Sleep apnea is one of the most common sleep disturbance problems in America.
It ruins the sleep of 25 million Americans, with likely millions more who are undiagnosed sufferers. The condition prevents the sleeper from entering REM and delta sleep, causing them to become anxious, irritable, and tired during the day. There are also serious health consequences of prolonged sleep disturbance and deprivation.
When diagnosed, the patient is told to lose weight, drink less alcohol, and quit smoking. Beyond that, surgery is a possibility, though it is painful and has limited success. Dental mouthpieces can be difficult to sleep with and their long-term effects on tooth alignment are questionable.
Another common option is to use a continuous positive airway pressure (CPAP) device. This forced-air mask, worn during sleep, does insure proper inhalation. Experience has shown though, that 60 percent of patients are not able to tolerate the mask and ultimately discontinue using it. And some users develop respiratory infections from the mask.
A novel approach
There is, however, a different approach that is less physically intrusive than surgery or a dental appliance, and far more comfortable than CPAP. Those devices and techniques address the symptoms of the problem, but leave the cause unaddressed. The cause, addressed succinctly, can be mitigated to a point where sleep is not disturbed.
The cause of the condition
To better evaluate the solutions, consider what causes sleep apnea. When people begin to fall asleep, they move from stage 1 (drowsiness) into stage 2 sleep. Stage 2 is the transition state before entering REM (rapid eye movement). REM sleep is where a person dreams.
When entering stage 2 sleep in preparation for dreaming, muscular activity is inhibited (blocked). This is called “reduction of muscle tonus.” This function occurs normally and appropriately to keep the dreamer from physically acting out the movements of their dreams.
The first problem is that the inhibition of signals from the brain to the skeletal muscles tends to inadvertently reduce the signal that tells the diaphragm to breathe. In patients with sleep apnea, upon entering stage 2 sleep, their breathing will actually come to a stop (apnea means “cessation of breathing”).
The muscles of the soft palate in the mouth also become weaker. This allows the soft palate to sag. While this is happening, the same inhibition of muscle tonus is attenuating the signals to the diaphragm. The result is that breathing becomes shallower, due to insufficient signal strength to the diaphragm muscles.
When breathing ceases, blood oxygens level drop and carbon dioxide levels rise. In a young and healthy individual, this would elicit stronger and deeper breathing from the control system that regulates these activities. In an older individual, the respiration reduction causes a significant imbalance in blood gases. This is where the safety back-up system comes in.
When blood gas levels get too far imbalanced, the brain 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 air flow and causes an explosive “snort” that partially or fully awakens the subject.
Most times, however, the subject is not fully awakened and thus isn’t aware that this is even happening. But it still disturbs their sleep enough so that they return to stage 1 sleep.
Upon awakening or returning to stage 1 sleep, the inhibition causing the reduction of muscle tonus for entry into stage 2 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 2, the muscle tonus drops, the soft palate sags, signals to the diaphragm diminish, and the cycle repeats anew. The resulting snorting awakenings typically occur every one to five minutes.
Searching for a solution
If breathing is sufficiently deep, then a rapid inhalation would not be demanded by the brain and the soft palate would not be sucked into the airway. There would then be no resulting snort that arouses the sleeper. The appropriate solution is to accentuate (increase) the ability of the brain to communicate with the diaphragm so that steady breathing is maintained throughout the night.
It is beneficial to strengthen the muscles of the soft palate, and it is advantageous to reduce muscular tension in the neck as the nerves from C3, C4, and C5 travel through this area and ultimately become the phrenic nerve that services the diaphragm.
Both of these things will make a noticeable improvement in the condition. But the most dramatic impact can be made by the administration of a few common herbs.
Because the root cause of this cascade of events is caused by a diminution of the signal from the brain to the diaphragm, you can turn to lobelia. Used in small doses, lobelia acts as a respiratory stimulant and has been used for thousands of years to treat respiratory conditions.
This herb, when taken before bed, can actually increase the quiescent level of respiration sufficiently to avert the dangerous drop in blood oxygen levels that occurs upon muscular inhibition. Lobelia can maintain deep steady breathing throughout the stage 2 sleep transition period. This keeps the brain from calling for a rapid inhalation that would suck in the soft- palate and arouse the sleeper.
Thyme has also traditionally been used to enhance pleural activity. It actually improves the ability of the lungs to exchange CO2 for oxygen and contributes 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. One may need to relax the upper trapezius muscles as they tend to tighten up during the day in response to stress.
The nerves that emanate from C3, C4, and C5 transition through this muscular region in the brachial plexus to form the phrenic nerve, which services the diaphragm.
This combination of herbs taken before bed has been demonstrated to relieve sleep apnea in most cases.
When a sleep apnea sufferer who has not been treated tries this combination, relief is often felt on the first night. There is no preconditioning required for the herbs to increase the respiratory level, relax the skeletal muscles, and improve gas exchange efficiency.
What happens next is that the body realizes it can now access REM sleep. The deprivation of REM caused by the preexisting apnea condition has built up a deficiency and the subject will experience REM rebound. This “over- dreaming” can actually cause the subject to feel less rested than normal.
The body will reestablish a normal sleep pattern within a couple of weeks and the overall results will be far superior restfulness. This REM rebound is not seen in patients who transition from CPAP to the herbal solution as they have not been REM deprived.
Steven R. Frank is an herbalist from the Front Range of Colorado, with many years of experience in treating musculoskeletal injuries with indigenous plants and herbs. He has studied the actions of these natural remedies in the clinic and the laboratory so that he can bring you the best that science and ancient wisdom have to offer. He can be reached with questions at firstname.lastname@example.org and his blog can be found at mynaturesrite.com.