want to go back to eating gluten just to have testing done, once I saw how much my quality of life improved without it, so I opted to go without a formal diagnosis.
I have obstructive sleep apnea and have used a c-pap machine for about five years now. I also have PCOS, PMDD, Adult ADD, and Fibromyalgia/Chronic Fatigue. I have known for a long time that every one of these conditions overlaps with the others, and that one affects another (during Fibro flareups, my PMDD is worse, accidental ingestion of even microscopic amounts of gluten makes my ADD and PMDD much worse [in addition to other symptoms], etc.). In fact, I blogged about this here: http://lifeischange.wordpress.com/2008/12/22/palpitations-migraines-and-fatigue-oh-my.
To answer the questions above:
1. Do you prefer to sleep on your side or stomach? I prefer to fall asleep on my side, but for some reason feel that my breathing is less obstructed when I sleep on my back. I generally spend most of the night sleeping on my back, and then wake up with a back ache.
2. Are you tired, no matter how long you sleep? Yes, but when I take my ADD medication, I find that goes away, provided I do sleep enough the night before (between 7 and 9 hours, generally).
3. Do you have cold hands or feet? Yes, both.
4. Do you get frequent sinus headaches or nasal congestion? Yes, both.
5. Do either of your parents snore heavily? Yes, both.
I don't know whether one issue causes any of the others, but I do know they are definitely connected. I am extremely happy to see a doctor asking these questions, who is willing to look further into these connections and try to find more information!
This is interesting but I would think it would be the other way around, in that celiac more likely causes the sleep apnea. It seems to me that someone with celiac that went undiagnosed until adulthood, who grew and developed with the disease active, would have improper nutrient absorption, and, I would theorize, if celiac can cause small stature, why not improper development of the jaw and head to create a small airway? If celiac can affect the mucus membrane of the small intestine, why not the mucus membrane of the mouth and nose? The problem, I feel, is that we have no good way of early detection, before the disease is so bad that our intestines are badly damaged, and that those of us who don't get diagnosed until we are much older have airways that have grown as they have, and so it can't be fixed now by removing gluten from our diets. Certainly stress can cause all kinds of problems in the body, but celiac is generally considered a genetic disease, and as such, seems doubtful that a sleep disorder could "cause" it. Although, perhaps it could be the final "trigger". But still, I vote for the other way around, that undiagnosed celiac causes problems with development that results in breathing, mucosal, and sleep problems later in life.
Chris…I can see where your thinking is coming from, yet from my understanding, sleep apnea is not genetics so much as hereditary bone structure. Our bone structures are already formed before birth, I don't think celiac can change that. It may be able to stunt our growth, but it can't change the way your face is shaped. My neuro told me my mouth is too small…hehe, what a shock to some who know me!!!
I wish celiac caused it, then going gluten free would be the answer to having it stop, and throwing out this CPAP machine.
I was diagnosed Celiac 4 months ago and on Gluten Free diet ever since. The thing about Celiacs is that they often have other auto-immune syndromes. I was diagnosed with Juvenile Rheumatoid Arthritis at 7yrs and due to that have small jaw. Diagnosed with Anemia for past 10 years, and due to that have cold hand and feet. I was diagnosed with PCOS about 10 years ago, and since that my belly hurt, so could only sleep on belly. Also have curveture of spine (probably due to the JRA or malnurishment due to Celiacs which causes osteoperosis) so I can't sleep on my back. I was always tired, due to the Anemia. Since going on Gfree diet, I have lost the pain in my stomach and am no longer cold in my hands and feet and I am not nearly as tired due to the fact that I am no longer severely Anemic as I once was. Before,I could fall asleep at the drop of a hat, sleep heavily until morning then take three naps a day, but due to Anemia couldn't get enough. I have only been Gfree for 4 months but for the last two months I haven't felt sleepy at all, even wake up right before alarm clock, can't take a mid-day nap, and feel as if I am taking speed. It's amazing, and I feel good. Not a big snorer nor were my parents. The lack of oxygen is something to look at though….Anemia….already robs your organs of oxygen, and maybe sleep disorders might contribute. I don't think sleep apnea is the catalyst or stress inducer you do, but I do think that Celiacs, due to some other associated conditions might be more likely to get sleep apnea.
As a child, I got at least several severe sinus headaches that lasted for a week or so every year. My father had the same thing. I didn't have sleep problems until I got what was diagnosed as fibromyalgia in 1994. I have had a lot of food allergies since my late teens, and have had nearly-constant swelling and pain in my nose and sinuses for the past 7 years or so. I don't like to take any drugs because they never seem to solve any problems for me and only add one or two extra problems as side effects, and as a primary care healthcare practitioners, I know that most drugs tax the liver or kidneys, which is not something I want to do. (I work in alternative health.) I snore some but not often, but I never wake up feeling refreshed, and often feel more tired in the morning than I did when I went to bed! I had a sleep study done, so I know I don't have sleep apnea. I know I have a rather severely deviated septum, and I have a rather small palatal arch. I breathe much better when I push my lower jaw forward a bit.
I've been studying Chinese medicine for the past 3 1/2 years, so I don't have money for surgery or appliances at the moment; I'll do that when once my private practice gets going, which might be a year or even two. What can I do to breathe better during sleep right now??
Dr Park,
I was diagnosed w/gluten intolerance 6yrs ago and have 2 children who were diagnosed gluten intolerant…via genetic testing. My mother also tests positive. While I do have the cold hands/feet and was contstantly tired, and sleep on my side, but I do not have sleep apnea. Before the diagnosis of GS, a former doctor told me I had IBS, which was really caused by the gluten.
I recently underwent testing for Adrenal Fatigue and had a completely exhausted Adrenal System, this was causing the chronic fatigue and appears to have been causing the cold as well. I've been taking supplements to balance out the Adrenals for 12 weeks and will do another test in 6 weeks to see if they have returned to normal. In addition many people don't realize is that they may also have additional food allergies, not just to the gluten. I found a dietician who put me on an elimination diet and found that I am also allergic to eggs, corn, and red meat. If you are consuming any additional foods that you are allergic to regularly the body is always going to be inflammed. This could be another reason that people continue to have issues after the gluten has been removed.
While I think there maybe a connection to apnea and celiac/gluten I would expect it to be reversed, meaning that the gluten (or another food allergen) is causing inflammation in the muscles of the throat to become inflammed thus cutting off the airflow. Obviously I am not a doctor, but have read as many studies as I can get my hands on over the past 6yrs. I would certainly be interested to know if there is a link in either direction, given that this gene is being passed on in my family.
I agree with Winaker…I do not believe sleep apnea causes celiac, but that celiac could cause apnea. I was diagnosed with apnea almost 2 yrs ago. Since then, I have finally realized how dangerous all those "gluten free" labeled foods actually are. They actually are not gluten free, simply gluten lite, which isn't good enough for any of us, although some do not show symptoms with small amounts of gluten. When I finally gave up all processed "gluten free" foods, and all grains, I am doing better. I am going to request a new sleep study, I truly believe I do not need the machine any longer. I have lost over 50# and have not put any weight back on, except when I get CC of gluten here and there. I have never been able to keep weight off.
Dabra,
Congratulations on your weight loss. I'm glad to hear of your success by treating your gluten intolerance issues. I'm assuming you have sleep apnea, since you mentioned that you have a CPAP machine. Losing weight through whatever means will definitely help your sleep apnea, so that by dealing with your gluten issues and losing weight, it may seem like your sleep apnea is cured. However, since sleep apnea is mainly due to jaw/structural issues, losing weight won't change the shape of your bones. Your apnea may be improved, but most likely won't be completely eliminated.
Even if your sleep apnea is significantly improved, you'll probably still have upper airway resistance syndrome, where you have multiple obstructions and arousals that don't qualify as being apneas. There are no stereotypes for sleep apnea—even young thin women that don't snore can have significant obstructive sleep apnea. But typically, younger, thinner people will have upper airway resistance syndrome, with no significant apneas. Later, if they gain weight, they move up into obstructive sleep apnea.
As I've stated before, people with upper airway resistance syndrome tend to have hypersensitive nervous systems. Even their immune systems are on overdrive, due to the chronic low-grade stress response that's created from poor breathing at night. This could potentially make you more hypersensitive to normal substances or food products, such as gluten, dairy, peanuts, etc. If you look at the natural history of celiac disease, what I find is that decades later the symptoms subside, especially if they gain weight. Then you'll see the more classic complications of sleep apnea, such as hypertension, diabetes, depression and heart diseases.
Regardless of what causes what, from a practical perspective, I routinely ask about gluten sensitivity issues (as well as addressing any underlying sleep-breathing issues), since by eliminating additional inflammation, breathing and the quality of your sleep can significantly improve.
Thank you Dr. Parks, not what I really wanted to hear, but actually what I knew I would hear. Maybe the pressure is wrong on my machine, I don't know anymore. I just know I sleep much better without it. I use it every night, but not all night, I know, I'm bad. I also have sensory neuropathy, and the mask is a constant irritant for me, I feel it, and it wakes me up. Outside of that, it dries me out so bad, I can hardly move my mouth in the morning or upon awakening. Yes it has a humidifier, turned up on high, and I keep it filled with distilled water at all times. I use the Resperonics Optilife mask with nasal pillows. I can't tolerate the nasal masks, or the full face mask, they just are too consuming…my sons love them. My pressure is only 9, and yes I know, sleep apnea is apnea, no matter your pressure. One son is around 15-17, the other son just had his pressure increased to 20, so I should feel very lucky. I have many other issues, so the apnea may not be the problem. I have CFS, FM, super sensitive gluten intolerance, dealing with yeast overgrowth at this time, Raynauds, gluten ataxia, plus sensory neuropathy. The FM pain in itself could be the aggravation waking me up, in turn causing the mask to irritate me simply because of the other pain, who knows.
Thank you for responding, it's good for others to hear your professional opinion too, even if I didn't want what you said to be true.Thank you.
Deb
Deb,
If you lose significant weight, then your pressure won't be optimal. It's probably too high, so it'll make things worse for you. Either you need another titration, or you can switch to an auto-PAP machine.
Your experience also goes along with studies showing that people with mild OSA or UARS typically can't tolerate CPAP or other devices, due to having a hypersensitive nervous system.
Ultimately, it's a vicious cycle: poor sleep lowers your pain threshold, waking you up more often, which lowers your pain threshold.
You have a very complicated picture, and you're right.—treating sleep apnea may not solve all your problems, but optimizing your sleep is possible, and that should improve the overall quality of your life. Good luck.
Dr. Parks,
Thank you…I wish I wasn't such a coward about driving into the city, I would love to have you as my sleep doctor. My sleep doctor is also a pulmonary specialist, and now isnt seeing sleep apnea patients, sent us all to another place where I have not gone yet. I am wanting to have a new sleep study done, which my PCP or neuro can order. I'm in East Islip, NY.
Thank you for responding to me, your advice is always very helpful. I was pretty sure my pressure is not correct for me any longer, and needs adjusting. I really wish I didn't have to be a hose head!:)
Keep working for us, we need all the help we can get (celiac's, that is).
Deb
I am pleased to read this. I was diagnosed as having Celiac Disease six months ago and have been on a GF diet since then. It has not alleviated any of the symptoms like fatigue, unfreshing sleep, poor concentration, poor memory, ED and loose stools. Last week I had a follow-up appointment with the Celiac specialist and he is not surprised that the symptoms are still present since I have such a mild case of the disease and showed only slight deformation of my villi. He thinks I may have other disorder(s).
Having been single for a long time, it was only until I slept in the same room as my mother that she pointed out that I had symptoms of sleep apnea, including restless sleep, snoring, gasping after lack of breathing, etc. I am now pursuing a diagnosis of sleep apnea, so I find this article encouraging. I diagnosed myself with Celiac before consulting the doctor and I have a feeling I may be right about this one also. Thanks from New Zealand.
Lloyd,
Thanks for your comment. Please keep us up to date as you go through the sleep apnea process. Good luck.
Take a look at Candida Albicans. I think it causes many of the symptoms that celiac and sleep apnea are known for. I've been dealing with my discovery of high levels in my blood stream since 1998. Today I have reduced it to more normal levels and have eliminated most of my symptoms, such as those mentioned above (except sleep apnea.).
We may be dealing with a chicken-and-egg situation. While this theory does sound plausible to me (a lay person), so does the potential that celiac disease causes an opioid effect in the brain for at least some sufferers which, when combined with abdominal inflammation and bloating encroaching in the breathing space, could (?) cause apnea. While I have celiac disease my sister's two children have Ehler's Danlos Syndrome, and her theory is that the EDS causes a breakdown of the gut lining allowing proteins through which then cause an autoimmune reaction to proteins that aren't supposed to be able to get through.
All in all, there's a lot more research to be done before we can say we understand this disease.
I do have Candida Albicans and have been on the yeast free diet since March. I am doing much better now, also finding out that all "gluten free" labeled processed foods still contain gluten, which is always at a higher level than I can tolerate. I do not eat any processed foods now and am doing much better. I also am within 20# of my goal weight, at which time I may change my goal!:)
I had a sleep study nearly 2 weeks ago. My titration level is being lowered 2 points to 7, maybe 6, but I do have to keep the machine. Otherwise, I do not hae any results back form the testing as of yet.
1. Do you prefer to sleep on your side or stomach?
sleep on side easier to breathe.
2. Are you tired, no matter how long you sleep?
Always tired
3. Do you have cold hands or feet?
Always have cold feet and hands
4. Do you get frequent sinus headaches or nasal congestion?
Had to have tonsils and adnoids removed but still feel congested but less sinus infections
5. Do either of your parents snore heavily?
Both parents snore
What’s your take on my theory?
I think your theory is possible, my mom was not able to breast feed. FYI I gained severe weight before being diagnosed over 100 pounds in less than 7 months…doctors had no idea what was wrong a herbal specialist figured it out. Since then this year my father recently found out he has Celiac ( he was diagnosed at age 24 with diabetes? Hum wonder what caused that since it was type I not type II ) I believe miss diagnosis is a very big issue also a town of 15,000 which is less than 30 miles away from me has over 1,500+ diagnosed Celiac members…how many can a town have before we truly say this is a major health concern.
Your title asks if sleep apnea can cause celiac disease. I don't think so, but there could be an association. I was diagnosed with sleep apnea about fourteen years before being diagnosed with celiac disease. I had no symptoms of celiac until about 6 months before being diagnosed. I had a rapid weight loss of 58# and no longer need my C-Pap machine while sleeping. Although I was totally gluten-free for 8 months after diagnosis, I continued with symptoms and weight loss. After my GI did an colonoscopy, he discovered I had microscopic colitis, which is very rare in the general population, but common in those with celiac who do not heal despite eating gluten-free. Once placed on Asacol, my symptoms subsided and my weight stablilized. After one year on the med, I am now off of the med and my appetite is back and I have gained some weight. If you are gluten-free and still not feeling better, consider the possibility of an additional immune disorder such as microscopic or lymphocytic colitis.
I have been diagnosed with Celiac for a year and a half now. I faithfully follow a GF diet and my numbers confirm this. I, however, have not seen any improvement in my symptoms. I DO have 3 or 4 of the 5 symptoms. I wish all of my hard work would show in my symptoms.
Shari,
Consider treating any underlying sleep-breathing problem, if present. Take a look at my article on UARS.
This article is unbelievable… I have Celiac I’m a 21 year old male. I always sleep on my stomach, and I always feel exhausted whether I get a full 8 hours of sleep or 10, I actually feel better if I get hardly any sleep at all. My hands are usually cold but I find myself adjusting the temperature in the house or car often, finding it hard to find a comfortable temperature. I have not been able to breathe out of my nose my entire life I have a narrow nasal passage. I’ve had my turbinates removed when I was was 12. and I was able to breathe better for a few years but they grew back and I have struggled immensely to breathe for at least 4 years now. Eating gluten free is the only way I can keep food down. My father has Sleep Apnea and does indeed snore heavily. My older sister also has Celiac and is extremely sensitive to even the slightest amount of gluten. I find this article very interesting. Have any tips on how I can make myself feel a little better? Thanks again
Not to sound salesy, but I recommend that you read my book, Sleep, Interrupted. It goes into much more detail about the connection between sleep, breathing and digestion. If you had your turbinates removed, it’s unlikely they grew back (unless they’re polypoid). Try using either Breathe Right strips, or better, yet, Nozovents. You probably have nasal valve collapse (flimsy nostrils that cave in when you inhale). Ultimately, you have to treat your condition like sleep apnea whether or not you have it. More likely, you have upper airway resistance syndrome. I recently did a teleseminar on this topic. Many people with upper airway resistance syndrome progress into obstructive sleep apnea later on in life. Also, make sure you’re not eating or drinking alcohol within 3-4 hours of bedtime. Try all these conservative options first, and then, if not significantly better, consider getting a sleep study. Looking forward to hearing from you with your results.
Thank you Dr Park,
My case has been the opposite way around.
I was diagnosed with obstructive sleep apnea late 2007, sleep study showed I was waking up an average 96 times/ hr…
My body was wearing out very quickly, plus type 2 diabetes to top it off.
Using a cpap machine I gained my life back, lost 30kg in 8 weeks and I have my diabetes controlled by diet.
However I have had problems with my ears, throat(glands), unexplained sores on my arms, shoulders and various other places.
My GP treated me for a bacterial infection, I was taking antibiotics for 12 weeks and it made no difference.
This has lead to me asking myself what is causing these problems?
I would like more information because your article makes alot of sense.
[...] is something else to consider: http://doctorstevenpark.com/can-slee…celiac-disease There is a lot of information here on this site if you want to do more reading this weekend. [...]
I agree with this theory. Notably, my father has sleep apnea, and I myself have celiac and pcos. I often wonder if I myself have sleep apnea, but have not been tested for it. I question my father, and believe that he has celiac, since I got it from his side of the family, with at least one of his sisters who has it as well.
However, when I tried to get him tested for celiac the doctors were against me. They told me that if he didn’t have abdominal upset that he couldn’t have it, especially if he made it to age 64 (I guess they failed to notice his lack of energy, and his ability to easily succumb to a virus that attacked the muscle of his heart…but I guess that’s normal right?) He also has permanent nasal congestion…has had it since I was a kid for sure. He has so much trouble breathing during the day even, it scares me. He makes a lot of noises, almost tick like sounds with his breathing, between sentences and after as a nervous tick he’ll breath out twice really strongly. I guess in my hearts of hearts I thought if he was a celiac and went gluten free that he would start to breath properly. And honestly when I was younger I had trouble breathing too, more because of anxiety.. but I remember forgetting to breath sometimes, as weird as that sounds… and not being able to breath properly at all when I spoke to people, despite not being nervous- i mean I remember that happened to me most right when I was going off of gluten, and then I would accidentally eat it on my break for example, and go and talk to customers again after at work and not be able to breath properly when answering questions. But that went away as i stopped eating gluten.
So i happened to mention that sleep apnea is related to celiac after reading this article, and also noting the similarities between both diseases, and then the doctor hit the ceiling and thought I was crazy for sure. He refused to test my dad for celiac through a biopsy despite his strong family history of celiac.
It hurts me, why can’t my dad be tested? We live in Canada, its free anyways! The same dr is testing him for colon cancer for which he has no symptoms, or family history… but refuses to test for celiac that he does have family history of.. I don’t know, does that make sense to you?
Cali,
Your experience with your father’s situation does sound frustrating. If you encounter so much resistance, he may be better off just trying a gluten free diet and seeing what happens. It’s similar to having a bad nasal allergy – it just makes his sleep apnea much worse. The other way to help him is to make sure that his sleep apnea is optimally treated. From what you’re describing, your father has very narrow facial anatomy, which is what’s causing his obstructive sleep apnea. People with celiac disease also tend to have relatively narrow faces and smaller jaws.
Thank you so much for your information Dr. Steven Park. I truly appreciate it. I will definitely encourage my dad to get his breathing machine and sleep apnea status re-evaluated with a sleep specialist, as he hasn’t been for 8 or so years for a check-up with this condition. The one time he did go gluten free for about 3 weeks he said he felt fantastic, and I noted that he didn’t have as many anxious breathing/nervous mannerisms. Perhaps I will try to get him to do it again, its just so hard to switch an older man’s diet around without a firm diagnosis. But we might be able to get a blood test for him for celiac. I’m not sure how accurate the blood tests are, but its worth a try.
And yes my father does have a narrow face. And a very small jaw for a male. But I do appreciate that I received his small nose through genetics, haha!
Anyways, many thanks, I will relay this information back to my father.
Dr. Park I cannot thank you enough for some of this information. I did write separately in the comment area, but perhaps I can reach yourself or others this way. Not only do I have Raynaud’s Disease, Meniere’s Disease, PCOD and terrible GI problems I’m finally on the way to be treated for (I hope, I’ve been in continuous pain for almost 2 weeks), but I have more interesting information: In regards to your questions:
1. Do you prefer to sleep on your side or stomach? I cannot sleep any other way than on my stomach in a “chalk line” position – with the arm and leg of one side straight down, the other arm and leg up at a 90 degree angle.
2. Are you tired, no matter how long you sleep? I am constantly tired and lethargic, I very seldom sleep through the night until I began taking xanex to help control my anxiety at night due to nightmares
3. Do you have cold hands or feet? Very, due to Raynauds
4. Do you get frequent sinus headaches or nasal congestion? I constantly have sinus headaches no medication can seem to touch
5. Do either of your parents snore heavily? My father more than my mother, but my father has such bad apnea he was recorded having not breathed for almost 2 minutes and another condition similar to night terrors where he’s paralyzed but still awake
If there is anything you can advise me to do, I would greatly appreciate it. I’ve been tossed from doctor to doctor with apparently nothing wrong but no answer why these things are happening until I read a post of yours and I finally found a connection. I have GI appointment coming up, finally, but I want to make sure I’m advocating for myself and not settling for another lazy doctor.
I debated including this information, but I’ve also struggled with bulimia since I was 12 years old…I’m 28 now. I’m sure this has had some impact on my digestion (I have terrible acid reflux) but considering the length and severity of my disorder I’ve been incredibly lucky. I wasn’t sure if that would have any bearing on how I’m proceeding with my treatment, but I know it’s something I have to be honest about.
This is very, very interesting.
I’m currently being tested for food intolerances due to my fatigue, inconsistent weight and constant stomach aches. I’ve mentioned some very random symptoms to my doctor, such as skin related and pins and needles in my legs!! All of which, he said can be linked to auto-immune diseases.
Celiac is one of the main speculations, I’m awaiting results from a blood test for referrals. I’m worried though, because my gluten in-take was very minimal and apparently this could affect the results.
However, I DID ask myself the following:
1. Do you prefer to sleep on your side or stomach?
Cannot fall asleep on my back! – suffer terrible insomnia.
2. Are you tired, no matter how long you sleep?
Yes, find myself wanting to sleep at such innappropriate times. And can’t motivate myself as much as I want to.
3. Do you have cold hands or feet?
Yes, but told this was probably low blood pressure.
4. Do you get frequent sinus headaches or nasal congestion?
At least once a month I have a sinus infection. I had my tonsils out at a young age and suffered severe migraines that eased off after a gluten restricted diet, but were put down to stress.
5. Do either of your parents snore heavily?
My mum’s a terrible snorer! Evidentially she has numerous health issues such as IBS, Fibromyalga and depression.
Could Celiacs, perhaps, be the silent culprit. I’m intruiged to as how my results come back. If positive- I’m going to persuade mum to get tested too!
Something that most doctors or celiac researchers are not aware of . I hope you will look into the work of Norman Borlaug. I fully believe there is a direct link between his bio -engineering of wheat and the high numbers of celiac disease ” cropping” up since the 50′s. I do believe Celiac disease existed before the bioengineering of wheat, but it was a rare occurrence. The work of Borlaug concentrated the gluten in the grain of the wheat plants so that those who came from certain genetic lines (mostly Europe where wheat was not grown as a staple thousands of years ago) were suddenly barraged with a Super-Gluten never known before .
instead of being called “the man who saved a billion lives” his title should be renamed “the man that cursed humanity”. I think anyone who has suffered the effects of celiac disease would agree with me.
I fear that he started a trend towards bioengineering nature’s crops that might kill many more in the future in different ways. more links must be drawn to Borlaug and celiac disease by more doctors and scientists so that this trend will be halted.
My 15 year old daughter had been very ill since September (requiring multiple trips to the ER via ambulance) because of severe symptoms now attributed to Celiac Disease. Her symptoms included hemiplegic migraines, low blood sugar, significant weight loss, severe drops in blood pressure and heart rate, loss of consciousness, intractable abdominal pain, parasthesias, and benign tumors in her liver, just to name a few of the more worrisome ones. She was started on a gluten free diet about a month ago and experienced nothing short of a miraculous recovery from most of her symptoms, however, fatigue and daytime sleepiness persist. She is not able to sleep (or even lie on her back) for long without it obstructing her breathing, wakes multiple times per night, and snores. Can you recommend a physician and sleep center in the Phila/Bucks Co. area that sees children other than CHOP (Children’s Hospital).
I have a child who has a positive ANA, pulmonary issues, recently told she has Bronchomalacia, a chronic cough for almost 3 months, lung infections, blood work always abnormal, sleep apnea with obstructive airway and mild oxygen desasurtation and just recently diagnosed with celiac disease. Are all of these related? I am scheduled to be seen again with Rheumotologist and another specialist for pulmonology and do not know what direction i am heading in anymore.
Any advise or input is always welcomed and greatly appreciated….
Wow! You are really on to something. Please continue your research.
My answers:
1. Always sleep on my stomach
2. I’m always tired period.
3. Cold hands always, sometimes my feet
4. I have chronic sinusitis, have had 2 sinus surgeries. Ism always congested.
5. My dad snores.
I was diagnosed a month ago with Celia disease via the biopsy.
I was diagnosed with celiac is 2010 at age 48. I have suffered from sleep problems my whole life: night terrors, insomnia, and now I have experienced sleep disturbance like never before: I awake to feeling of a fluttering heart, then heart pounding, and arms and hands tingling. Doctor suspects sleep apnea mixed with some kind of panic attack.
I was reading of another guy on a different forum who suffers from chronic a-fib and was also recently diagnosed with celiac disease. His a-fib only occurs in his sleep.
very interesting connection
I have sleep apnea, seizure,gluten intoleranc……and have been treating the gluten and seizure issues for years…gotten a lot of relief but not completely…just recently got diagnosed with apnea…wind pipe is too small…My sleep specialist swears this cpap will help all three! So here we go for a test run…I hope it does….but coincidentally he has his entire office go gluten free also …so maybe ur on to something :)
quite interesting. would you suggest that celiac could be reversed by improving one’s breathing during sleep?
what would you say about a baby who was put to sleep on his back from birth till age 2. and has been diagnosed with celiac disease at age 6.