Sleep Apnea

People with sleep apnea stop breathing for short periods of time while they are asleep. You generally don't wake up fully when this happens but in the morning you don't feel rested and you feel sleepy during the day. Sleep apnea can be caused by a blocked upper airway (called obstructive apnea) by your brain not signaling your lungs to breathe (central apnea) or by a combination of these two problems.

Signs and Symptoms

The symptoms of sleep apnea include the following.

• Loud irregular snoring then quiet periods of at least 10 seconds when breathing stops; these episodes can happen up to 100 times or more each hour
• Daytime sleepiness always feeling tired
• Morning headaches sore throat dry mouth cough
• Feeling depressed moody irritable
• Unable to concentrate or remember
• Possible impotence or high blood pressure

What Causes It?

Apnea is caused by many physical conditions (such as obesity or large tonsils and adenoids). The typical person with sleep apnea is an overweight middle-aged man who has allergies but apnea can occur at any age and in women as well as men. Sometimes drugs such as alcohol sleeping pills or heart medications can trigger apnea. It can also be inherited.

What to Expect at Your Provider's Office

People who have sleep apnea often seek medical help because they feel tired all the time or because their partner complains of loud snoring. Your health care provider will check your weight and blood pressure and ask about allergies. He or she may send you home with a device to check your oxygen levels while you sleep. Your provider may also refer you to a sleep clinic for overnight testing.

Treatment Options

Treatment Plan

Most of the drugs available for sleep apnea have quite serious side effects. Various ventilator devices are available to keep airways open. Tongue- or jaw-retaining devices worn in your mouth at night may be helpful. Surgery is available but does not have a high degree of success. Making the following lifestyle changes helps stop obstructive apnea.

• Lose weight.
• Minimize your use of alcohol antihistamines or tranquilizers.
• Get treatment for allergies and colds or sinus problems.
• Gargle with salt water (without swallowing) to shrink your tonsils.
• Develop regular sleep habits and especially make sure you get enough sleep at night.
• Sleep on your side or sitting up rather than on your back. You may want to sew a couple of tennis balls to the back of your sleepwear or put pillows behind you so you stay on your side.
• Use an air humidifier at night.
• Don't smoke or expose yourself to other irritants (such as dust or perfumes).
• Raise the head of your bed by placing bricks under the headboard.

Drug Therapies

Prescription

For central apnea:

• Acetazolamide—promising results
• Clomipramine—tolerance develops in 6 to 12 months; side effects include impotence
• Doxapram—experimental drug with potentially serious side effects

• Medroxyprogesterone—only somewhat effective; potentially serious side effects
• Protriptyline—rarely used; potentially serious side effects

Over the Counter

• Internal dilators and external nose strips—effectiveness has not been proven

Complementary and Alternative Therapies

Alternative therapies may be useful in treating sleep apnea caused by allergies. Homeopathy and nutrition are most likely to have a positive effect. While many supplements are touted as good for weight loss none have proven to be as effective as eating less and exercising more.

Nutrition

• Diet: Try eliminating mucus-producing foods (dairy and bananas) for two weeks reintroducing them and noticing any difference.
• Essential fatty acids (EFAs) moderate inflammatory response decrease allergic response; EFAs are found to be low in obese people.
• Chromium helps regulate insulin and decrease insulin resistance; Chromium may not be effective at burning fat but effective at stabilizing blood sugar and decreasing sugar cravings.

Homeopathy

Some of the most common remedies used for sleep apnea are listed below. Usually the dose is 12X to 30C every one to four hours until your symptoms get better.

• Grindelia is recommended if you also have advanced heart or lung illness and if you wake suddenly with the feeling that you are suffocating.
• Lachesis is recommended if you also have frequent nightmares are unable to sleep on your right side and talk in your sleep.
• Sambucus nigra is recommended if you have trouble breathing at night and if you wake suddenly with the feeling that you are suffocating especially if you have asthma or a nasal blockage.
• Spongia is recommended if you wake with a feeling of suffocation you have a harsh dry cough and your throat feels tight ticklish or dry.
• Digitalis can help if you have a slow heartbeat that may be accompanied by palpitations.
• Opium can help if you snore loudly and your sleep is very deep and hard to disturb especially if you have a condition called narcolepsy (inability to control falling asleep).
• Sulfur is recommended if you have trouble falling asleep and have nightmares especially if you also have skin rashes that become worse with heat.

Acupuncture

May be helpful in treating sleep apnea.

Following Up

Sleep apnea is a serious condition that can cause fatal heart problems so it's crucial to stick with your treatment plan. If you are using a mask and ventilator equipment be sure to take care of them. Keep in contact with your health care provider or sleep clinic to make sure your treatment is working.

Special Considerations

If you are pregnant you may have nasal congestion that makes you snore in a way that people with apnea do but this is not apnea. If you have apnea and become pregnant be sure to continue your treatment so that your condition will not affect your baby.

Supporting Research

Caldwell JP. Sleep: Everything You Need to Know. Buffalo NY: Firefly Books; 1997.

Dunkell S. Goodbye Insomnia Hello Sleep. New York NY: Carol Publishing Group; 1994

Lipman DS. Snoring From A to ZZZZ: Proven Cures for the Night's Worst Nuisance. Portland Ore: Spencer Press; 1996.

Morrison R. Desktop Guide to Keynotes and Confirmatory Symptoms. Albany Calif: Hahnemann Clinic Publishing; 1993.

Pascualy RA Soest SW. Snoring and Sleep Apnea: Personal and Family Guide to Diagnosis and Treatment. 2nd ed. New York NY: Demos Vermande; 1996.

Smolley LA Bruce DF. Breathe Right Now: A Comprehensive Guide to Understanding and Treating the Most Common Breathing Disorders. New York NY: WW Norton & Co; 1998.

Copyright © 2000 Integrative Medicine Communications

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