Some of my patients have asked me how I got interested in sleep apnea. I’ve always thought that it was a gradual process that began early in private practice, culminating in my eureka moment that I describe in my book after our first two children were born. But recently, I finally realized what gave me the background to be able to appreciate the complexities of sleep apnea: my training in biophysics.
I majored in biophysics during my undergrad years at Johns Hopkins. Essentially, I was a physics major with an interest in solving biological problems. For my undergraduate research experience, I spent some time in a research lab that studied shear stress on rat sperm during ejaculation. Air or fluid with various densities or viscosities have very different flow characteristics depending on the nature of the channel. There tends to be more turbulence at the periphery of the tube, which can shear and damage sperm bodies, making them immobile. Soft or malleable passageways can collapse depending on the structural characteristics of the wall, as well as the material that flows through this channel.
These basic science principles have given me an appreciation for how our upper airways work. Our breathing passageways are not just channels that funnel air into the lungs. The air is filtered, moisturized, heated and smoothed before it even reaches the lungs for oxygen extraction. The entire upper airway is dynamically changing constantly in multiple areas, affected by your anatomy, any allergies, the weather, what you just ate, or even your emotions. Even slightly narrowing one part can significantly affect another part, either upstream or downstream.
This is why simple colds or an allergy attack can wreck havoc on your sleep quality. Additional narrowing due to inflammation of an already narrowed passageway (due to smaller jaws) can aggravate further collapse in other areas. At first glance it may seem a little complicated, but if you look at the big picture, it’s a beautiful and simple explanation for what happens when our nasal and throat air passageways become inflamed or narrowed for any reason.