If you are one of the nearly one billion people worldwide that suffer from some form of sleep apnea, you know how much it can impact your quality of life both day and night. From making it hard to stay asleep to its impact on blood pressure and cognitive health, sleep apnea is not just a sleep disorder, but can make it hard to maintain optimal health throughout your entire body. Therefore, it is vital to treat sleep apnea not only at night, but during waking hours as well. Besides surgery and medication, continue reading for ways you can improve your sleep apnea while you are still awake.
What is Sleep Apnea?
Sleep apnea is a common condition that occurs when the airway gets blocked during sleep. In turn, this causes a person to have slow or stopped breathing during sleep. This condition can lead to symptoms such as:
- Frequent loud snoring
- Gasping for air during sleep
- Excessive fatigue and sleepiness during the day
- Decrease in attention span and/or concentration
- Dry mouth or headaches upon waking
- Waking up during the night to urinate
Sleep apnea can be caused by a variety of conditions such as obesity, large tonsils, endocrine disorders, and heart or kidney failure, among other reasons. Risk factors for sleep apnea include drinking alcohol, smoking, an unhealthy diet, as well as uncontrollable risk factors like family history and genetics. Untreated sleep apnea can increase risk of chronic conditions like type 2 diabetes, heart disease, chronic kidney disease, asthma, certain cancers, and even Alzheimer’s disease.
Because of the long-term health risks of sleep apnea, it is important to visit your doctor as soon as you recognize symptoms. A medical exam and sleep study will help to diagnose sleep apnea. There are two major forms of sleep apnea known as obstructive sleep apnea (OSA) and central sleep apnea (CSA). Obstructive sleep apnea is the more common form of sleep apnea that involves a blockage of the airway that usually happens when the soft tissue in the back of the throat collapses during sleep.
Types of Sleep Apnea
There are three forms of obstructive sleep apnea that depend on the number of times breathing is interrupted per hour during sleep. When you get a sleep study done, your level of OSA can be determined. The three types of OSA include:
- Mild OSA: With this level of OSA, you have between 5 and 14 sleep interruptions per hour during sleep.
- Moderate OSA: With this level of OSA, you have between 15 and 30 sleep interruptions per hour during sleep.
- Severe OSA: With this level of OSA, you have 30 or more sleep interruptions per hour during sleep.
On the other hand, central sleep apnea affects breathing without a blocked airway. Instead, the brain fails to signal the muscles to breathe due to issues in the respiratory system. An echocardiogram, lung function test, or MRI of the brain, spine, or neck can be used alongside of a sleep study to diagnose central sleep apnea. If your sleep apnea does not fit into either of these two categories, you may have what is called mixed sleep apnea, which is a type of sleep apnea whose cause stems from both obstructive and central sleep apnea origins.
Treatment of sleep apnea typically involves use of a continuous positive airway pressure, or CPAP machine. Other treatments may include surgery or medications if the CPAP treatment is not enough to help. However, if you can’t or are unable to use CPAP for OSA, are not a candidate for surgery, or wear an oral/dental appliance, there are ways you can treat your sleep apnea that have been successful for others. Read below for 20 alternative ways to treat your sleep apnea symptoms. These alternate ways of treating sleep apnea can help those currently using a CPAP that are still experiencing trouble sleeping or other related issues.
20 Ways to Improve Sleep Apnea
According to the 2013 American College of Physicians guidelines for treating sleep apnea, weight loss is one of the top recommended treatments. This guideline is confirmed by a 2018 study that also recommended weight loss in treating obstructive sleep apnea. This study reveals that weight loss interventions, especially comprehensive healthy lifestyle changes can improve OSA severity, heart health risk factors, as well as overall quality of life. Therefore, it is important as part of your sleep apnea treatment plan to make healthy lifestyle changes in your diet to help you lose weight and improve your sleep apnea symptoms.
One healthy diet that could help sleep apnea symptoms is an anti-inflammatory diet. This type of diet is simply one that helps the body fight inflammation. And research shows that a plant-based diet full of antioxidants helps to reduce inflammation in the body and in turn reduces chronic disease risk. Researchers suggest that a Mediterranean-style diet full of fruits and vegetables, plant-based fats from such foods as olive oil and avocado, and limited intake of red meats and alcohol may help improve symptoms of those with sleep apnea.
Fish oil with DHA
Fish oil is an example of a supplement that may help reduce symptoms of sleep apnea. Research shows that omega-3 fatty acid supplementation may help reduce symptoms of OSA as well as related heart disease risk. This theory is confirmed by a study that shows that lower levels of omega-3 fatty acids in the blood may be linked to increased risk of OSA. Therefore, try to get at least one serving of fatty fish like salmon, trout, mackerel, tuna, or sardines in your diet each week. If fish is not your favorite, then perhaps add in a supplement that will give you your daily dose of omega-3 fatty acids and DHA.
Another way to help reduce inflammation in the body, and in turn reduce OSA symptoms, is taking daily antioxidant supplements. Research shows that antioxidant therapy helps in the treatment of OSA by reducing oxidative stress. Furthermore, another study shows that the antioxidant vitamin C may help improve symptoms of sleep apnea. This is due to the ability of the vitamin to improve vascular function and reduce endothelial dysfunction associated with OSA. In simpler terms, vitamin C can help improve the function of the lining of small arteries that deliver oxygenated blood to the lungs and tissues from the heart. So, if you are not eating enough antioxidants in your diet, add in a supplement to help you reap the health benefits of antioxidants.
Add a vitamin D supplement to your daily regimen
Vitamin D is well-known for its impact on bone health. However, research also shows that it may be linked to OSA symptoms too. This study reports that those with OSA had lower serum 25(OH) vitamin D levels as compared to control patients. Therefore, be sure to get your vitamin D tested if you have sleep apnea since a report from the Vitamin D Council has linked low vitamin to more severe OSA symptoms. If you are low in vitamin D, you can have your doctor prescribe you a daily supplement. Also, be sure to get at least 10-15 minutes of outdoor time most days of the week to soak up some vitamin D from the sun.
You may hear a lot about gluten-free foods helping digestive health, but it may also benefit your sleep apnea. A 2018 study of children with OSA and celiac disease looked at the impact of a gluten-free diet on symptoms. Study results show that a gluten-free diet may improve OSA symptoms in this population. The results from this study warrant further study on a gluten-free diet on adults with OSA symptoms. In the meantime, it may not hurt to try limiting gluten containing foods such as wheat bread and pasta, barley, and rye to see if it helps reduce your sleep apnea symptoms.
Cut out drinking alcohol
You may know that limiting alcohol is good for weight management and heart health. However, research is starting to show that limiting alcohol may also help lower your risk of sleep apnea too. A 2018 study analyzed the results of 21 studies on sleep apnea to see if there was any link between the condition and alcohol intake. Study results show that alcohol consumption is in fact associated with an increased risk of developing sleep apnea. Not only that, but alcohol intake can make it hard to fall asleep and stay asleep. Also, alcohol can also make sleep apnea symptoms worse since it relaxes muscles in your body even more, in turn blocking airways more, and making it harder for you to wake up if you do stop breathing. Therefore, limit alcohol intake as much as possible to at least the recommended one standard drink a day for women and two a day for men to lower your sleep apnea risk. One standard drink is equal to 12 ounces of beer, 8 ounces of malt liquor, 5 ounces of wine, or 1.5 ounces of liquor.
Stop smoking or don’t start
Since smoking constricts blood vessels, affects breathing, and impacts heart health, it may come as no surprise that stopping smoking can help improve sleep apnea symptoms. A 2014 study shows that stopping smoking can help improve airway inflammation, provide less sleep disturbance from coughing and wheezing, and in turn improve OSA-related symptoms from improved overall sleep quality. Another more recent study shows that smoking can also increase risk of heart health risk factors associated with sleep apnea. Therefore, if you smoke, visit your healthcare provider or sites like smokefree.gov for resources on how to quit.
Acid reflux treatment
Acid reflux is a painful condition that involves the acidic contents of the stomach flowing backwards into the esophagus. Although it may not sound like it is related to sleep apnea, research shows that this condition is often seen in those with OSA. A 2016 study found that this relationship is likely due to the link between obesity and the two conditions. Also, a 2018 study found that those with gastroesophageal reflux disease (GERD), a more severe form of reflux, had more severe OSA symptoms. Therefore, treatment of GERD and acid reflux could help improve OSA symptoms. At home, you can reduce acid reflux symptoms by eating smaller meals, wearing looser clothing, avoiding acidic foods like citrus fruits and tomatoes as well as spicy foods, and not going to bed too soon after eating. A doctor may be able to prescribe you medications to help treat your acid reflux.
Sleep on your side
The way you sleep can impact sleep apnea symptoms. It is recommended to sleep on your side or on your stomach to help the airways stay open and reduce snoring in cases of mild sleep apnea. Research shows that lying on the back, known as the supine position, has been linked to higher severity of sleep apnea symptoms. Furthermore, a 2017 study found that about one in five obese patients who lost weight, sleeping in a non-supine position helped to significantly reduce their OSA symptoms.
Staying active can have multiple benefits for those with sleep apnea. Not only can it help strengthen your heart, but it can also help you manage your weight, which can in turn help reduce OSA symptoms. Also, a 2016 study shows that exercise can reduce OSA severity, daytime sleepiness, and can help increase your body’s ability to use oxygen during activity, regardless of weight loss. Therefore, try to engage in moderate activity such as walking, cycling, jogging, or other aerobic exercises at least 30 minutes total a day for most days of the week to help improve your sleep apnea symptoms.
Yoga is not only good for relaxing your body but may also help improve sleep apnea symptoms. A 2017 article in the Journal of Clinical Sleep Medicine compares the breathing exercises in yoga with the positive airway pressure therapy (PAP) for sleep apnea. Both methods help to regulate breathing, improve metabolism, and lower heart health risk. This report warrants further study on the effects of Pranayama yoga versus PAP therapy on sleep apnea symptoms. In the meantime, yoga may help increase lung capacity, enhance respiratory muscle function, and help airways stay open better, in turn improving sleep apnea symptoms.
Use a humidifier
When you first start using a CPAP machine for sleep apnea treatment, you may notice symptoms such as dry mouth, runny nose, congestion, or burning of the nasal passages. Therefore, it is so important to make sure your humidifier settings are where they need to be for your optimal sleep quality. It may take some experimentation to find the settings that work best for you, or perhaps ask your sleep doctor or sleep center team for advice. Another option is to ask about a heated humidifier for your CPAP machine. A 2016 study found that CPAP compliance and quality of life factors improved when patients with OSA used a heated humidification system.
Research shows that aromatherapy with essential oils such as lavender oil may help improve sleep quality. In turn, this may help those with sleep apnea improve their symptoms. This study looked at college students, but similar results were found in a study of nursing home residents of older age as well. Therefore, it may be beneficial to get a diffuser for essential oils set up by your bedside and purchase essential oils that are 100% pure to include as part of your bedtime routine.
Allergies on their own can make it hard to breath due to runny nose, sneezing, and congestion. However, this can be even worse for those with sleep apnea as well. Although research shows that conditions such as allergic rhinitis does not necessarily worsen OSA symptoms, it can significantly disturb sleep. In turn, disturbed sleep can impact overall quality of sleep and daytime sleepiness symptoms in those with OSA. Therefore, seek treatment for your allergies from your healthcare provider to help improve your quality of sleep with sleep apnea.
Yohimbe is an evergreen tree native to Western Africa, of which the bark contains an active ingredient known as yohimbine. Yohimbine has been used for improving athletic performance and fat loss, but it may also be helpful in improving sleep apnea symptoms. Research shows that yohimbine is safe when prescribed at a clinically recommended dose and can help benefit hypoglossal motor neuron activity. It is this activity that assists with motor function of the tongue and helps protect the upper airway from collapse in those with OSA. Therefore, it may be beneficial to ask your healthcare provider to prescribe yohimbine for you to help with OSA symptoms.
Nasal dilators are most well-known as breathing strips that are a convenient, over-the-counter treatment often used to help reduce snoring. However, nasal dilators also come in an internal form. It is these internal nasal dilators that research shows can help provide a mild improvement in sleep apnea symptoms. These dilators work to reduce symptoms of sleep apnea by improving air flow through the nostrils. In turn, nasal dilators can help improve breathing and reduce snoring in those with sleep apnea.
Orofacial myofunctional therapy (OMT) is a type of treatment that involves exercises of the face. These exercises activate muscles of the face to help coordinate the tongue and facial muscles. Exercises must be done consistently every day, and treatment usually lasts between 6 and 12 months. A properly trained myofunctional therapist will provide such exercises and will supervise treatment. Research shows that myofunctional therapy can significantly improve the apnea-hypopnea index, which measures severity of OSA, by around 50-percent in adults and 62-percent in children. Also, a 2018 study found that OMT is successful in reducing severity of OSA symptoms and improving quality of life.
Oral pressure therapy
Oral pressure therapy (OPT) is a system of treatment that involves a console that is connected to flexible tubing and a mouthpiece. The console is by the bedside and uses negative pressure in the mouth to help bring the soft palate and tongue forward to create an opening in the airway. This helps to improve breathing in those with OSA. Research shows that oral pressure therapy can improve sleep apnea symptoms in certain patients. The most successful OPT treatment is seen in those with retro-palatal collapse. This occurs when the space behind the palate bone collapses. This collapse causes a blockage of the airway and obstructs breathing. A polysomnogram test (PSG) can determine if this treatment will work best for you.
Hypoglossal nerve stimulation
Hypoglossal nerve stimulation is a treatment for sleep apnea that involves a pacemaker-sized device being implanted near the collarbone. A wire extends out from the device and connects to the hypoglossal nerve under the chin. This device basically stimulates the hypoglossal nerve, which helps keeps airways open to improve breathing in OSA patients without waking them up. Research shows that hypoglossal nerve stimulation can provide a significant improvement in OSA symptoms in a subset of patients. This subset includes patients that have a body mass index less than 32, and the success of hypoglossal nerve stimulation will depend on what is causing the blockage of their airways.
Take home message
There are so many ways to help your sleep apnea symptoms. Not all these alternative treatments will work for you. However, together with the advice of your healthcare provider and sleep center team, you can find treatment options that will help control and improve your sleep apnea symptoms. It is important to follow the advice of your healthcare provider and use these alternative treatments as part of a comprehensive and holistic treatment plan for your sleep apnea.