Obstructive sleep apnea affects a patient’s quality of life. The snoring, daytime tiredness, and increased risk of other medical disorders lead many patients to doctors for prescriptions, medical devices, and even surgery. Chiropractic care may offer a non-medical alternative, or complement, for some patients who suffer from obstructive sleep apnea. Obstructive sleep apnea (OSA) is a serious disorder is characterized by a patient who repeatedly stops breathing throughout the night. There can even be “hypopnea” or “low breathing” episodes as well. A patient is diagnosed after participating in a “sleep study” (an overnight sleeping test called a polysomnogram) or with a home test of oxygen saturation in the blood called “pulse oximetry”. A person may not realize they have OSA, because they breathe normally throughout the day. They may even have become used to their own daytime tiredness and fatigue, memory loss, moodiness, and decreased attentiveness. Patients are often referred to a doctor by someone else who witnesses the snoring or breathing difficulties at night. The people most at risk for sleep apnea are men and the elderly, though anyone at any age can have OSA. OSA is caused by “low muscle tone and soft tissue around the airway”, often in overweight people or people with other structural abnormalities (i.e., enlarged tonsils). Age, obesity, and smoking increase the risks of developing OSA.1
Complications of Apnea
Without treatment, people with OSA are at high risk for other serious complications. These can include cardiovascular problems: high blood pressure, stroke, atrial fibrillation, and congestive heart failure. Stress on the cardiovascular system is caused by the blood oxygen levels dropping so suddenly. Other complications include daytime fatigue and other mood and attention problems, headaches, memory loss, and sleep-deprived partners, as noted before. OSA can also cause issues with taking medications and having future surgery, because of the patient’s difficulties with breathing.2
Traditional Treatments of Apnea
Some of the first methods for addressing sleep apnea include having a patient avoid sleeping pills and alcohol, positional changes (such as sleeping on the side rather than the back), quitting smoking, and losing weight. Typically, medical doctors may prescribe dental devices to keep the airway open, or even the use of a Continuous Positive Airway Pressure (CPAP) machine, which is a mask that forces air into the patient through the nose or nose and mouth. This keeps the airways open all of the time. It is the most effective medical treatment known, and it requires consistent, nightly use. Some doctors will perform nasal surgery, Uvulopalatopharyngoplasty (UPPP) to removes soft tissue in the throat and palate, or Mandibular Maxillar Advancement Surgery to correct facial and throat abnormalities.3
Chiropractors may advocate the conservative approaches to treating apnea, such as dietary and sleep position changes. Some chiropractors feel that, in addition to obesity, OSA could also be caused by neck trauma or neck curvature. They may recommend neck stretching, exercises, massage, or even acupuncture (to open the airways), in addition to other regular chiropractic adjustments. It is recommended that patients comply with the recommended lifestyle changes at home because they are meant to maintain the work and important changes and adjustments the chiropractor does at the office.4 There is a chiropractic theory that “Tightness in the TMJ or Temporomandibular Joint can further compound the issue by causing pharyngeal spasming.” Therefore, some chiropractic treatments can “retrain the neck muscles and improve the neck and cervical spine posture”.5 Chiropractic treatment could also help relieve additional sleep disorders among a variety of other physical and mental disorders and conditions that the patient could have.
Mild cases of obstructive sleep apnea might be reduced with the patient’s participation in yoga. Milder cases are defined by the patient having specifically five or less episodes of apnea during their average sleep cycle. Breathing exercises can be performed to increase oxygen intake, improve metabolism, tone abdominal muscles, strengthen the immune system, and maintain lung tissue elasticity. One breathing exercise is done while sitting cross-legged on the floor. The stomach should be pushed in with each, quick and deep breath out of the nose. Another uses slower, forceful breaths, alternating blocking nostrils so that the patient breaths in and out of one nostril at a time. The goal is to gain control over breathing and strength in the lungs. Additionally, if being overweight is the cause of the sleep apnea, yoga is a great way for the patient to lose weight. There are variations of most poses and exercises that are made easier for beginners, and those patients can slowly increase difficulty as they gain ability. Yoga can be performed in a class for a social aspect or at home with instructional videos. There are many options for both classes and online courses for patients to choose from.6
Learn about other sleep disorders.