Sleep apnea is one of the most common sleep disturbance problems in America, giving 25 million Americans a tired and irritable start to the day, not to mention the health consequences of long-term sleep deprivation. Despite the gravity of this condition, sleep apnea is treated with weight loss, smoking cessation, CPAP machines, or surgery—none of which address the actual cause of the problem.
So, what is the cause?
When we begin to fall asleep we move from stage I (drowsiness) into stage II where muscular activity is inhibited and muscle tone is temporarily reduced. This function occurs primarily to keep the dreamer from physically acting out the movements of their dreams. It is accomplished by suppressing the flow of signals from the brain along the spinal cord.
Unfortunately, as we age, the boundaries of neural signals to muscles become blurred and the inhibition of skeletal muscles causes unintentional reduction in the signal to the diaphragm muscle. Next, inside your mouth, the muscles of the soft palate become weaker, allowing it to sag. (Keep in mind that this is the same soft palate that you have during the day, and it doesn’t cause you problems while you are awake.)
The nerves that reach the diaphragm in your abdomen emanate from the spinal column at vertebrae C3, C4, and C5 in your neck, then combine to form the phrenic nerve. Unfortunately, a large amount of the tension that develops in our shoulders throughout the day is residual and does not dissipate when we enter stage II sleep—this restricts nerve signal flow to the diaphragm as well.
The result of all of this is twofold. Upon entering stage II sleep, the muscle tone holding the soft palate out of the airway is reduced, allowing the soft palate to sag into the airway. While this is happening, the same inhibition of muscle tone is reducing the signals to the diaphragm on an already obstructed communication channel. The result is that our breathing grows shallower due to insufficient signal strength to the diaphragmatic muscles. In sleep apnea sufferers, breathing will stop completely.
Interruption of breathing allows the carbon dioxide level to rise. When it gets high enough, the brain intervenes and causes the body to make a large and immediate inhalation. This causes a large pressure differential in the pharynx, which literally sucks the sagging soft palate into the airway, obstructing airflow and causing a loud “snort,” which disturbs sleep or awakens the subject.
Upon awakening, respiration begins again, the sleeper then returns to stage I sleep, muscle tone is reduced for entry into stage II sleep, and the cycle repeats.
Treatment options for sleep apnea include behavioral, surgical, mechanical, and herbal interventions. Initially your doctor will likely suggest that you lose weight, stop smoking, don’t drink before bed, and avoid sleeping on your back. If you are able to do any or all of these, they will certainly help. However, since they are not the root cause of sleep apnea, they will not completely rid you of the problem.
The surgical option
The surgical options are many and seem to grow every year.
Somnoplasty is a minimally invasive procedure to reduce the soft tissue in the upper part of the airway. There is a rather painful recovery process associated with this procedure that can last a couple of weeks. Results are inconsistent: In some cases it doesn’t help or makes the problem worse, and in some cases it leads to remission.
Nasal surgery involves correcting the nasal passageway for any obstructions that may exist, such as a deviated septum. This surgery, though, presumes that you have nasal obstructions that are major enough to cause sleep apnea. This is not likely the problem unless you have recently had growths in the region or nose damage due to injury.
Uvulopalatopharyngoplasty (UPPP) is a procedure that removes soft tissue on the back of the throat and soft palate, increasing the width of the airway at the opening to the throat. This also has a rather painful and lengthy recovery path and has shown no more than 50 percent effectiveness.
Mandibular maxillary advancement (MMA) is a rather invasive surgery to correct certain facial abnormalities that can be correlated to sleep apnea such as throat obstructions and narrow airways due to gross jaw position. While the success rate of this surgery has been higher than others, it is far more expensive and extensive. It is also not indicated for all patients.
The mechanical option
Clearly the most common choice for treating sleep apnea is either a CPAP or BPAP machine. Both of these machines require wearing masks to bed and literally force air into your lungs for each breath. They require expensive disposables, adjustment of the pressure for comfort, and rather sizeable (i.e. non-portable) equipment, not to mention the clear interference that wearing a full plastic facemask has with the intimacy that some enjoy in bed.
Most patients diagnosed with sleep apnea are initially provided with a prescription for a CPAP or BPAP machine, though unfortunately only about 40 percent of them are able to tolerate the device long-term. Despite the drawbacks and modest success rate, this remains the most often recommended therapy.
The herbal option
There are no known available pharmaceutical products that treat sleep apnea. In fact, the common party line suggests that most of the cases are caused by obstruction and other habitual issues that we covered previously.
But, as discussed earlier, the real problem is the reduction in signal from your brain that reaches your diaphragm, producing insufficient breathing amplitude from your diaphragm. Because your breathing is insufficient you take a rapid inhalation and this sucks the soft palate into the airway with a snort, disturbing your sleep. The appropriate intervention is to increase the ability of the brain to communicate with the diaphragm so that you breathe deeply and steadily throughout the night.
Some foods, like wheat products and cheese, should not be eaten near bedtime as they can cause congestion, which aggravates the condition. The most dramatic impact, however, can be made by the administration of just a few common herbs.
Lobelia acts as a respiratory stimulant and has been used for thousands of years to treat respiratory conditions. When taken before bed, this herb will increase the level of respiration enough to avert the dangerous drop in respiration intensity that occurs upon muscular inhibition. It will maintain deep steady breathing through the stage II sleep period, directly addressing the cause of the problem.
Thyme has traditionally been used to enhance lung activity. It improves the ability of the lungs to exchange carbon dioxide for oxygen, thus helping maintain sufficient blood oxygenation. To round out the combination, chamomile helps one relax, while cramp bark relaxes the upper trapezius muscles specifically.
Since it enhances respiration, relaxes muscles that restrict nervous flow, and increases drowsiness, this bouquet of herbs represents a holistic solution to sleep apnea. The combination of lobelia, thyme, meadowsweet, and cramp bark is found in a supplement called Sleep Apnea Relief, designed to foster and maintain deep, steady breathing as the subject drifts off to sleep. This precludes the tendency that a sleep apnea sufferer has toward diminished breathing and reduces the number of “apneas,” or times when breathing stops.
This product has been in limited distribution for a number of years and has shown profound results on many sleep apnea sufferers. Many users have reported their ability to sleep soundly without the use of their CPAP or BPAP machines. Still others have gotten great results and offered reports of reduced snoring.
Steven R. Frank has been designing medical products for more than 30 years and has been doing medical research for more than a decade. His foray into natural health solutions lead him to start Nature’s Rite where he serves the function of innovative herbalist. He can be reached for comments at firstname.lastname@example.org.