Tips to Relieve Shortness of Breath During Sleep Easily

 

What is Sleep Apnea (SA)?

 

SA is a breathing disorder that involves temporary reduction (hypopnea) or complete cessation (apnea) of breathing during sleep.

These episodes can last from a few seconds to several minutes and can occur multiple times throughout sleep.

SA is classified as either obstructive or central, depending on the underlying cause.

 

Key Features:

• Apnea: Complete absence of inspiratory airflow lasting at least 10 seconds.

• Hypopnea: Partial reduction in airflow for 10 seconds or more, accompanied by a drop in blood oxygen levels or changes in brain activity (e.g., awakening on EEG).

 

Obstructive Sleep Apnea (OSA):

• Prevalence: OSA is the most common sleep breathing disorder, affecting 9%–38% of the general population.

• Health Effects: OSA is associated with psychiatric, metabolic, and cardiovascular conditions such as depression, diabetes, hypertension, and stroke.

• Impact on Daytime Functioning:

• Causes sleep deprivation due to:

• Upper airway obstruction.

• Hypoxemia (low blood oxygen levels).

• Sleep fragmentation/arousals.

• Activation of the sympathetic nervous system.

 

Figure 1. Normal Airway vs. Sleep Apnea Airway (Dr. Tan, 2024)

 

Symptoms of OSA:

• Snoring.

• Excessive daytime sleepiness.

• Choking or gasping during sleep.

• Night sweats.

• Neurocognitive disturbances.

• Heartburn.

• Morning headaches.

• Maintenance insomnia.

• Erectile dysfunction.

• Nocturia (frequent urination at night).

 

How to Treat OSA:

 

1. Weight Loss Program/Diet Management

• A balanced diet rich in fruits, vegetables, whole grains, and high-quality protein.

• Very low-calorie diet combined with an active lifestyle.

 

2. Exercise

• Aerobic exercise and myofunctional therapy.

• Light cardiovascular training to strengthen the tongue, throat, and soft palate muscles.

 

Figure 2. Jaw Exercises (Lindfors, 2018)

 

3. Quit Smoking/Alcohol

• Stopping smoking and limiting alcohol intake to reduce the risk of airway obstruction.

 

4. Assistive Devices

• Positive Airway Pressure Devices:

• Continuous Positive Airway Pressure (CPAP).

• Bilevel Positive Airway Pressure (BiPAP).

• Mandibular Advancement Devices:

• Mandibular repositioning appliances.

 

Figure 3. CPAP Device for Sleep Apnea (Soares et al., 2008)

 

5. Breathing Exercises/Activities

• Various types of breathing exercises, such as diaphragmatic breathing.

• Playing wind instruments.

 

Additional Information:

• Women may present different symptoms than men, such as fatigue, insomnia, or depression, rather than snoring or gasping.

• It is estimated that 1 in 5 adults has mild obstructive sleep apnea (OSA), and up to 85% of cases go undiagnosed.

 

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References:

• Adekolu, O., & Zinchuk, A. (2022). Sleep Deficiency in Obstructive Sleep Apnea. Clinics in Chest Medicine, 43(2), 353–371. https://doi.org/10.1016/j.ccm.2022.02.013

• Andrade, F. M., & Pedrosa, R. P. (2016). The role of physical exercise in obstructive sleep apnea. Jornal Brasileiro de Pneumologia, 42(6), 457–464. https://doi.org/10.1590/S1806-37562016000000156

• Andrisani, G., & Andrisani, G. (2023). Sleep apnea pathophysiology. Sleep & Breathing, 27(6), 2111–2122. https://doi.org/10.1007/s11325-023-02783-7

• Courtney, R. (2020). Breathing retraining in sleep apnea: a review of approaches and potential mechanisms. Sleep & Breathing, 24(4), 1315–1325. https://doi.org/10.1007/s11325-020-02013-4

• Huang, Z. J., & Scheiffele, P. (2008). GABA and neuroligin signaling: linking synaptic activity and adhesion in inhibitory synapse development. Current Opinion in Neurobiology, 18(1), 77–83. https://doi.org/10.1016/j.conb.2008.05.008

• Javaheri, S., Barbe, F., Campos-Rodriguez, F., Dempsey, J. A., Khayat, R., Javaheri, S., Malhotra, A., Martinez-Garcia, M. A., Mehra, R., Pack, A. I., Polotsky, V. Y., Redline, S., & Somers, V. K. (2017). Sleep Apnea: Types, Mechanisms, and Clinical Cardiovascular Consequences. Journal of the American College of Cardiology, 69(7), 841–858. https://doi.org/10.1016/j.jacc.2016.11.069

• Kaleelullah, R. A., & Nagarajan, P. P. (2021). Cultivating Lifestyle Transformations in Obstructive Sleep Apnea.Cureus, 13(1), e12927. https://doi.org/10.7759/cureus.12927

• Lindfors, E. (2018). Jaw exercises in the treatment of masticatory myofascial pain: efficacy, patients’ views, and dentists’ experiences. Corpus ID: 55706096

• Peppard, P. E., Young, T., Barnet, J. H., Palta, M., Hagen, E. W., & Hla, K. M. (2013). Increased prevalence of sleep-disordered breathing in adults. American Journal of Epidemiology, 177(9), 1006–1014. https://doi.org/10.1093/aje/kws342

• Soares, S. M., Oliveira, R. A., Franca, S. A., Rezende, S. M., Dragosavac, D., Kacmarek, R. M., & Carvalho, C. R. (2008). Continuous positive airway pressure increases inspiratory capacity of COPD patients. Respirology, 13(3), 387–393. https://doi.org/10.1111/j.1440-1843.2008.01263.x

• Stansbury, R. C., & Strollo, P. J. (2015). Clinical manifestations of sleep apnea. Journal of Thoracic Disease, 7(9), E298–E310. https://doi.org/10.3978/j.issn.2072-1439.2015.09.13

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