Elite Runners, Jaw Size, And Insomnia

I came across this article in Runner’s World about an up and coming marathoner, Tera Moody, who suffers from chronic insomnia. She was found to have obstructive sleep apnea, but could not tolerate CPAP or a dental device. She eventually found some help by undergoing CBT, or cognitive behavioral therapy. She still suffers from insomnia occasionally, and take sleeping pills for emergencies. It’s clear that she’s not treating her sleep apnea. This puts her at significantly increased risk later in life for depression, diabetes, high blood pressure, heart disease, heart attack and stroke.

While the article was well written, the writer brings up the same old stereotypical thinking that sleep apnea patients must be older, male, heavy set, snores, and with a big neck. We now know that even young thin women that don’t snore can have significant sleep apnea. 

One thing that’s striking about her picture is the smallness of her jaw. It’s significantly recessed. Coincidentally, while I was searching for other profile pictures of her, I came across a profile picture of Joan Benoit Samuelson, the 1984 Olympic marathon winner. Not too surprisingly, her jaw is pretty recessed as well.

One thing I’ve noticed is that certain elite distance runners (and even the most avid distance runners in my track club), all have various sleep problems. They can never get deep refreshing sleep, and they prefer not to sleep on their backs. I’m guessing that continuous running is what makes them feel alive, so they thrive on it, leading to their elite statuses. Some athletes (in running and in other sports) are literally addicted to exercise. Not exercising for a day or two can lead to depression and lethargy. Sleep-breathing problems can definitely aggravate, if not cause insomnia. One recent study showed that surgery for sleep apnea cured chronic insomnia in many cases.

Do you know any intense athlete that also has a major sleep problem?



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4 thoughts on “Elite Runners, Jaw Size, And Insomnia

  1. Hello Dr. Park! I read that article on Tera Moody, that article TOTALLY relates to my story. I too am an intense athlete. I was diagnosed with sleep apnea, refuse to use the machine and even took my tonsils out a month ago. My sleep still sucks! I need help, maybe my jaw is too small as you say Tera’s is? I don’t know but all I know is I am desperate for sleep!!! It’s ruining my life, can you help me ? I need help!

  2. smita,

    The first place to start is to read all my articles and resources on upper airway resistance syndrome (UARS) and obstructive sleep apnea (OSA). A better, more comprehensive place is my book, Sleep, Interrupted: A physician reveals the #1 reason why so many of us are sick and tired. We just sold out with our first printing, and should have our second printing available in a few weeks. You can also get the PDF version at sleepinterrupted.com, and the Kindle version should be available in the next few days. Assuming you have UARS, besides doing all the conservative options I mention, a consultation with a dentist regarding an oral appliance should be a good option.

  3. Dear Dr. Park, I had a lateral cephalogram recently and noted that my oropharyngeal airway is very small, about 5mm. I saw a oromaxillofacial surgeon who mentioned that he did surgery on elite athletes. He told me he could extend my mandible 6mm, giving me an airway of 11mm. But back to the running. For the past 5 years I have been working on my running form, a process that was really about improving my posture. I had kyphosis and a forward head position–both of which are somewhat better–and rounded shoulders. Last year for the first time I was able to sleep on my back and voila! a few episodes where I awoke feeling as though I was drowning. It seems as though my posture was keeping my airway more open. In trying to fix it, I am fighting against the most primal instinct–to breathe. I also noticed that Tera has rounded forward shoulders. Is a runner’s overall posture, as well as a recessed jaw, another way of assessing her airway size? Is surgery something appropriate for non-elite runners who want to improve their posture for better running but also better overall functioning and avoid issues with sleep disturbances? Thank you, Lisa

  4. Lisa,

    That’s an interesting question. Dentists are providing mouthguard that open the airway. I do lots of nasal surgery to improve nasal airflow. Cosmetic surgeons perform bony surgery to reduce or enhance facial features. We do jaw, tongue and soft palate surgery routinely for obstructive sleep apnea. In theory, surgery can be done for athletic enhancement, but financially out of reach for most people unless you have a sleep apnea diagnosis. Lots of runners will have upper airway resistance syndrome, which can be just as bad as obstructive sleep apnea, with very small jaws and airways, along with a normal sleep study.