Breathing Lessons for Sleep Apnea Sufferers

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.

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2 thoughts on “Breathing Lessons for Sleep Apnea Sufferers

  1. Dr Park
    I am in the process of deciding whether or not to have an MMA surgery. I have seen a good surgeon with many credentials.
    However,currently I have lost 8 pounds from my last sleep study and I think that I am sleeping better. However I know that keeping off the weight is very hard as I get older and that the only reason I am able to keep off the weight is because I am currently not working and focusing on losing weight. I believe it is inevitable that I will gain the weight and feel exhausted again. I have been trying to use my cpap for over a year and can not stand it. I keep ripping the mask off my face.
    In addition, an oral appliance is not something for me. I have had trouble even keeping a retainer in my mouth when I had braces.
    I am wondering how long will the good effects of MMA surgery last?
    And when does one know when in their life to do an MMA. It seems as most people just give up and have it as a last resort. For me I am almost at the giving up on CPAP and moving forward for the MMA surgery.

  2. Ricky,

    Undergoing any type of surgery, especially the MMA is a major decision, with lots of pros and cons. It sounds like you've done your research and know what's involved with the surgery. Unfortunately, your decision is a personal one, and different people will choose to undergo the same surgery for different reasons. Have you spoken to any of the patient that your MMA surgeon operated on? Did you see another surgeon for a second opinion?

    Surgery of any type for sleep apnea (except for the tracheotomy) won't cure you completely, What it does is to lower you down the sleep-apnea continuum. In theory, even with the MMA, if you gain significant weight, it may get worse again. This is true for any type of sleep apnea surgery (but not as severe with the MMA, since your airway is much more open). 

    Sorry I can't give you any additional advice.