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Health Protocols

Sleep Apnea


Sleep apnea is an increasingly common and often overlooked disorder characterized by repeated pauses in breathing during sleep (Jordan 2014; Hayes 2014; Strohl 2013). These frequent respiratory pauses result in periods of low blood oxygen levels, nervous system dysfunction, and sleep fragmentation, leading to an array of serious health problems. In fact, an abundance of research shows that sleep apnea considerably increases the risk of dying from any cause (Panossian 2013; Kendzerska 2014).

Sleep apnea is an under-recognized but growing epidemic with alarming public health implications. The National Sleep Foundation estimates that more than 18 million people in the United States have sleep apnea, but this insidious condition is believed to be vastly underdiagnosed (NSF 2014; Ramirez 2013; Paiva 2014; Yu 2011; Peppard 2013; Hayes 2014; Motamedi 2009).

There are many consequences of untreated sleep apnea, including the hallmarks of chronic sleep deprivation: daytime sleepiness, cognitive difficulties, depression, and increased risk of accidents and injuries (Seneviratne 2004; Hayes 2014; NSF 2014; Thompson 2012; NIH 2006; Ellen 2006; Findley 1991; Mayo Clinic 2012). In addition, a significant and growing list of serious chronic ailments have been associated with sleep apnea, including cardiovascular and neurological diseases, pregnancy complications, obesity, bleeding peptic ulcers, and insulin resistance and type 2 diabetes (Paiva 2014; Jordan 2014; UMMC 2013b; Mirrakhimov 2013; Hayes 2014). Researchers are also investigating possible associations between sleep apnea and autoimmune diseases, osteoporosis, and even cancer (Kang 2012; Mirrakhimov 2013; Yen 2014; Noguti 2013; Pamidi 2014).

The first-line treatment approach for obstructive sleep apnea is a device that provides continuous positive airway pressure, known as CPAP (NSF 2014; Hayes 2014). The device is worn during sleep and introduces mildly pressurized air into the airways to keep them open (Mayo Clinic 2012; NSF 2014). The benefits of CPAP are particularly evident in those with sleep apnea who experience excessive daytime sleepiness (Chiner 2013). Moreover, research suggests CPAP use might improve markers of cardiovascular health and glucose metabolism for those with sleep apnea (Monahan 2011; Gottlieb 2014; Gallegos 2014; Chen, Pei 2014; Schlatzer 2014; Ayas 2006).

Some patients are unable to tolerate CPAP, in which case other therapies may be considered. Dental devices and surgical procedures to open the airway may be beneficial in some people with sleep apnea. Other methods sometimes recommended include bariatric weight loss surgery and negative pressure devices (Freedman 2014; Hayes 2014).

Dietary and lifestyle interventions can have a significant impact on the severity and consequences of sleep apnea. Weight loss is the most common and well-supported adjunct to CPAP, and it can be effective on its own (Hayes 2014; UMMC 2013a; Thompson 2012). Exercise, even without weight loss; correct sleep position; avoidance of alcohol and sedatives before bed; and a generally healthy diet are important for managing sleep apnea (UMMC 2013b; Hayes 2014). Integrative interventions may both reduce the severity of sleep apnea and help minimize the consequences of some of the serious conditions associated with sleep apnea (Grebe 2006; Singh 2009; Sadasivam 2011; Lee 2009).

In this protocol, you will learn about the causes of sleep apnea and factors that increase sleep apnea risk. Conventional treatment approaches will be reviewed, as will several novel and emerging treatment strategies. A number of lifestyle considerations and natural, integrative interventions that may lessen the impact of sleep apnea will be discussed as well.