As physicians and surgeons, we like to think that offering medications or surgery is what makes the most impact, but I’ve learned over the years that it’s the simple lifestyle changes that make more of a difference in almost every chronic medical condition we have. It’s a humbling realization.
With every patient, I give a handful of conservative recommendations to being with. This applies to most routine ENT visits such as for sinusitis, ear problems, nasal congestion, throat pain, or hoarseness. In about 75% of my patients, I don’t give prescription medications at all on the first visit.
Of all the recommendations I make, the single most important tip I give to just about everyone is not to eat within 3-4 hours of bedtime. You may have heard this before from your doctor or from magazines or articles, but the reason why this is so important is not for the reasons that you may be thinking. I also stress that it’s not a recommendation—it has to be done, or your throat pain, sinus or ear problems won’t get better.
Traditionally, it’s thought that eating late slows down your metabolism. Another is that food doesn’t digest well since your bowels shut down while sleeping, thus converting the nutrients into fat. There are dozens of other explanations. Here’s an article on the benefits of eating early.
Here’s one that that makes sense: All modern humans have narrowed upper airway anatomy due to the fact that we can talk. Over the past 100 years or so, due to a radical change in our diets and eating habits, our jaws are not widening like they used to. This is why most people in Western countries need braces, since there isn’t enough space for the teeth.
This predisposes people to breathing pauses at night due to the tongue falling back (due to gravity when on our backs) and due to muscle relaxation in deep sleep. You can stop breathing multiple times every hour and not have obstructive sleep apnea. Every time you stop breathing, you’ll literally vacuum up your stomach juices into your throat, causing you to wake up into a lighter stage of sleep, and causing more inflammation and swelling, which causes more obstructions. Your stomach juices (acid, bile, enzymes and bacteria) can then go into your lungs and your nose, causing even more inflammation.
So the later you eat, the more juices you’ll have in your stomach, and the more it’ll come up into your throat. This leads to more frequent obstructions and arousals, leading to less efficient sleep. We know that poor sleep causes weight gain, hormonally, neurologically and biochemically.
Unfortunately, some people are very resistant to this recommendation since it disrupts their lifestyles or they have job schedules that make it very difficult. These are the people who keep coming back over and over again for more medications, and in the long term, many years later, being diagnosed with obstructive sleep apnea.
How many of you notice that you sleep much better when you eat early?