Do you always feel tired, sleepy, and feeling irritable during the day? Do you wake up frequently at night, and your sleep is not refreshing, affecting your memory and concentration? Chances are, you may experience narrowing or obstruction of your airway during sleep, causing you to choke and arouse frequently. It is a disordered sleep condition known as obstructive sleep apnoea (OSA) [1].
OSA is a common condition. According to the Singapore Health Study 2012, 30.5% of the sampled population experienced a moderate-to-severe level of difficulties in breathing during sleep, and about 18.5% had OSA. However, 91% of the OSA patients were previously undiagnosed [2]. Hence, having OSA is very common, but most people are not aware of!
Who is more at risk of OSA? Generally, OSA affects older people, and the risk is higher in men than women, especially among snorers. Additionally, there is a higher risk of OSA in the overweight or obese population with high blood pressure, high blood sugar, and high cholesterol. Smoking and frequent alcohol consumption can also make the condition worse [3]. Not surprisingly, OSA patients are also associated with a higher incidence of cardiovascular diseases such as coronary heart disease, heart failure, stroke, and atrial fibrillation or irregular heart rate [4].
How to prevent or improve OSA naturally? The American Academy of Sleep Medicine recommends several lifestyles and behavioural approaches based on scientific evidence [5].
Lose weight with a healthy diet
The first on the list is to lose weight through diet, ideally to lower the body mass index to less than 25 kg/m2. In weight loss, diet quality plays a critical role. OSA patients were found to have a lower overall quality of diet, as shown in a study in American with a diverse population. Their diets are low in whole grains and high in red or processed meat [6]. So, losing weight with a change in the dietary patent by increasing the consumption of whole grains and reducing red or processed meat is a good start for OSA patients. Following a healthy diet plan focus on unprocessed foods, fruits and vegetables, plant-based fats and proteins, legumes, whole grains, and nuts are the recommended way to reduce the risk of chronic diseases [7], including OSA.
Exercise
Exercise is another lifestyle recommendation for OSA [5]. In fact, there are physical exercise programs for OSA patients which can help to improve the condition. These programs not only focus on weight loss but also to increase the muscle tone of the upper airway. The exercising of upper airway muscle can help to prevent the pharyngeal collapse (the part of the throat behind the mouth and nasal cavity) during sleep [8]. Exercise can also help to increase deep sleep and reduce arousal, reduce fluid retention in the neck that can worsen breathing in sleep, and decrease inflammation in the body [8]. Exercise is known to reduce the severity of sleep apnoea, even without weight loss. It also has positive effects on cardiorespiratory fitness, daytime sleepiness, and sleep efficiency [9].
Avoid alcohol
Having a few drinks before bedtime appears to promote sleep initially, however, studies have shown that such effects will diminish after a few days of continued use. Sleep disturbances increase with the regular use of alcohol before sleep [10]. Taking a large amount of alcohol near bedtime also can make one harder to get into sleep. Alcohol in blood will affect brain activity during sleep. It can reduce the amount of deep sleep and increase rapid eye movement sleep. After the blood alcohol levels decreased in the later of the night, one tends to be more awake [11]. According to a study among OSA patients, drinking even one alcoholic drink per day can increase the chance of disrupted sleep breathing by 25% in men. Hence, reduced alcohol consumption and not just avoidance near bedtime is recommended [11].
Sleeping sideways
Sleep position can affect airway openness. The area of the upper airway reduces when one is lying with face upwards (supine position) when compared to lying sideway (lateral position) [5]. A study that 13 sleep studies between 1983 to 2008 found that patients are sleeping in the supine position were consistently experiencing more severe OSA than those sleeping in the non- supine position [12]. For this reason, correction of OSA by sleep position using devices such as alarm, pillow, backpack, and others is a recommended treatment strategy for OSA [5]. Attachment of a specialised device at the neck or chest to correct the sleep posture was shown to reduce the severity of OSA by 84% when compared to sleeping in the supine position [13]. So, turn to your side in bed, it is the simplest way to reduce the risk of OSA.
Conclusion
Obstruction of breath during sleep is common, and most people are not aware of it. OSA is a chronic sleep disorder that can cause daytime sleepiness, fatigue, and irritable. It can also increase the risk of cardiovascular diseases. OSA can be managed and treated through changes in lifestyles. Weight loss with diet, exercise, avoid alcohol use, and sleeping sideway are proven ways that can reduce obstruction of breath during sleep and improve sleep quality. Try them!