Can You Treat Sleep Apnea Naturally?
“Can I treat my sleep apnea naturally, myself?” I get asked that question by patients from time to time. If you have obstructive sleep apnea, you may have been told that CPAP is your only choice. While CPAP and other medical treatments are highly successful for many people, making changes to your lifestyle can also make a big difference.
Natural ways to treat sleep apnea are not always enough by themselves, especially if your case is moderate or severe. However, they can be very helpful on their own for mild sleep apnea or as important additions to other treatments.
Let’s go over the lifestyle changes that can really help.
Weight Loss: The Single Most Impactful Change
Obesity is the biggest factor that leads to obstructive sleep apnea. About two out of three people with sleep apnea are overweight or obese.
Research has shown that overweight or obese patients who lose weight can reduce the severity of their sleep apnea. People who lose 10% of their body weight reduce their apnea-hypopnea index (AHI) on average by 32%. If you weigh 200 pounds and you lose 20 pounds, it is likely that you will significantly improve your obstructive sleep apnea. Further weight loss will lower the AHI even more.
Understanding the Connection Between Weight and Sleep Apnea
Carrying extra weight, especially around your neck and throat, puts pressure on your airway while you sleep. This can make the airway narrower or cause it to collapse during sleep. Additionally, as your weight increases, more fat is found in the tongue and walls of the throat. The tongue actually gets larger, the palate gets thicker and the sides of the throat close inward. This narrows the airway and makes obstruction more likely. People who gain 10% of their body weight will see about 30% more apneas during sleep and greatly increase their risk of developing moderate to severe obstructive sleep apnea.
Weight loss should be discussed as part of the treatment plan for anyone who is overweight or obese.
A Multidisciplinary Approach to Weight Loss
Losing weight is a tremendous challenge for most people and especially for people with sleep apnea. Successful weight loss requires changes in behavior and nutrition that must be maintained for continued success.
Cognitive behavioral therapy can help you understand how stress, emotions, and habits can affect your eating. A registered dietician can teach you how to monitor and record what you eat, make healthier choices, and set daily calorie goals. These strategies alone can result in a 10% weight loss which can reduce your AHI by 32%.
However, more than 10% weight loss is very difficult to achieve with natural interventions. This is especially true in people with sleep apnea. Disrupted sleep and low oxygen levels cause higher levels of hormones that make you feel hungrier. Because you feel hungry, you eat more and gain more weight. Additionally, poor sleep affects parts of the brain that control impulses and this can lead to binge eating. These factors make weight loss extremely difficult without medical or surgical therapies.
I’m passionate about fitness, and I exercise almost every day. Regular physical activity has many health benefits. However, exercise alone almost never leads to weight loss, because people usually eat more to make up for the calories burned during exercise. However, regular exercise does help people keep the weight off. Strength training as you lose weight will help you maintain strength and prevent muscle loss.
Exercise improves sleep apnea and lowers risk
Regular exercise that increases your heart rate and makes you sweat can reduce the severity of obstructive sleep apnea even without weight loss. Additionally, moderate exercising three hours a week has been shown to improve blood pressure, blood vessel function, inflammation, memory, and heart function, all of which are worsened by sleep apnea.
Recent studies show that exercise lowers your risk of death more than weight loss alone. Someone who exercises regularly but is still overweight gets more health benefits than someone who loses weight but does not exercise.
In short, exercise by itself will not help you lose weight, but it is very important for your overall health. Being fit, even if you are overweight, can greatly improve your health.
Other Natural Approaches to Managing Sleep Apnea
Sleep Position
Research has shown that elevating the head of the bed can reduce the apnea-hypopnea index by as much as 31%. A wedge or adjustable bed can be used to raise the head 7.5% to 30%. This may help to keep the upper airway open during sleep and reduce the pressure needed to reopen the airway.
Some people with obstructive sleep apnea have most of their apneas when they are sleeping on their back. Sleep apnea is usually worse when lying on your back, because gravity pulls your tongue and soft tissues backward. For people with mild sleep who are not obese, sleeping on their side can reduce the number of apneas. You can use a special pillow, an electronic device that vibrates when you lie on your back, or sew a tennis ball to the back of your pajamas to help you stay on your side.
Avoiding Alcohol and Sedatives
Alcohol and sedative medicines relax the muscles in your throat, which makes it more likely for your airway to collapse during sleep. If you have obstructive sleep apnea, try to limit alcohol, especially in the hours before bedtime, to help reduce your symptoms.
Orofacial myofunctional therapy
Special exercises can optimize tongue position in the mouth and increase the tone of upper airway muscles. Studies have shown that these exercises can reduce AHI, sleepiness, and how much oxygen drops during apneas. These exercises are taught by Certified Orofacial Myofunctional Therapist (COMT®). There are also smart phone apps that can demonstrate the exercises, which must be done regularly.
Nasal Breathing
Ideally, you should be breathing through your nose when you sleep. If you are able to breathe through your nose during the day but find that you generally sleep with your mouth open, using mouth tape at night to encourage nasal breathing may reduce apneas. In patients who have mild obstructive sleep apnea, using mouth tape during sleep has been shown to reduce AHI, sleepiness, and snoring scores. However, some people with sleep apnea may need to breathe through their mouth to compensate for their airway collapse, and mouth tape will worsen their AHI and sleepiness.
Consistent Sleep Schedule
The circadian rhythm sets your body’s wake and sleep cycle. It is disrupted in people with sleep apnea. Going to bed and waking up at the same time each day helps minimize this disruption and improves sleep overall. Getting bright light in your eyes for 20-30 minutes within an hour of waking up and limiting light and screen exposure in the evening can improve circadian function.
When Natural Approaches Aren’t Enough
I want to be clear: Lifestyle changes can help a lot, but they are not always enough, especially if you have moderate or severe obstructive sleep apnea.
If sleep apnea is not treated, it raises your risk for high blood pressure, heart disease, stroke, memory problems, dementia, and other serious issues. If your sleep apnea is moderate or severe, you need medical treatment, such as CPAP, an oral device, or surgery.
Natural methods should be used along with medical treatment, not instead of it. Even if you are working hard on weight loss and lifestyle changes, keep using your prescribed therapy. After you have lost weight or made other changes, we can see if you still need the same treatment.
Patient Selection: Finding the Right Treatment
Every person is different. The best treatment for you depends on how severe your sleep apnea is as well as your overall health, airway anatomy, lifestyle, and prior treatments.
When patients visit my office, I don’t push them toward one treatment. I consider all the factors that could be impacting their sleep apnea, and we make a plan together.
If you have been told that CPAP is your only option or your current treatment is not working, it might be time to get a second opinion from a doctor who knows that sleep apnea treatment is not the same for everyone.
Take the Next Step
If you have sleep apnea, you don’t have to figure out your options by yourself. Whether you want to try lifestyle changes, need help with CPAP alternatives, or want to learn about surgery, I’m here to help.
Your health, energy, and focus all depend on getting good sleep. Treating sleep apnea, whether with natural methods, medical devices, surgery, or a mix of these, is one of the best things you can do for your long-term health and well-being.
Schedule a consultation today to discuss your treatment options.
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