December 28, 2010
As the New Year approaches, there are a number of articles and advice about simple ways to avoid a hangover. Besides not drinking at all, there’s really no proven method that works. This US News & World Report article does give some practical advice on how you can lessen the severity of your hangover the day after New Year’s festivities. As I read through this article, I couldn’t help but to point out some common myths that are still perpetuated in the media and the medical profession:
Myth #1: Alcohol causes dehydration. Just because you pee more doesn’t mean you’re dehydrated. If you drink an excessive volume of liquids, your kidneys will make sure to pee out the excess amount. However, since alcohol is a strong muscle relaxant, which causes you to stop breathing much more often when you’re in deep sleep. For many people, alcohol will temporarily cause obstructive sleep apnea, which is a common sleep-breathing disorder where you literally stop breathing anywhere from 10 to 100 times per hour, lasting anywhere from 10 to 50 seconds.
We know that in sleep apnea patients, due to the intense negative pressures that are generated in the chest, blood flow is partially diminished during these breathing pauses. But as soon as breathing resumes, blood rushes back into the heart chambers, causing your heart to think that it’s fluid overloaded. This causes your heart to make a hormone called atrial natriuretic peptide, which makes your kidneys make more urine. But then, because you’re more likely to wake up every time you stop breathing, you feel a little distention in your bladder, and you think you have to go to the bathroom. Studies have shown that it’s the breathing pauses that wakes you up, and not having too much urine in your bladder.
Myth #2: Your pounding headache is from the alcohol. Notice how the typical features of a hangover—pounding headache, nausea, sensitivity to bright lights or noises—are almost identical to a migraine. Many people with obstructive sleep apnea wake up every morning with very similar symptoms, without having ingested any alcohol. Deep sleep deprivation is a major cause of headaches.
Myth #3: Eat crackers, toast, bananas or pretzels. The reason is to make up for a drop in blood sugar and lost potassium from increased urination. While this advice may be true, and can be helpful if you don’t stop breathing at all. But since by definition a hangover means you stop breathing much more often than normal, having any food in the stomach is the worst thing you can do. Every time you stop breathing, you’ll create a vacuum effect, which suctions up your stomach juices into your throat. This not only wake you up more often from deep to light sleep, it’s what also causes you to have a sore or dry throat in the morning. It’s not from dehydration. This can then go into your nose and cause a stuffy nose.
Looking at hangovers from my sleep-breathing paradigm, the smaller your jaws, or if you prefer to sleep on your side or stomach, the more likely you’ll suffer from a hangover after a night of drinking. The smaller jaw volume allows your tongue to fall back and obstruct your breathing more easily with the same amount of alcohol. This is why in general, it’s a good idea to avoid any alcohol within 3-4 hours of bedtime.
There’s one simple tip that may help some people from having a hangover (but not everyone): Use Afrin nasal spray and Breathe Rite strips just before going to bed. Since alcohol causes nasal congestion, it can cause your tongue to fall back easier and obstruct your breathing. Having an overly open nose may be enough to prevent your tongue from falling back too often.
For those of you who plan on celebrating this New Year’s eve and indulge in alcohol, try this simple nasal tip. Please report to me your experiences. Did breathing better through your nose lessen or eliminate your hangover after a night of drinking?
December 7, 2009
If you’ve ever suffered from a hangover, the pounding headache, facial pressure, sensitivity to lights and loud noises will be familiar. Most people will also have a very dry, raw throat, and this is usually blamed on dehydration that’s caused by drinking too much alcohol. As far as I know, there’s no scientific proof that drinking alcohol causes significant dehydration.
Furthermore, notice that many of the features of a hangover, which usually happen only after waking from sleep after drinking too much, resemble the same symptoms when someone suffers from a migraine headache: pounding headache, nasal and sinus pressure and congestion, light and sound sensitivity, lightheadedness and imbalance, brain fog, and nausea.
Interestingly, there’s another condition that give you headaches when you wake up in the morning: obstructive sleep apnea. Not too surprisingly, you’ll have a pounding headache, sinus pain and pressure, light and sound sensitivity, and mild nausea, and brain fog. Numerous studies clearly document that alcohol can worsen or uncover obstructive sleep apnea.
This is not too surprising, since alcohol is a strong muscle relaxant, causing your throat muscles to collapse and obstruct your breathing every time you go into deep sleep. When your throat obstructs, you’ll create a vacuum effect in your throat, which literally suctions up your normal stomach juices into your throat. This is why your throat is so dry and sore in the morning during a hangover. Not getting any deep sleep will give you pounding headaches, nausea, light and sound sensitivity, and brain fog.
This process also explains why some people are less susceptible to hangovers, no matter how much thy drink. If your throat anatomy is wide to begin with, muscle relaxation and collapse won’t progress to the point of obstruction and arousals as often.
What’s your take on hangovers? Please enter your opinion below in the comments box.
September 26, 2008
You may have thought after reading this post’s title, “I know that already.” But in science, you can’t say A causes B without double blinded prospective randomized placebo-controlled studies. Even then you can’t say definitively that A causes B—all you can say is that there is a very high likelihood that A is associated with B.
In the fields of sleep medicine and ENT, I see occasional studies that are similar to the water curing dehydration title. For example, in one article, “The nasal decongestant effect of xylometazoline in the common cold,” the authors show that applying an over the counter topical decongestant spray can help you breathe better. Here, a double-blinded placebo-controlled study was performed, where the placebo was nasal saline. Other common titles that I see frequently go something like this: “CPAP improves quality of life in patients with obstructive sleep apnea,” or “Lack of sleep is associated with drowsiness and poor concentration.”
There are many well-intentioned investigators that publish good papers, but sometimes you have to question the value of some of these studies. How does it help you and me, now? Of course, for three reasons, no one will ever do a large, expensive prospective study on the merits of giving water for dehydration. First, it’s just common sense that it’s true, and two, there’s no profit in marketing water for dehydration. Third, you can’t say that something cures or helps a medical condition without FDA approval. Essentially, mothers are practicing medicine without a license by giving water, an unapproved “supplement,” to their young children whenever they get dehydrated from diarrhea.
If you scan the health news headlines, it’s the same old stuff – exercise can reduce your weight, or lowering stress can prolong your life. Yes, there’s been tremendous advances with technology, but why is it that as a whole, our country is sicker than ever?
I think this is one of the major reasons why there’s not too much progress in medicine. We continue to perform studies to confirm previous confirmed studies which confirm previous confirmed studies, and so on. For this reason it’s rare to ever see a radically new approach to treatment.
Do you think our current scientific method is adequate for our health care needs, or de we need to revamp the entire system?