Functional Medicine Approach to Sleep Apnea
After helping others, including family members, to diagnose and treat sleep apnea, I decided to write an article about sleep apnea. If you were diagnosed with sleep apnea, or having symptoms associated with sleep apnea, this article is for you!
In this article I am going to cover what is sleep apnea, the risk and what is the best treatment according to the Functional Medicine Approach.
What is sleep apnea?
Sleep apnea is a sleep disorder, in which breathing stops and restarts during sleep. It can be life-threatening if left undiagnosed and untreated. Within the United States, up to 18 million people have been diagnosed with sleep apnea; however, it is estimated that up to 4% of Americans have an undiagnosed case of sleep apnea.
Sleep apnea symptoms include: Loud snoring, Insomnia, Fatigue and excessive daytime sleepiness, Irritability, depression, anxiety, Memory loss and trouble concentrating, repeat wakings during the night, Sexual dysfunction, Waking with a headache and dry mouth.
OSA occurs when the muscles in the back of the throat, which support the soft palate, uvula, tonsils, throat, and tongue, relax. When these muscles relax, the airway narrows during inhalation, impairing normal breathing. The brain senses lower oxygen levels in the blood, which causes the patient to awaken. .
How Does it Affect Your Life?
Untreated OSA has been linked to an increased risk of death from cardiovascular complications (i.e., abnormal heart rate, high blood pressure, heart attack, stroke, heart disease, type 2 diabetes, pulmonary hypertension), life-threatening postoperative complications, and liver disease. Additionally, daytime sleepiness and lack of concentration make potentially fatal car crashes more likely.
Daytime fatigue is a common symptom of sleep apnea. The interrupted breathing episodes during sleep can cause a person to partially wake up, although they may not be fully aware of it. This disrupts the natural sleep pattern and prevents the individual from getting enough restful sleep. As a result, they may experience excessive sleepiness and fatigue during the day.
In addition, sleep apnea can cause a variety of other health symptomes, such as gut issues, mitochondria disfunction, thyroid issues, anxiety, hormones imbalance, difficulty to lose weight and more. I will elaborate more about it later on.
It is uncommon, but people with OSA can die during sleep if they cannot reinitiate breathing during an apneic episode.
How To Prevent
Maintaining a healthy weight is important to prevent sleep apnea. Excess weight and obesity, especially when fat deposits around the upper airway, can obstruct breathing.
Avoiding smoking, drugs and alcohol. Alcohol, sedatives, and narcotics are associated with an elevated risk of OSA because they can relax the muscles in the throat. Additionally, smoking can cause inflammation and fluid retention in the upper airway, contributing to airway blockages.
Treating other medical conditions, including congestive heart failure, high blood pressure, type 2 diabetes, chronic lung disease, nasal congestion, hormones imbalances and hypothyroidism. All of these conditions are associated with an increased risk of developing sleep apnea.
Functional Medicine Treatment for Sleep Apnea
The first-line treatment for sleep apnea, in both conventional and functional medicine, is continuous positive airway pressure (CPAP), which keeps the airways open. Other airway pressure devices and oral appliances are available as alternative options for those who cannot tolerate CPAP.
Maintaining healthy weight and lifestyle - weight loss can reduce fatty deposits in the neck, tongue, and abdomen, which improves airflow and lung volume. In addition, avoiding alcohol and drugs is a main part in decreasing the amount and the severity of sleep apnea symptoms.
Functional medicine labs help finding the root cause of sleep apnea and personalize treatment.
There are few lab tests that are truly important to do as part as the protocol of treating sleep apnea.
HORMONES& STRESS AND SLEEP TEST-
Hormone imbalances can potentially contribute to the development or worsening of sleep apnea. In addition, sleep apnea can affect hormone levels and creating vicus cycle.
Cortisol is a stress hormone that helps regulate various bodily functions, including metabolism, immune response, and stress response. Chronic stress and elevated cortisol levels have been associated with weight gain and abdominal obesity, which can contribute to sleep apnea. Additionally, cortisol levels may be dysregulated in individuals with sleep apnea, potentially affecting sleep quality and exacerbating the condition..
Estrogen is the primary female sex hormone, and its levels fluctuate throughout a woman's menstrual cycle, pregnancy, and menopause. Estrogen has been implicated in the development and severity of sleep apnea in women. During menopause, when estrogen levels decline, the risk of sleep apnea increases.
Decreased testosterone levels may lead to decreased muscle tone in these muscles, potentially contributing to the development or worsening of sleep apnea. In addition, sleep apnea can have an impact on testosterone levels in men. There is evidence to suggest that untreated sleep apnea can lead to a decrease in testosterone production and disrupt hormonal balance in the body.
ORGANIC ACID TEST-
While the Organic Acid Test is not specifically used to diagnose sleep apnea, it can provide valuable insights into certain aspects of health that may be relevant to sleep apnea or its management.
The Organic Acid Test can identify specific nutrient deficiencies or imbalances in the body. Nutritional factors play a role in overall health, including sleep quality and respiratory function. Addressing any deficiencies detected through the OAT may help support optimal functioning and potentially contribute to better sleep and respiratory health.
In addition, the OAT can provide information about detoxification capacity and oxidative stress markers. Sleep apnea has been associated with increased oxidative stress and impaired antioxidant defense mechanisms. By assessing these markers, the OAT may offer insights into the body's ability to handle oxidative stress and potentially guide interventions to support antioxidant systems.
The OAT can also evaluate markers related to gut health, including microbial overgrowth and markers of inflammation. Gut dysbiosis and inflammation have been linked to sleep disorders, including sleep apnea. By assessing these factors, the OAT may provide information about potential gut-related issues that could impact sleep and contribute to sleep apnea.
Taking this test is also helpful in identifying the right balance of macro nutrients. The OAT can provide insights into how effectively your body is utilizing carbohydrates, fats, protein, and can assess the efficiency of the body's energy production pathways.
Food sensitivities can exacerbate sleep apnea by contributing to nasal congestion and inflammation/narrowing of the airways. Screening of common food and following the right elimination diet, can help reducing symptoms. In addition, food sensitivities can cause gastrointestinal symptoms, such as gas pain and reflux, which can also exacerbate symptoms.
Studies have shown that individuals with untreated hypothyroidism may be more prone to developing sleep apnea. Sleep apnea itself may also have an impact on thyroid function. Sleep apnea-related intermittent hypoxia and sleep disruption can affect the hypothalamic-pituitary-thyroid axis and potentially lead to alterations in thyroid hormone levels.
VITAMIN D TEST-
Lower vitamin D status has been noted in patients with OSA compared to healthy controls. Both vitamin D deficiency and sleep apnea have been linked to inflammation. Vitamin D plays a role in modulating the immune system, and its deficiency may contribute to increased inflammation. Sleep apnea can also trigger inflammation in the body. In addition, Vitamin D deficiency may affect muscle function, and weakened muscles could potentially contribute to the collapse of the airway during sleep, leading to sleep apnea.
HEART HEALTH TEST-
Given that cardiometabolic disease increases the risk for sleep apnea and vice versa, a comprehensive cardiometabolic assessment is recommended to assess metabolic function. This test should include advanced lipid panel, fasting insulin and hemoglobin A1c (HbA1c).
Personalized Protocol for Treating Sleep Apnea
As mention, sleep apnea can be a life-threatening condition and can increase the risk for other types of health conditions.
However, there is not a all size fits all approach for treating sleep apnea. While a conventional treatment (recommended by your healthcare provider) is crucial, a personalized integrative protocol can help you manage the symptoms and prevent other types of conditions.
After taking the recommended functional diagnostic lab tests, your functional medicine practitioner will be able to recommend the best diet, exercise regimen, stress relive techniques, sleep management and supplements.
Each of the test above will give more information about the root causes for your condition, healing opportunities and the best treatment for you.