Breathing Lessons for Sleep Apnea Sufferers
January 14, 2010
Proper breathing is fundamental to good health and vitality. It's also the most basic physiologic function that we must do to survive. Improper breathing can lead to illness, disease, and ultimately, death. Ancient Hindu cultures recognized this basic principle and developed very sophisticated breathing techniques that we now realize are scientifically sound when it comes to promoting optimal health, energy and life balance. These breathing concepts have spread across various continents to different cultures, but the basic fundamental principles remain the same. What Most Holistic Doctors Already Know Breathing means spirit in many languages (Hebrew, Latin, Greek, and Sanscrit), but not in English. In Latin, the word for breath and the word for soul are the masculine and feminine roots of the same root. In Greek, the two words are the same. Breathing is a natural physiologic function which continues, regardless of whether or not you notice it. It's controlled by two parts of the autonomic nervous system: the sympathetic and parasympathetic nervous systems. The sympathetic nervous system is the classic fight-or-flight half that's needed if you're in a fight or running from a tiger. The parasympathetic nervous system is the relaxation half, promoting sleep, digestion and reproduction. Inhalation is activated by the sympathetic nervous system and exhalation is activated by the parasympathetic part. When you slow down your breathing, your heart rate slows down. If you take a little longer exhaling relative to inhaling, then you're spending more time activating your parasympathetic nervous system. This is the physiologic reason why breathing techniques such as the relaxing breath is literally relaxing. These same concepts also apply to singing, humming or whistling. Notice that when you sing, you're spending up to 10 to 20 times longer exhaling relative to inhaling. By activating your vagus (parasympathetic) nerve, this is why you feel good when you sing. What Some Doctors Don't Know We all take it for granted that the physical air passageways that we breathe through is more than sufficient as conduits for air to travel into and out of our lungs. However, our upper air passageways are dynamically changing all the time, depending on your head position, weather status, allergies, emotions, moods, stress levels and even what you just had for lunch. Your nose is exquisitely sensitive to pressure or humidity changes, swelling or shrinking your internal nasal turbinates to significant degrees. Air passing through the nasal cavity is being filtered, humidified, and warmed before passing into the lungs. Any temporary or permanent blockage to proper breathing in this area can prevent optimal airflow into the lungs. In addition, the nose and sinus cavities make a gas called nitric oxide, which has two important beneficial properties. The first property is that nitric oxide is antimicrobial, both in the nose as well as in the lungs. This gas, when inhaled even in small amounts into the lungs, can increase oxygen absorption up to 20%. Not breathing through your nose for whatever reason has potentially detrimental effects on your health. What Most Doctors Don't Know Everyone in the Western, alternative and complementary fields of healing naturally assume that we are able to breathe properly at night. We now know that there are certain medical conditions such as sleep apnea where you have complete obstruction and repeated bouts of oxygen deprivation. Most practitioners still think that this typically occurs in some people who are overweight, snore, and have big necks. But now we know that even young, thin women who don't snore can have significant obstructive sleep apnea. Even more, many people who don't officially meet the criteria for obstructive sleep apnea still can have significant breathing pauses but wake up too quickly to be classified as an apnea. These are the patients that are commonly diagnosed with idiopathic hypersomnia. However, the bigger issue is that by definition, all modern humans are susceptible to breathing problems at night for the following reason: Due to jaw narrowing and dental crowding from a radical change in our diets, our tongues take up relatively too much space, and as a result, we're more susceptible to obstructing the airway when sleeping on our backs (supine) and in deep sleep due to muscle relaxation. In his classic nutritional text, Nutrition and Physical Degeneration, Dr. Weston Price documented these physical changes. Our ability to talk also positioned our voice boxes below the tongue, which can aggravate this process. Many modern humans can't sleep on our backs anymore since the tongue and voice box falls back the most in the back position. As a result, we compensate by sleeping only on our sides or stomachs. The problem is that it's not good enough. A simple cold or an allergy attack, or with even 5 to 10 pounds of weight gain, can cause more frequent obstructions occur, leading to less efficient sleep. Less efficient sleep leads to a physiologic stress response that can cause or aggravate a number of various medical conditions such as anxiety, depression, insomnia, cold hands, digestive problems, high blood pressure, etc. What I describe in my sleep-breathing paradigm is that all modern humans are on a continuum, where the one extreme end is called obstructive sleep apnea. The rest of us are lower down, but we creep up during various life stages, such as puberty, pregnancy, and menopause. A simple cold, by causing nasal congestion in a young, healthy woman, can cause her to toss and turn at night, due to repeated tongue collapse. Once the cold improves, sleep improves as well. What We All Must Know Breathing should never be taken for granted. We must do everything to make sure that proper breathing occurs not only during the day, but also at night. Many younger, thinner patients who complain of being tired all the time will also be found to have hypothyroidism, anemia, cold hands and feet, low blood pressure, anxiety, depression, or other various disorders. Later in life, as they slowly gain weight, they move up the continuum, and eventually will go into obstructive sleep apnea. Almost invariably, one or both parents will snore and have known or unknown cardiovascular disease. If you see a high-arched hard palate, an extra small mouth or a recessed jaw, or scalloping on the side of the tongue, ask about sleep position, fatigue issues, and sleep. You'll be surprised how often all these features come together to explain your chronic fatigue and various health problems.
To hear Dr. Park's interview with master Yoga teacher and Feldenkrais expert on the proper principles of breathing for better health and better sleep, click here.
Discover The Secret To Better Health & Better Sleep
December 9, 2009
Learn the secrets of proper breathing for better health and better sleep…
Get your FREE access to this interview with Ms. Deborah Quilter, a master yoga teacher, personal trainer, and Feldenkrais practitioner, on the importance of proper breathing in yoga as well as life in general.
Learn:
- How to improve your breathing during the day to help you sleep better at night.
- What breathing exercises can help you de-stress, and relieve tension and anxiety
- What common mistakes people make when doing breathing exercises
- How to maximize your nasal breathing using simple yet proven techniques
Register below to get a link to download the MP3 replay of this valuable interview for FREE!
How Sleep Apnea Can Cause Anxiety And Panic Attacks
December 8, 2009
As we approach the most stressful time of the year, the one thing that we all forget to do is to remember to breathe. Literally. Tension and stress causes a nervous system reaction that causes you to take short, shallow breaths, leading to carbon dioxide (CO2) retention. Interestingly, a recent study showed that increased levels of carbon dioxide has been shown to affect areas in the brain that triggers fear and panic attacks.
This makes sense since if you’re chronically oxygen deprived from not breathing at night due to sleep apnea, you’re going to build up carbon dioxide, which can increase the acidity levels in the amygdala, which is the area of the brain that processes fear and behavior.
This biochemical reaction, along with generalized nervous system over-responsiveness that comes along with inefficient sleep, is a good reason for you to feel over-stressed, over-anxious, and on edge. I’ve also described a situation where your tongue suddenly collapses and obstructs your breathing, and you’ll wake up violently, in a state of panic, in a cold sweat, and with your heart racing. This happens much more commonly than you think.
This study makes me wonder what all the carbonated beverages are doing to us as a society.
What’s you’re take on this? Do you find yourself taking short, shallow breaths or even hold your breath when you’re stressed? Please enter your comments in the box below.
Free Workshop on How To Breathe Your Way to Better Health
August 9, 2009
Is Your Breathing Making You Sick?
If you'd like to experience the benefits of breathing better and learn a breathing exercise that you can do at home to refresh your mind, body and soul, register below to download my latest recording of this live workshop I did with Deborah Quilter, a noted Feldenkrais practitioner and premiere yoga instructor, I explain on how reinvigorate your breathing.
In two hours, you'll learn:
• Which simple breathing exercises can melt away stress and alleviate back pain
• Why breathing better can dramatically improve your sleep quality-even eliminate insomnia
• Which breathing exercises can enhance your concentration and memory not to mention help you lose weight!
You'll learn the proven breathing methods I teach to those who suffer from chronic sleep problems and those that Deborah teaches to her clients who suffer from chronic pain and work related stress injuries.
Many registrants who attended the live workshop paid $45, but I'm giving you access to this workshop to you for FREE if you register below.
There's absolutely no obligation to register but if you sign up, you'll gain a wealth of new insights that will turn your health and life around.
This recording is the closest you'll get to experiencing this workshop live, and in person.
Register below to download and listen to this receive your FREE downloadable mp3 recording of this interview.
A Surgeon’s Adventure With Yoga
December 18, 2008
Last night, I went to my first ever yoga class. I was invited by Deborah Quilter, a certified yoga teacher, personal trainer, author and consultant, to experience her class. I gladly accepted and I’m so glad that I did.
You may be wondering what a card carrying member of the American Academy of Otolaryngology – Head and Neck Surgery and the American Academy of Sleep Medicine is doing going to a yoga class. You see, it all started with may passion for helping people to breathe better. What I discovered was that not being able to breathe properly at night also affects how you breathe during the day, and vice versa. After having read tomes of book and articles on breathing, I was drawn to the concepts of pranayama in the yoga literature. When I was invited by Ms. Quilter to experience her techniques of breathing in her yoga class, I gladly accepted.
One thing that struck me about her method of teaching is that nothing is forced, not even the breathing. One particular aspect of pranayama breathing that I’ve already learned is what’s called the relaxing breath, where you take longer slowly exhaling compared to the time you take to inhale. In Ms. Quilter’s class, she emphasizes that you should follow and observe your natural breathing rhythms, rather than trying to modify it or alter it in any way. After this "natural" breathing pattern is established, she adds subtle, gentle movements that are in sync with theses natural, spontaneous breathing patterns. I must say that the one hour session seemed more like 15 minutes. It was truly a memorable, and relaxing experience.
Even my wife, who’s 8 months pregnant, is raving about her yoga for pregnancy DVD program that she performs 4-5 times every week. This is the best she’s felt out of her 3 pregnancies to date. Now I know having experienced this first hand, why people seem to love yoga.
Have you tried yoga, and if so, how do you feel afterwards?
New Age Dawning: Breathe Well, Sleep Well, Age Well
May 28, 2008
Sleep May Not Be the Number One Factor In staying Young and Healthy
“Early to bed, early to rise, makes a man healthy, wealthy and wise.”
This short proverb can be traced as far back as 1496, and even earlier if you count all its variations. It seems that people have always understood the necessity of a good night’s sleep, but these days quality sleep has become a luxury rather than a necessity. But going without sleep may not be so easy since it’s not something your body can easily do without.
The Growing Sleep Deficit
According to a recent Harvard Health Publications survey, “more people are sleeping less than six hours a night, and sleep difficulties confound 75% of us at least a few nights per week.” Most people are shown to be getting inadequate sleep, and as a result chronic fatigue is a major problem for millions of Americans.
But even with the sleep “catch up” on the weekends there are still those who are tired and listless no matter how many hours of sleep they get. In these circumstances, something else may be awry: the sleepiness patients feel is usually the end result and not the actual cause of their sleepiness. In fact, it may be their poor breathing at night and not the quantity of sleep they’re deprived of.
Breath Well To Sleep Well
Whenever you undergo any form of exercise training, you’re almost always reminded to take long deep breaths and to focus on your breathing. From Pilates, to yoga to running and Tai-Chi, exerting control over one’s breath, especially as it pertains to one’s stamina and endurance, is key to maintaining good form and gaining mastery.
But think what would happen if you couldn’t breathe well while you slept. You’d get more than a flabby body. You’d be headed for some serious health problems. But if you’re suffering from obstructive sleep apnea, or OSA for short, this is exactly what’s happening.
Having Trouble Breathing While Sleeping?
Although all humans have varying degrees of airway narrowing, those with sleep apnea, or its milder variant upper airway resistance syndrome (UARS) have anatomies that are more prone to collapse than others. If you have a triangular facial structure or if you have a long neck or if you have a thick, stocky neck, like a football player, or if your tongue happens to sit higher up on your arches (see diagram), all of these anatomical factors can predispose you to airway obstruction or breathing problems while you sleep. Obesity, or one’s weight is not the primary indicator as once believed for having sleep apnea.
This is why for some OSA and UARS patients, sleeping on their sides or stomaches is an important prerequisite for getting a good nights rest. The reason being that this position, as opposed to sleeping on their backs, gives the tissue around their airway a bit more openness, and their tongues don’t tend to collapse as easily if they were lying flat on their backs, especially in deep sleep when throat muscles tend to relax more.
Although many OSA and UARS patients think they prefer to sleep this way just because this is how they’ve always slept, they may very well have made a choice to sleep this way for very good reason. It’s almost like a reflexive survival mechanism, since these preferences to sleep on our sides or stomachs, may have been formed not by any conscious effort, but as a reflexive coping mechanism for something that’s ailing us. This is why oftentimes when patients come to me with sinus and or chronic fatigue issues, I always ask: “Which position do you prefer to sleep in?” It’s almost a given that if patients like to sleep on their sides or stomaches their airways will look like the opening of a coffee stirrer when I look at their airway with my video endoscope.
Breathing For Life
Although many of us intuitively know that breathing is necessary for life, those with sleep apnea and UARS aren’t breathing for their lives. Even though they’re sleeping and therefore should rest allowing time for their brain, muscles, and organs to reset and replenish, their apneas or frequent breathing cessations are constantly interrupting this process. It’s like their “fight or flight” response is on all the time, even though it needs some time off. Think what would happen to your car if the ignition was never turned off. Well, this is what’s happening with sleep apnea patients.
Problems with Sleep Apnea
There are many serious consequences to having sleep-breathing problems—many of which are preventable yet as I’d mentioned before, this is not very likely because so many people who have this condition are unaware.
For one thing, research has found that sleep apnea is inked with a higher incidence of high blood pressure and heart disease. Many patients that come to me already on high blood pressure medications or have a history of heart disease are found on examination to have some sort of a sleep-breathing disorder.
Some other chronic conditions related to sleep apnea are diabetes, depression and many anxiety issues. Many fatigue and attention deficit problems like ADHD (attention deficit hyperactivity disorder) in children have also been linked to sleep apnea. A recent study showed that some children having undergone tonsillectomies (where a high percentage of them present with obvious symptoms of OSA) showed significant improvement in their ability to focus and pay attention in schools if not a significantly noticeable decrease in their behavior problems as a result. As you can see, not breathing well while you sleep can have serious consequences for both the old and the young.
When Being Young Is Not Enough
Because sleeping well is almost synonymous in people’s minds with feeling well, looking young and healthy, many people neglect their breathing as a simple fact of life. Little do we realize that this is wherein life originates.
People don’t often ask themselves, “How well did I breathe last night” when they feel groggy and listless in the morning. Instead, most people fixate on the amount of sleep they got or not. This may be the reason why sleeping pills and anti-anxiety medications are so popular in America today.
Moreover, as everyone jumps on the latest new anti-aging rage, breathing is becoming not a secondary, but a tertiary issue in the medical community. In the scheme of holistic or preventative medicine, breathing is often taken as a matter of fact. Although many proponents of these therapies often tout breathing exercises as a means to reducing stress and improving mental wellness they nonetheless overlook this matter when they provide dietary regiments or herbal supplements as sleep aids with little or no regard to the fact that none of these regiments are all that effective unless the mechanism that allows for efficient sleep is working well too. It’s almost like an auto shop owner shoving premium gasoline at customers with cars with broken fuel lodges. Sooner or later, that car is either going to break down or stop dead in its tracks, or at the very least, waste the very good thing you put in to it to make it work better. Similarly, if your sleep problems originate from an anatomical issue, like your airway, no amount of pills or supplements, no matter how potent, can effectively cure your problems with sleep. These problems need to be addressed from the source where it originates—the airway.
Your Breathing Problems Solved
In lieu of giving out bottles of air to my OSA and UARS patients, there are simple measures you can take on your own to improve your breathing while you sleep if you suspect that this may be the source of your problems.
The first most obvious thing I recommend to all my patients who suffer from fatigue issues is to avoid sleeping on their backs. This is one of many reasons why snoring sometimes ceases when people turn over while they sleep. The next best thing to do, if you’re not able to change your sleep position in this way due to an injury or habit, is to lose any excess weight you’ve gained recently. Yet, if you’re still feeling tired or having trouble maintaining focus at work my recommendation will be to get a formal sleep study or polysomnography to determine the root cause of your day time fatigue or exhaustion.
You Want Me To Sleep Where?
A typical “sleep study” takes place in a sleep laboratory where a sleep technician can hook you up to a monitor while you sleep, and a “sleep doctor” can use the readings to objectively measure and quantify the real source of your sleep problems. (Watch meundergo a sleep study.)
Although you may or may not be officially diagnosed with OSA even after the sleep study, I’ve seen many if not a great majority of these patients gain useful information to address any other sleep problems they may be having. Yet, most if not in all cases, patients who I suspect have these conditions, are found to have some mild to moderate breathing component that goes along with their sleep problems. And for these patients, in lieu of treating the underlying breathing problem, no amount of sleeping pills will cure the airway blockage that’s at the root of their sleep problems.
Decelerating the Aging Process
To understand how essential it is to get the sleep you need, it’s equally if not more important to understand how you can get the restorative sleep you need as well.
Essentially, sound sleep offers vital services to your body. After spending a full day learning new skills and having new experiences, sleep allows your brain to shut down its learning mode and consolidate and commit the newly acquired information to memory. Adequate sleep also allows the body to produce the right balance of hormones to help stabilize weight and use carbohydrates efficiently (this may be why research studies show that inadequate sleep is often linked with weight gain). Getting enough sleep also helps to ensure your safety by keeping your brain more alert and in tune with your reflexes preventing injury, and keeping you happy and well adjusted.
Sleep also helps keep the body healthy by boosting your immune function, reducing your chances of getting certain cancers and lowering your blood pressure too. In a nutshell, if you’re not sleeping well, you’re missing out on one of the most valuable methods for keeping you young and healthy for a very long time.
However, ensuring that your good night’s sleep isn’t impaired by breathing problems like Obstructive Sleep Apnea may be more important than sleeping that extra hour of shut eye. As the new-age gurus of aging are telling us, it’s not how old you are chronologically as how old you are biologically. Similarly, if your breathing is impaired while you’re sleeping, your health may not depend so much on how much you sleep every night but how well you’re sleeping through the night, and moreover, how well you’re breathing while you’re asleep. In short, take a closer look at what’s happening on the inside and not on the outside for the answers to your sleep problems. You may be surprised by what you find.
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