Have Sleep Apnea? These Factors May Affect Your Rest

You’ve been diagnosed with sleep apnea. Now what? You likely already know that sleep apnea is a condition when breathing patterns become abnormal while sleeping, including temporary pauses in breathing. This irregular breathing causes disruptions in our sleep cycles and can lead us to feel more lethargic and have low energy as a result. You may not know that when untreated, sleep apnea can lead to various health issues, including cardiovascular conditions, high blood pressure, and even mood disorders.

But there’s good news! By making small changes with nutrition habits, physical activity, mindfulness, and sleep hygiene/environment, you can reduce sleep apnea symptoms and get more restful sleep. Here, Logan Schneider, sleep neurologist and Clinical Lead for Sleep Health at Fitbit Research, shares some tips for managing your sleep apnea. 

How does physical activity impact sleep apnea? Are there certain times of day where it’s better to exercise?

Physical activity and sleep apnea are intimately intertwined. Getting adequate amounts of exercise can help with weight loss, which research shows can reduce the severity of obstructive sleep apnea. Yet, there are additional benefits of exercise on obstructive sleep apnea that go beyond reductions in weight, including for people who are at a healthy weight. 

Obstructive sleep apnea is caused by intermittent obstruction of the airway, and this blockage can come from multiple factors, one of which is a lack of muscle tone in the airway. When exercising regularly, you tone all the muscles in your body, including those in your airway. This helps your airway stay open at night, when your breathing is on autopilot.

As for when it’s best to exercise, the answer is, whenever it works for your schedule. If possible, scheduling exercise shortly after awakening or in the middle of the day can help strengthen your circadian rhythm to ensure an on-time bedtime and sound sleep.

What are some adjustments I can make in my sleep environment to improve my symptoms?

According to Logan, one of the factors that can make airway obstruction more likely is irritation or inflammation, which can cause congestion. People may not realize that there may be elements in their sleep environment contributing to irritation. Fortunately, here are a few steps people can take to improve their sleep environment, including using certain environmental monitors, using an air purification system, and working on allergy-proofing their home.

For some individuals who suffer from seasonal allergies, irritation can develop during certain times of the year—for example, when pollen is floating around in the air during springtime or if the air quality index is poor due to wildfires in the area. There are a number of over-the-counter remedies that can help soothe irritated airways or decrease inflammation. These range from sinus rinses to medicines. However, before attempting to use any therapies, individuals should consult with their physician to see if they’re making the right choices for them.

What are some positions that can help me sleep easier? 

Your position can certainly impact how easy it is for your airway to remain free and clear of obstructions during sleep. The most obvious culprit for airway blockage is the tongue. Just like all the other muscles in your body, as you fall more deeply asleep, your tongue becomes more relaxed, making it easier to fall back into your airway and block the flow of air. Side sleeping or even sleeping on your frontside can help the tongue to fall out of the way as it gets more relaxed. People have tried all varieties of devices to help them stay in a specific sleep position, but most of them aren’t very effective, because most people move around quite a bit during sleep, so we don’t tend to stay in one position for very long (even if we go to sleep and wake up in a certain position).

Another way to try to get the tongue out of the way is to sleep on an incline. While this isn’t the preferred position for most folks, sleeping at a slight incline, with the head of the bed elevated about 30 degrees or more, can help let the tongue rest in the jaw instead of the back of the throat. You can accomplish this with special pillows, mechanical beds, or by other methods.

Another aspect of the sleeping position that may narrow the airway is alignment of the head and neck. Particularly for back sleepers, if your pillow provides too much support, it can prop your head up in an unnatural position, forcing your neck to flex forward, which can compress the softer parts of your air passages. If you’re a back sleeper, it’s important to choose a pillow that provides adequate neck support without forcing the head out of alignment (on the back, the ideal position is called the “sniffing position”). Getting the right pillow can even help reduce disruptive snoring by keeping the airway nice and open during sleep.

How do alcohol, smoking, and/or caffeine affect my sleep apnea?

Alcohol is one of the most significant contributors to sleep apnea, because it causes the airway to become too relaxed while sleeping, and may disrupt the brain’s ability to arouse in response to airway obstruction. It’s also important to note that alcohol alone tends to cause less restful sleep due to sleep becoming more light and fragmented in the second half of the night, after the body has cleared the alcohol out.

The links between smoking and sleep apnea are less clear. Even though smoking can cause airway irritation and, with time, lung disease, many of the associations between smoking cigarettes and sleep apnea may be related to shared clinical conditions. 

Nonetheless, it’s important to note that smoking can make existing sleep apnea more severe, because of the presence of an underlying disease (such as chronic obstructive pulmonary disease, or COPD). It’s also important to note that nicotine has a physically and mentally stimulating effect that can disrupt sleep.

There isn’t a strong connection between caffeine consumption and sleep apnea. While one study demonstrated that caffeinated sodas were associated with a higher risk of OSA, the lack of association with coffee or tea consumption may suggest that the soda was the source of the association. 

That being said, because sleep apnea can disrupt sleep, making you tired during the day, many people will resort to caffeine to stay alert. Anyone who is getting adequate sleep quantity and quality should be able to remain awake throughout their day without the need for caffeine, so excessive caffeine consumption may actually be a sign that there’s something about sleep that isn’t working, which may be explained by the presence of sleep apnea.

What are some dietary changes I can make so I can better cope with my sleep apnea?

There aren’t clear and consistent associations between specific macronutrients and obstructive sleep apnea. Despite one study finding an association between dietary fat content and sleep apnea, this association was caused by body weight. Toward this end, dietary habits should follow general health guidelines (like those from the World Health Organization and Centers for Disease Control and Prevention). 

Logan’s recommendation is to choose a dietary plan that integrates with your lifestyle (rather than dieting on and off), ensuring a balance of macronutrients (protein, fats, carbohydrates) and micronutrients (like vitamins and minerals) that are consumed in an appropriate balance and in moderation such as the balanced plate approach. 

Can practicing mindfulness have any impact?

There’s little evidence to suggest that sleep apnea can be impacted by mindfulness practices. That being said, in individuals who have sleeping difficulties, including frequent awakenings that may be caused by obstructive sleep apnea, mindfulness based practices may help improve the quality of sleep. 

Additionally, among individuals who have obstructive sleep apnea and are treating it with positive airway pressure (PAP) therapy, it appears that mindfulness may play a role in usage. Finally, one of the consequences of inadequate sleep quantity or quality can be stress, so it makes sense that individuals who are able to manage that stress with mindfulness practices might experience better days.

Is there one tip that really resonated with you? Set a specific and approachable goal for yourself and give it a go! Notice patterns and track your progress with your Fitbit sleep tools, like the new Snore & Noise Detect feature.