Help Me Choose A New Book Cover for Sleep, Interrupted

March 25, 2015 by  

For the longest time, I haven’t been too happy with the cover for my first book, Sleep, Interrupted. Please help me to choose a new cover from the following 4 candidates below. Scroll to the bottom to see all the covers and to submit your choice. I will announce the winner shortly. I truly appreciate your help with this important decision.
 

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7 Tips to Breathe Better Through Your Nose

March 25, 2015 by  

bigstockphoto_face_close_up_-_nose_and_mouth_352732Most people take breathing through their nose for granted. But for many chronic mouth breathers, breathing through the nose is a struggle, if not impossible. Not only is their quality of life diminished, but they’ll also have a variety of other health-related conditions such as dry mouth, snoring, fatigue, and poor sleep. In my last article I addressed 5 reasons why it’s important to breathe through your nose. In this article, I’ll talk about 7 ways that you can breathe better through your nose naturally. 

Nasal Anatomy 101

Before I discuss the various ways to breathe better, a short anatomy course in in order. The nasal septum is a thin piece of cartilage and bone that splits your nasal cavity right down the middle. No one has a perfectly straight septum; everyone’s septum is slightly curved. Sometimes, nasal trauma can shift or move the septum away from its’ midline position. The nasal turbinates are wing-like structures that line the sidewalls of your nose. It’s covered with a mucous membrane, and normally it helps to smooth, warm and humidify air. The turbinates and sinuses also produce about 2 pints of mucous every day. The turbinates swell and shrink, alternating from side to side every few hours. This is called the nasal cycle. 

The front side walls make up your nostrils, which are soft cartilages covered on the inside and outside with skin. The back of your nose is one big cavity (called the nasopharynx), and the passageway turns down 90 degrees into the back of your throat. The nasopharynx is also where your ears connect via the Eustachian tubes. 

If any part of the anatomy that I described becomes obstructed partially or completely, you’ll feel stuffy in your nose. Usually it’s not one thing, but usually due to a combination of different reasons. For example, if you have a mildly deviated septum, suffering from mild allergies will swell up your nasal turbinates, narrowing you nasal passageways. This may not be enough to clog up your nose, but if you have flimsy nostrils or had rhinoplasty in the past that weakened the nostrils, then breathing in with a stuffy nose may trigger your nostrils to collapse. 

1. Do you have flimsy nostrils?

Starting from the tip of your nose, the first thing you must do is to find out if you have flimsy nostrils. If you have a very narrow nose, or if your nostril openings are very narrow and slit-like, then you may be prone to having flimsy nostrils. Try this experiment: Take both index fingers and press them just besides your nostrils on your cheek. While firmly pressing on your cheeks, lift the cheek skin upwards and sideways, pointing towards the outer corners of your eyes. Take a deep breath in. Can you breathe much better through your nose? Let go and try it again. If this maneuver works for you, you may benefit from using nasal dilator strips at night (one brand is called Breathe-Rite). Sometimes, the adhesives on these devices are not strong enough, or end up irritating the skin. Another way of treating this condition are various internal dilators (such as Nozovent, Breathewitheez, Nasal cones) that you can find over the counter or over the internet. 

2. Try Nasal Saline Irrigation

Second, try using nasal saline sprays. You can use the simple spray bottles that put out a fine mist, to more sophisticated methods such as aerosol cans or even using a Water-pik machine (there’s a nasal adaptor that you can buy for this). Another popular variation is something called a Nedi-pot, which uses gravity to pour salt water into your nose and sinuses. You can either use prepared saline packages, or mix your own recipe (one cup of lukewarm water and 1/2 teaspoon of sea salt or Kosher salt with a pinch of baking soda). Whatever method you use, you’ll have to do it frequently to get maximum results. Besides cleansing out mucous, pollutants and allergens, saline also acts as a mild decongestant. 

3. Avoid Eating Before Bedtime

Third, try not to eat anything within three hours of going to bed. If you still have food or juices lingering in your stomach when you go to bed, it can leak up passively into your throat and not only prevent a good night’s sleep, but these same juices can also leak up into your nose, causing swelling and inflammation. In addition, many people will also stop breathing once in a while, which creates a vacuum effect in the throat which actively suctions up your stomach juices into your throat and nose. 

4. Don’t Drink Close to Bedtime

Fourth, try to avoid drinking alcohol close to bedtime. Not only does alcohol irritate the stomach, it also relaxes your throat muscles as you sleep, which aggravates the process described in the previous paragraph. 

5. Control Your Allergies

Fifth, if you have any known allergies, especially if it’s something in your bedroom, try to either remove it or or lessen your exposure to it. For example, many people are allergic to dust or molds, and if you have carpeting, or an area rug, it can harbor these allergens. Frequently washing your bed sheets in very hot water also helps. Investing in a quality HEPA filter should help even more. If you have any pets, consider keeping them out of your bedroom. If conservative measure to control allergies is not good enough, consider seeing an allergist for a more formal evaluation. 

6. Get Out And Exercise

Sixth, get regular exercise, especially outdoors. Not only are you exercising your heart and your muscles, you’re also exercising the nervous system in your nose. Vigorous physical activity activates your sympathetic nervous system, which constricts the blood vessels that supply your nasal turbinates. This allows you to breathe better through your nose, with all the added benefits described in my previous article. 

7. Take A Deep Breath And Relax

Lastly, slow down and relax. Modern society has removed all the natural built-in breaks throughout the day. Along with all the information overload and constant stimulation, going nonstop all day only adds to the increased stress levels that everyone experiences. In between major activities, take a minute or so to stop what you’re doing and stretch, get up and move around, and do some deep-breathing exercises. Stress can tense up the muscles, causing you to breathe shallower, which causes physiologic changes that can ultimately aggravate nasal congestion. 

 

These simple 7 steps won’t help everyone, but If you can go down the list and apply all the steps, many if not most of you should feel some improvement in your ability to breathe through your nose. If you’ve tried all these steps and still can’t breathe through your nose, then seek medial help. An otolaryngologist (an ear, nose and throat doctor) is the best doctor to take care of this condition. 

If you are a chronic mouth breather, in addition to what I described above, your jaw is probably more narrow than normal, with some degree of dental crowding. Chronic mouth breathers also tend not to sleep well at night due to various degrees of breathing difficulty. I talk about this new phenomenon my my book, Sleep, Interrupted.

I discuss in more detail how you can breathe better in my free report: How to Unstuff Your Stuffy Nose. Click here to access your free report.

 

 

 

5 Reasons Why Your Nose is Stuffy

March 20, 2015 by  

A repost of an article on why your nose is stuffy this allergy season.

Although many people assume that big nosed people naturally breathe better, there’s nothing further from the truth.  The shape and size of your nose is mostly cosmetic. How well you breathe actually depends on what your internal breathing passageways look like. And for many sleep apnea sufferers, a stuffy nose can make or break their treatment therapy.

Yet, opening up the nose through medical therapy or even surgery has been found to “cure” sleep apnea in only 10% of people. Patients will definitely feel and breathe better, but it’s unlikely that their sleep apnea is addressed definitively. However, I have seen many of the people in the “10%” group derive significant benefits from clearing up their nasal congestion. Besides breathing better for the first time in years, opening up the nose can allow the person to tolerate and benefit from other treatment options for OSA besides CPAP.

Why Is My Nose Stuffy?

Problem #1:  Deviated Nasal Septum

One of the more common reasons for a stuffy nose is due to a deviated nasal septum. A “septum” is a term that describes a structure that acts as a wall or separator between two cavities. Your heart has one too. No one has a perfectly flat or straight septum.

All septums, by definition, have slight irregularities or curvatures. A major reason for a crooked septum, unbeknownst to many people, even other doctors, is because your jaw never developed fully. Most people with sleep apnea have narrow upper jaws, which pushes up the roof of your mouth into your nasal cavity, which causes your septum to buckle.

If medical options don’t help you to breathe better through your nose, then you may be a candidate for a septoplasty. To get a much more detailed explanation about this procedure see the accompanying article, Myth and Truths About Septoplasty.

Problem #2. Flimsy Nostrils

In some people, the space between the nasal septum and the soft part of both nostrils is either too narrow to begin with, or they collapse partially or completely during inspiration. In many cases, this can be seen years after reduction rhinoplasty, where the nose was made smaller or narrowed for cosmetic reasons. Occasionally, people can have naturally thin and floppy nostrils.

Another common reason for flimsy nostrils is due to a narrow upper jaw. The width of your nose follows the width of your jaw. If the angle between the midline septum and the nostril sidewall is more narrow than normal, then it’s more likely to collapse with any degree of internal nasal congestion. It’s not surprising that people with sleep-breathing disorders will typically have narrower jaws, and thus more susceptible to nostril collapse. Certain ethnicities are also more prone to this phenomenon than others.

One way that you can easily tell if you have this problem is to perform the Cottle maneuver: Place both index fingers on your face just beside your nostrils. While pressing firmly against your face and simultaneously pulling the skin next to the nostril apart towards the outer corners of your eyes, breathe in quickly. Then let go and breathe in again. If there is a major improvement in your quality of breathing while performing this maneuver, then you have what’s called nasal valve collapse.

The simplest way of correcting nasal valve collapse is by using nasal dilator strips, or Breathe-Rite® strips. If you do the Cottle maneuver and there is no significant difference in your breathing, don’t waste money buying these strips. If you perceive an improvement in your breathing, you can continue using the strips at night while you sleep. For some people, these “strips” are not strong enough to hold up the nostrils, or may cause irritation to the skin.

There are also many other “internal” options available over the counter, including metal springs or plastic cones that are placed inside the nostrils. People tolerate these particular devices differently, so the only way to know if you’ll like them is to try them. Three examples are Breathe With EEZ, Nozovent, and Sinus Cones.

 To find out if your nasal valve collapse is from weak or flimsy cartilages or is aggravated by internal nasal congestion, you can spray nasal saline (which is a mild decongestant) into your nose. If your nostrils doesn’t collapse as much, then you need to address your internal nasal congestion first. A stronger over-the-counter medication that you can use is oxymetazoline, which is a topical spray decongestant. There are many brand name and generic versions that are sold that contain this ingredient. It’s very important that you don’t use this medication for more than two to three days—otherwise, you may get addicted to it.

If you want a permanent solution to this problem without having to use dilator strips or internal devices, the only option is surgery. The traditional way of dealing with this issue is to perform a kind of reconstructive rhinoplasty surgery, usually by taking small portions of your nasal septal cartilage or ear cartilage and placing in underneath the weakened portions of your nostril walls. A newer, simpler way of addressing this problem is by attaching a permanent suture just underneath the eye socket and tunneling the suture under the skin and looping it around the weakened area to suspend the nostril to prevent collapse.

Problem #3: Wings in Your Nose

Another common source of nasal congestion is from swelling of your nasal turbinates, which are the wing-like structures on the side-walls of the nasal cavity opposite the septum. Turbinates are comprised of bone on the inside and mucous membrane on the out- side. The area just underneath the mucous membrane is filled with blood vessels which can swell significantly. As the turbinates swell due to allergies, colds, or weather changes, the air passageways narrow further, especially if you have a mildly deviated nasal septum, and particularly if you have nasal valve collapse.

One of the most common misunderstandings that I see by both doctors and patients alike is that they think that swollen turbinates are polyps. The nasal turbinates can swell so much that you can sometimes see the reddish-pink, fleshy grape-like mass through your nostrils. Once decongested, they shrink dramatically and the air passageways open up again.

If conservative treatment including prescription allergy medications don’t work, various surgical options are available from very conservative 5 minute in-office procedures to more aggressive procedures that are performed in the operating room. These procedures are usually performed alongside a septoplasty to improve nasal breathing.

Problem #4: Sinusitis

If you suffer from sinusitis, this can cause nasal congestion and inflammation combined with post-nasal drip, sinus pressure, and pain. Put simply, pure misery. Sinus infections typically follow either a routine cold or allergy attack; they cause both swelling and blockage of the sinus passageways, leading to negative pressure initially and, if allowed to progress, can turn into a full-blown sinus infection, with yellow-green discharge, fever and severe facial pain. Your teeth can also hurt since the roots of the upper molars jut up into the floor of the maxillary sinuses. Similarly, dental pain can sometimes feel like sinus pain.

Fortunately, most cases of sinus congestion will eventually go away. The body has a remarkable ability to take care of these issues without any intervention. Sometimes bacterial infections occur, and with proper conservative treatment using saline and decongestants, the infection gradually resolves. Rarely, you may need an antibiotic to control stubborn bacterial infections.

Problem #5: Poor Sleep

As you can see from the above discussion, there are a number of various reasons for having a stuffy nose. But the most common reason for nasal congestion that I see routinely is due to inefficient breathing and poor sleep. This is why sleep apnea sufferers, more often than not, suffer relentlessly from nasal congestion. 

Without a doubt, structural reasons like allergies or nasal polyps can definitely block your nose and these issues must be dealt with appropriately. But in general, it’s the inflammation that’s created by a combination of your hypersensitive nasal nervous system and possible stomach acid regurgitation into the nose from multiple obstructions and arousals, that causes nasal congestion. Without addressing this underlying source of inflammation, correcting a deviated nasal septum or treating for nasal allergies will only provide a temporary solution.

 

Allergy Solutions for Sleep Apnea Sufferers

March 18, 2015 by  

Reposting a classic article that’s very relevant this month.

Spring is in the air, and so are the tree pollens. Millions of people suffer this time of the year from sneezing, scratchy, itchy eyes, nose and throats, nasal congestion and chronic cough. It’s also a given that if you have allergies, you won’t sleep as well, along with everything from asthma, cough, and sinusitis to diarrhea. So how do allergies cause sleep problems, and in general, and how does it specifically cause or aggravate obstructive sleep apnea?

When Allergies Lead to Something Worse

There are already tomes of articles, books and websites offering tips for allergy sufferers including traditional options like nasal saline irrigation, homeopathic remedies, and using a HEPA filter to prescription medications and allergy shots. But again, how can having a runny nose cause you not to sleep well at night? I’ve combed through numerous medical and internet resources and to date, I haven’t found one good explanation.

However, looking at it from a sleep-breathing standpoint, it makes total sense: any degree of nasal congestion, whether from allergies, colds, or even weather changes, causes a slight vacuum effect downstream in the throat which can aggravate tongue collapse, especially in certain susceptible people. Who then, are susceptible to tongue collapse? Almost every modern human!

It’s All In Your Jaws

To be more specific, the smaller your jaws, the more likely you’ll sleep poorly when you have allergies. Even if you’re completely normal, having a stuffy nose can suddenly cause your tongue to fall back and block your breathing. Plugging your nose has been shown to cause obstructions and arousals during sleep. This is why you’ll toss and turn when you have an allergy or a simple cold.

Many people with allergies and small mouths will also have grooves or indentations along the side of their tongues. This is called tongue scalloping. Since the tongue and other soft tissues grow to their genetically predetermined size, and due to crowding from having smaller jaws, the teeth leave their imprints along the side of the tongue. If you have additional inflammation from gastric reflux that’s a given with sleep-breathing problems, then this scalloping problem gets worse. Not too surprisingly, tongue scalloping is predictive of having apneas, hypopneas, or oxygen drops in almost 90% of people.

Allergies From Stress?

So then, why do allergies happen in the first place? Again, there are tons of proposed explanations that I don’t have the space for, but here’s a simple concept from Robert Sapolsky’s classic book, Why Zebras Don’t Get Ulcers:

Humans can handle big stresses such as a major catastrophe, a death in the family, or running away from a tiger. In these scenarios, your stress response leads to an intense activation of your immune system (in addition to your nervous system’s fight or flight response). Once the stress is over, your immune system’s activity level drops down to normal, but only after it dips below normal for a short period of time. During this short period, you’re also more susceptible to getting sick.

However, modern societies don’t have very big stresses such as running from a saber tooth tiger. Rather, we have multiple micro-stresses spread throughout the day such as being honked from the rear on the way to work, your boss yelling at you, or your computer crashing. These little stresses push your immune system’s activity higher and higher, with not enough time for it to recover and go back to normal levels. After a certain point, your immune system is on constant overdrive, leading to the typical allergic or autoimmune conditions that are all-too-common today.

When Your Allergy is Not An Allergy

This process also explains why you may also have a chronically runny nose. This is called chronic or nonallergic rhinitis, when the involuntary nervous system in your nose overreacts to irritants, chemical, odors, or weather changes (either pressure, temperature, or humidity changes). Symptoms include runny nose, sneezing, nasal congestion, post-nasal drip and headaches, and is often mistaken for regular allergies. This condition may respond to regular allergy medications, but not as well. Either way, inflammation and swelling can also cause nasal congestion, leading to poor quality sleep.

Overcoming Your Allergies

If you have classic allergies, you must start with the basics: Avoid outdoor activity on high-pollen days, shower before bedtime to get the allergies out of your hair, don’t wear shoes indoors, get a HEPA filter, and take over-the-counter medications as needed. Some people benefit from routine use of HEPA filters as well in their bedrooms. You may have to see your doctor if conservative measures don’t help.

There are various over-the-counter allergy medications. The newer, nonsedating antihistamines block the effects of histamine, which is what causes watery, itchy, runny eyes and nose. The most common brands are Claritin, Allegra, and Zyrtec. They all work differently in different people, so the only thing you can do is to try each one and see which you prefer. Although they are nonsedating in theory, there are reported cases of drowsiness with all three. Benadryl is an older antihistamine that’s very effective for allergies, except that many more people may get drowsy.

If your nose is stuffy, then two options are nasal decongestant sprays (which you can only use for 2-3 days) or decongestant pills. Routine nasal saline irrigation can also help your breathing and sleep.

There are a number of prescription medications, including topical nasal steroid or topical steroid sprays. Leukotriene phosphate inhibitors, such as Singulair, and various others also available. Oral steroids can also be useful in emergency situations. As a last resort, an allergy evaluation with shots are a consideration.

Regardless of which way you treat your allergies, it’s important to follow all my recommendations for better breathing while sleeping, such as avoiding eating or drinking alcohol within 3-4 hours of bedtime, sleeping on your side or stomach. Having a stuffy nose for whatever reason can trigger breathing pauses downstream, ultimately giving you a bad night’s sleep.

 

Ask Dr. Park Your Question About Obstructive Sleep Apnea

March 3, 2015 by  

My monthly Ask Dr. Park Teleseminars in years past were very popular with many of you. It was also a way for me to understand the frustrations and pains for those of you with obstructive sleep apnea. I truly enjoyed the live Q&A format, but due to recent time constraints from my new academic position, I’ve had to transition my telesemianrs to pre-recorded podcasts. My recent 3-part podcast series on Vitamin D and sleep with Dr. Stasha Gominak was extremely well-received, with well over 2000 downloads so far. 

As a way of connecting with you again, I’ve decided to re-launch my Ask Dr. Park series, but in a different format. Submit your one question in the text field below, and I’ll try to answer as many as I can. I will then select a handful of questions to answer on an upcoming Ask Dr. Park podcast. If possible, please state at least your first name, where you live, and a brief question. I’ll try to choose questions that can help as many people as possible. 

Please enter your question for Dr. Park below.

Podcast #5: Interview With Dr. Stasha Gominak on How Low Vitamin D Can Ruin Your Sleep (Part 3)

February 25, 2015 by  

This is part 3 and the final segment of my conversation with Dr. Stasha Gominck, a neurologist with some very insightful information about vitamin d and how it’s vitally related not only to sleep, but to every aspect of your health. As mentioned previously, Vitamin D is actually a hormone that’s needed by every area of your body, including your brain. 
 
In this segment, Gominak is going to tell us
  • How to optimize growth hormone release
  • The link between slow wave sleep and the B vitamins
  • How this b vitamin can help REM behavior disorder 
  • How much Vit D is made in your skin by sunlight
  • Vitamin D’s anti-cancer properties
  • The importance of quality sleep and cancer prevention

Download MP3 audio file

NY Time article on Meditation for a Good Night’s Sleep.

Mindfulness meditation sites: calm.com, headspace.com, and saagara.com

CBT-i sites: cbtreferee, CBT-i coach and cbtforinsomnia

Visit Dr. Gominak at drgominak.com
 
Subscribe in iTunes. I would appreciate it if you can rate my podcast and provide feedback within iTunes.
 
Please leave your feedback or any comments about this episode in the space below.

Podcast #004: Interview With Dr. Stasha Gominak on How Low Vitamin D Can Ruin Your Sleep (Part 2)

February 19, 2015 by  

This is Part 2 of my interview with Dr. Stasha Gominak, a neurologist practicing in Tyler, Texas. Dr. Gominak has unique views on how Vitamin D can significantly affect the quality of your sleep, independent of obstructive sleep apnea or upper airway resistance syndrome. In this intervew, she will reveal:

How B vitamins interact with Vitamin D
How B vitamins are related to fibromyalgia
The link between irritable bowel syndrome and headaches
How Vit D is linked with weight gain
What’s the right dose of B vitamins? And for how long?
Which vitamins are made in your gut?
 
 
Visit Dr. Gominak at drgominak.com
 
Subscribe in iTunes. I would appreciate it if you can rate my podcast and provide feedback within iTunes.
 
Please leave your feedback or any comments about this episode in the space below.
 

Podcast #003: Interview With Dr. Stasha Gominak on How Low Vitamin D Can Ruin Your Sleep (Part 1)

February 11, 2015 by  

This is Part 1 of my interview with Dr. Stasha Gominak, a neurologist practicing in Tyler, Texas. Dr. Gominak has unique views on how Vitamin D can significantly affect the quality of your sleep, independent of obstructive sleep apnea or upper airway resistance syndrome. In this intervew, she will reveal:

1. How Vitamin D is related to sleep
2. Why Vitamin D3 is better than D2
3. How Mice and Pigs Confused Doctors About Vitamin D
4. Why Sleep became much worse in the 1980s
5. How much Vitamin D do we need?
 
Download audio file
 
Visit Dr. Gominak at drgominak.com
Vitamin D Council
Dr. Walter E. Stumpf
 
Subscribe in iTunes. I would appreciate it if you can rate my podcast and provide feedback within iTunes.
 
Please leave your feedback or any comments about this episode in the space below.

How Anemia Can Be Caused By Upper Airway Resistance Syndrome

January 28, 2015 by  

I just saw Kim (name changed for privacy), who is a 24 year old graduate student for her recurrent sinus infections. She tried multiple antibiotics which helped only temporarily. She also mentioned that she was chronically tired, which she blamed on her anemia. As I see in many women (and men) with upper airway resistance syndrome, she also had frequent headaches, cold hands and feet, low blood pressure, and cannot sleep on her back.
 
One of the most common explanations by doctors for fatigue in younger women is said to be from anemia. It’s thought that losing regular amounts of blood during the normal menstrual cycle can lower blood count levels. There are a number of other explanations for anemia, including Vitamin B12 and folate deficiency.
 
One of my guest bloggers, Dr. Deborah Wardly, recently published a review article a few years back on the effects of atrial natriuretic peptide (ANP) on various aspects of your body. ANP is created in your heart muscles every time it’s subjected to obstructed breathing. The heart thinks that the body has too much fluid, and creates ANP which goes to the kidneys to create more urine, lowering blood volume. She also points out that ANP has been shown to lower your blood pressure, keep you thin, make your nervous system more excitable, make you chronically tired, and makes you pee more than usual. In particular, ANP is also known to lower the angiotensin-aldosterone pathway in the kidneys.
 
So how does lowering angiotensin-aldosterone cause anemia? A quick review of the renin-angiotensin-aldosterone system (RAAS) is in order. I know it sounds a bit complicated, but take a look at the referenced figures, and you’ll see how everything in the body is so well interconnected.
 
The RAAS is a hormone system that regulates blood pressure and fluid balance. If the kidneys sense that you’re dehydrated (lower blood flow through the kidneys), the cells in your kidneys convert an already circulating protein (prorenin) into renin, which converts angiotensinogen (made by the liver) into angiotensin I. Angiotensin I is then converted into angiotensin II by angiotensin converting enzyme (ACE) in the lungs. Angiotensin II constricts your blood vessels, raising your blood pressure. It also stimulates the hormone aldosterone, which is made in the adrenal cortex (which also makes epinephrine). Aldosterone causes the kidneys to reabsorb sodium and water, causing you to hold onto sodium, raising your blood pressure. 
 
As you can see in this diagram, there are a number of steps that can be blocked by certain prescription medications.
 
ANP has the opposite effect of angiotensin II, lowering renin and aldosterone in the kidneys. One review article states that angiotensin II acts to stimulate erythropoietin, which is made in the kidneys to stimulate red blood cell production in your bone marrow. So by lowering the salt and fluid conserving properties of angiotensin II, you can in theory lower erythropoietin levels. This supports the observation that you can have mild anemia if you’re taking ACE inhibitors for high blood pressure or in certain people with chronic kidney disease. Now you can add upper airway resistance syndrome to the list (via ANP production).
 
If you have been diagnosed with anemia, do you also have cold hands, low blood pressure, headaches or chronic fatigue? Do you also prefer to sleep on your side or stomach? Please tell us your story in the box below.

The Most Misunderstood And Often Overlooked Treatment For Sleep Apnea (HINT: It’s NOT CPAP)

January 21, 2015 by  

John Wooten, UCLA’s legendary basketball coach was a stickler for fundamentals. He looked down on trick plays, fancy footwork, or high-tech strategies. Similarly, before looking for state-of-the-art treatment options for obstructive sleep apnea, you should always first consider the fundamentals. 
 
If you’ve been newly diagnosed with obstructive sleep apnea, you’re likely to be told to lose weight, diet and exercise. Everyone know this already. Avoiding alcohol is another big no-no, since it relaxes your throat muscles. 
 
One option that is mentioned only casually is to avoid sleeping on your back. This is because being on your back allows your tongue and soft tissues of your throat to fall back more severely. When you add muscle relaxation during deeper levels of sleep, then you’ll either snore, or stop breathing altogether (called an apnea). 
 
In sleep studies, you’ll routinely see that in most cases, being on your back can lead to double, or even triple the number of apneas on your back compared to sleeping on your side or tummy. One study showed that sleep positioning was almost as good as CPAP.
 
Many people know not to sleep on their backs. The problem is that in most cases, you can’t control your sleep position all night long. 
 
If you are one of these people, then there’s an opportunity to use gravity to your advantage. 
 
One of the oldest recommendation is to sew a tennis ball inside a sock to the back of your pajamas. This may work sometimes, but more often than not, you’ll just sleep on top of it, or it’ll keep annoying you causing you to wake up. One of my patients misunderstood me and filled an entire backpack with tennis balls during sleep, and it worked well for him.
 
There are now multiple options for keeping you off your back during sleep. One popular option is the Rematee Anti-snore shirt. It’s a vest that you wear at night with pockets in the back that’s filled with inflatable bumpers. 
 
Another variation is the isidesleep mattress, which is an inclined wedge with a cutout at the top that allow you to drop your arm below the mattress, which cradling your head on a pillow that sits above the cutout. 
 
If you have shoulder or back problems and you can’t sleep on your side, then sleeping on your back on a incline is another option. There are a number of different options that you can find including this wedge pillow. This can be also be good for acid reflux. It’s also why some people can only sleep on recliners.
 
If you must sleep on your back, then it’s important to use a pillow that will tilt your head back somewhat, which will open up your airway. This is similar to what you do as the first step in CPR, but not as far back. There are many of these “contour memory foam” pillows that are promoted to reduce snoring. It’s not going to cure your sleep apnea, but used in conjunction with various other methods, it can help to various degrees.
 
Two of my patients wore neck braces (one soft and one hard) with some success. This may work by preventing your chin from dropping forward, while keeping your neck extended.
 
If you must sleep on your back, there aren’t too may options. One desperate patient actually bought a massage table and slept tummy down with his face inside the hole. 
 
As a last resort, you can always fly into space, where there’s no gravity. In fact, it’s been shown that astronauts have less snoring and apneas while in space compared to levels found back on earth.
 
If none of these options work for you, then it’s time to see a sleep physician. If you’re already using CPAP or an oral appliance, you can supplement positional therapy to your current regimen. Oftentimes, you’ll have to combine multiple options for better results.
 
I’m sure that many of you have tried other creative ways to get rid of snoring using positioning devices or contractions. If so, please share what worked for you in the comments area below.

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The material on this website is for educational and informational purposes only and is not and should not be relied upon or construed as medical, surgical, psychological, or nutritional advice. Please consult your doctor before making any changes to your medical regimen, exercise or diet program.



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