Background:
Sleep apnea is one of the most common sleep disturbance problems in America. It ruins the sleep of an estimated 25 million Americans on a regular basis. The condition prevents the sleeper from entering REM and Delta sleep causing them to become anxious, cantankerous and tired during the day. There are very serious health consequences of prolonged sleep deprivation. Additionally, due to the nature of the condition, it causes blood oxygen levels to be lower than normal for very prolonged periods of time. This is damaging to the brain and heart in particular.
Presently, there are several ways in which the problem is addressed. Initially, the patient is told to loose weight, drink less alcohol and quit smoking. With just a smidgen of insight into human nature, anyone can figure out how unsuccessful this approach will be. Beyond that, surgery is offered to reduce obstruction in the inhalation pathway. This has provided some success, but the procedure is painful and often provides no relief. The last option is for the patient to purchase a CPAP device. This is a forced air mask, worn during sleep, that insures proper inhalation. Most patients are not willing to go to this expense or to endure this level of machinery and the resultant nasal irritation.
What has continued to plague the appropriate treatment of this condition is that none of the "solutions" address the actual cause of the problem. Being over-weight does not cause this problem, smoking does not cause this problem, sleeping on ones back does not cause this problem. So what then, does cause the problem?
Cause of the condition:
Our bodies have numerous types and styles of control systems. Some systems regulate and maintain physiological conditions. For example: your core body temperature is maintained within a degree or so (when you are healthy) with a control system that is always operating. The metabolism is regulated to smoothly and continuously provide just enough heat from digestion of food and stored fat to maintain the desired temperature. When the temperature gets too high, you begin proportionately releasing sweat in order to cool the body. When the temperature gets too low, you burn more stored fat to release heat energy. This is an illustration of a proportional control system. That is to say, one that makes continuous corrective actions that are "in proportion" to the error that the system is experiencing. Your respiration is such a system. As the blood oxygen level starts to drop, your respirations become deeper and more regular while your heart pumps faster.
There is another type of system which controls your physiology and needs to be discussed. It is a "bi-valent" system. This is a system that has two states: either active or in-active. Let's consider as a good example for this the gag reflex. When a foreign object advances down your throat, your body will convulsively expel it by a rapid contraction of esophagus and stomach. This is not a response that is proportional to the amount of penetration of the foreign object nor is it proportional to the size of the object. It is an "all or nothing" response. Bi-valent; either vomiting or not.
There are many control systems active in your body and many protective systems as well. The two that we need to discuss are directly relevant to the respiration system; one is proportional and the other is bi-valent. As mentioned previously, there is a control system that is responsible for maintaining the blood oxygenation level. This is a proportional control system and it relies on several devices. It must be able to control the diaphragmatic muscles in order to regulate the depth of respiration. This is where the trouble comes in.
When we start to fall asleep, we move from stage one (drowsiness) into stage two sleep. Stage two sleep is the transition stage before entering REM (rapid eye movement) sleep. REM sleep is where we dream. Dreaming is critical to a good nights sleep. When we enter stage two sleep in preparation for dreaming, muscular activity is inhibited. It is called "reduction of muscle tonus". This is a function that occurs primarily to keep the dreamer from physically acting out the movements of their dreams since the part of the brain that controls muscular movement cannot tell the difference between you dreaming of walking down stairs and you actually walking down stairs. This muscular inhibition is absolutely necessary. It is accomplished by suppressing the movement of signals from the brain along the spinal cord. Unfortunately, as we age, a couple of problems develop.
The first problem is that the muscles of the soft palate in your mouth become weaker. This allows the soft palate to sag. This is not particularly unusual since most people are not professional vocalists and don't exercise their soft palate. As we age and levels of HGH drop, many muscles in our body atrophy to a lower level of capability.
The second problem is that the communication between the diaphragm and the brain becomes somewhat obstructed. The nerves that reach the diaphragm emanate from the spinal column at C3, C4 and C5. These are cervical vertebrate that are right at the insertion of the upper trapezius muscles. The upper trapezius muscles are the most common expression of stress and tension in humans. This tension reduces the intervertebral foramen from which the nerves emanate and restricts the nervous flow along the root of the nerve through direct restriction. Unfortunately, a large amount of this tension is residual and does not dissipate when the subject enters stage two sleep.
The result of this is that upon entering stage two sleep, the muscle tonus holding the soft palate out of the air-way is reduced. This allows the soft palate to sag into the airway. While this is happening, the same inhibition of muscle tonus is attenuating (reducing) the signals to the diaphragm on an already obstructed communication channel. The result is that our breathing becomes shallower and shallower due to insufficient signal strength to the diaphragmatic muscles.
As our breathing becomes shallower, the blood oxygen level drops. In a young and healthy individual, this would illicit stronger and deeper breathing from the control system that regulates these activities. In an older individual with restricted nervous flow to the diaphragmatic muscles, there is no residual ability to increase for the purpose of offsetting the inhibition caused by stage two sleep entry and restricted nervous flow due to muscular tension in the neck region. Consequently, the respirations reduce in intensity and the blood oxygenation drops.
The blood oxygen level drops and the normal proportional control loop is un-able to maintain the desired level. This is where the safety back-up system comes in. When the blood oxygen level gets low enough to cause the individual to suffer physiological damage, a bi-valent system intervenes and causes the body to make a large and immediate inhalation. This causes a large pressure differential in the pharynx and literally sucks the sagging-soft palate into the airway. This obstructs the flow and causes a loud "SNORT" awakening the subject.
Upon awakening, the inhibition causing the reduction of muscle tonus for entry into stage two sleep is released and respiration begins again in a somewhat normal manner. As the subject starts to drift off to sleep again, they move into stage two, the muscle tonus drops, the soft palate sags, the signal to the diaphragm diminish and the cycle repeats. The resulting snorting awakenings typically occur every minute or so.
The Solution:
So you see, the problem is not the sagging soft palate. The problem is not the rapid inhalation that sucks your soft palate into the airway. The problem is the reduced ability of your brain to produce sufficient breath amplitude from your diaphragm. If your breathing was sufficiently deep enough, then you would not make a rapid inhalation, suck your soft palate into the airway and snort yourself awake.
The appropriate solution is not to cut flesh from your pharynxor to use heavy equipment to force air into your lungs. The appropriate intervention is to accentuate the ability of the brain to communicate with the diaphragm so that it can maintain the proper blood oxygen level and keep the safety bi-valent system from causing a rapid inhalation.
Now that we have accurately characterized the problem, the solution becomes obvious. Sure it is beneficial to strengthen the muscles of the soft palate. Yes it is advantageous to reduce muscular tension in the neck. Both of these things will make a noticeable improvement in the condition. However; the most dramatic impact can be made by the administration of just a few common herbs.
Lobellia is used in small doses as a respiratory stimulant. In larger doses, it has the opposite effect. This herb, when taken before bed, can actually increase the quiescent level of respiration sufficiently so as to avert the dangerous drop in blood oxygen level that occurs upon muscular inhibition. Since it can have some un-settling effect on the stomach, it should be used in conjunction with Meadowsweet to eliminate nauseous feeling. After all, Lobellia was called "Puke weed" by the Native Americans.
Thyme has traditionally been used to enhance pleural activity and makes an excellent contribution to maintaining sufficient respiratory amplitude. To round out the combination, Chamomile aids the subject in relaxing and cramp bark helps the upper trapezius muscles to relax.
This bouquet of herbs relaxes muscles that restrict nervous flow, increases drowsiness, enhances respiration and protects the stomach lining. It represents a wholistic natural solution to sleep apnea. It is non-habit forming and no-preconditioning is required. The first night of an apnea episode will be mitigated within 30 minutes of ingesting a capsule.
