Can H1N1 Cause Sleep Apnea?

November 24, 2009

You may be thinking that I’m stretching things a bit by making the suggestion that H1N1 can cause sleep apnea, but in my mind, there’s no doubt that whether it’s H1N1, the common cold, allergies, or strep throat, any degree of inflammation and swelling in the nose and the throat can aggravate sleep-breathing problems. If you didn’t have sleep apnea to begin with, then you may go into sleep apnea territory temporarily, and come back to normal once the infection is gone. This is why you’ll toss and turn when you have a simple cold. If you already have some degree of sleep apnea, then any infection or inflammation will only make things worse. Some people will recover, whereas others will be stuck in a continuous vicious cycle, leading to various other medical complications.

As I detail in my book, Sleep, Interrupted, most modern humans have narrowed jaws that lead to dental crowding and a predisposition to breathing problems while sleeping at night. My sleep-breathing paradigm proposes that all modern humans are on a continuum, where the upper extreme is formally called obstructive sleep apnea. But even if you don’t have sleep apnea, you can still stop breathing multiple times every hour. This disrupts your sleep and causes more inflammation and swelling due to suctioning up of your stomach juices into your throat. More swelling causes more upper airway narrowing, leading to more obstruction, which leads to more swelling.

The most dramatic example is what happens with mononucleosis. The Epstein-Barr virus which is thought to cause mono preferentially attacks lymphoid tissues. Your tonsils are made of lymphoid tissues, like the glands in your neck, armpits and groins. When your tonsils swell up for whatever reason (infection, irritation, inflammation), it narrows the throat, aggravating more frequent collapse, perpetuating the vicious cycle described above. This is why it takes a long time for mono to go away. In some people, the cycle never stops, leading to chronic fatigue syndrome. The physiologic consequences of this process can lead to hormonal, biochemical, and neurologic changes which may or may not show up on blood tests.

In this situation, it’s not that the tonsils are too big, but the jaws are too small, causing chronic inflammation and swelling, which keeps the tonsils larger than normal. This leads to further narrowing of the upper airways. It’s also been shown that you can have persistently enlarged lingual tonsils, which are lymphoid tissue at the base of the tongue in the midline. The size of lingual tonsils has been correlated to the level of reflux material in the throat. Your adenoids, which are lymphoid tissue in the back of your nose, can also become inflamed from colds or allergies, aggravating nasal congestion, which creates a vacuum effect downstream in the throat.

Ultimately, what’s more important than what’s infecting you is the size of your upper airway and how well your body is able to handle these infections. An underlying sleep-breathing problem can definitely aggravate your symptoms. This is why living by the principles that incorporate my sleep-breathing paradigm will help you to minimize or even prevent serious complications from any infection this winter season. My wife and I live by these principles and so far (knock on wood), so good.

Do simple colds lead to prolonged symptoms or repeated infections for you? If so, please explain in the comments box below.

Written by Steven Park · Filed Under Blog | 1 Comment