Sleep Apnea (Apnoea)

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Sleep apnea (also spelled 'apnoea') means you stop breathing during your sleep. It may be for a few moments or for many seconds. If chronic, your body and brain are regularly starved of oxygen when they should be renewing themselves.

It can happen every few minutes: 5-10 times per hour, so up to 80 times per night.

After sleep you feel tired and under par when you should be fresh. 

With less energy  ( 'Qi' in Chinese medicine ) -

  • your immunity will be lower,
  • your performance suffers and
  • you may feel depressed.

© Amy Walters

This condition is a serious threat to your health.

Not only is it associated with obesity but, because your metabolism then suffers from oxygen insufficiency, you burn fat less effectively so the condition can actually lead to increased fat.

This page explains current thinking in Chinese medicine about it, but first, here are the facts about the condition.

Sleep Apnea Symptoms

Obstructive Sleep Apnea

This is the commonest kind of sleep apnea. The other type is discussed below.

  • you stop breathing during sleep, or breath so shallowly it can be detected only with instruments
  • you partially or wholly awake after each episode
  • often occurs after periods of loud snoring
  • you have episodes of gasping, choking and snorting
  • on waking you feel short of breath and need to breathe deeply for a while
  • on waking you may have a dry mouth or throat
  • on waking your nose may be blocked
  • on waking you may have chest pain
  • on waking you may have a headache
  • during the day you may feel tired and sleepy and may even have episodes of narcolepsy - falling asleep without knowing
  • during the day you may feel irritable, tired and/or depressed, however long you sleep at night
  • your performance suffers in many spheres of life
  • you may feel more tired after sleep than before it
  • because it prevents you reaching deep levels of sleep (when your brain enters the theta and delta wave patterns) your body doesn't generate so much HGH - human growth hormone - to repair itself properly
  • because it can happen during light sleep (REM - rapid eye movement sleep) it may prevent you getting enough of this too, leading to a lack of mental freshness

Who is Susceptible to Sleep Apnea?

  • Men are more susceptible than women
  • Obese people more than thin people
  • The tendency increases with age
  • People who snore are more susceptible
  • Some thin people are susceptible: apnea may increase their weight
  • People with large tonsils or narrow airways in the nose
  • Smokers, including of drugs such as marijuana
  • If you have risk factors for heart problems or stroke
  • High Blood Pressure
  • Family history of sleep apnea
  • Some racial groups including Hispanics and Afro-Americans
  • Alcohol may worsen it: it doesn't improve it
  • Medication, including sleeping pills, may worsen or cause it
  • Sleeping position: for many, sleeping on your back makes you more susceptible, but this is not the case with everyone.
  • Mouth breathers also get it
  • Nose breathers may get it if their noses become clogged. Waking, tired, to find that your nose is unaccountably clogged might suggest you have sleep apnea.
  • Taking stimulants, including caffeine, may increase susceptibility in some people

Central Sleep Apnea

This is the other kind of sleep apnea. Although the symptoms are the same - or at least, not enough research has been done to establish differences - this apnea emanates from a miscommunication between the part of the brain that controls breathing and the chest muscles that do the work.

One meditator, who said he sometimes used meditation in bed to get back to sleep if he woke, reported to me that he thought this kind of sleep apnea had occurred to him a number of times.

His explanation was that, lying supine whilst meditating, he thought he had relaxed so much that his breathing had slowed down then stopped. He found that he returned to full consciousness desperately needing to breathe deeply for a while, with great sighs. His partner, a light sleeper, had never noticed this during his normal sleep.

Causes of Sleep Apnea

In terms of Western medicine (a discussion on sleep apnea from the Chinese medical point of view is below), it happens when there is either or both of

  • a build up of fatty tissue around the throat and airways
  • a relaxation of the muscles in the area

Causes of Sleep Apnea in Chinese medicine

1. There are four main syndromes that describe or explain the condition in Chinese medicine. They are often interlinked.

Find out far more about these by clicking on the links but briefly these syndromes arise as follows.

The Spleen in Chinese medicine turns food into Blood and energy - Qi; it keeps things in place; it governs how we process things and it clears out garbage. You could say that like a concerned parent, it feeds you and makes sure you are ready to go to school.

When its function fails for some reason,

  • your energy goes down including your ability to sleep properly
  • your appetite is affected (in one of a number of ways, including desiring foods that are harmful and on the other hand, losing your appetite) - read Nutrition
  • your digestion is affected
  • things begin to lose their tone, so they prolapse or swell
  • you find it harder to process thoughts and actions
  • garbage collects inside you

As regards sleep apnea,

  • your sleep patterns alter
  • you may eat the wrong foods, or wrong foods, or eating at a time when your body isn't able to digest food properly
  • your muscles along your digestive tract lose their tone
  • food isn't digested so well
  • the garbage is 'phlegm'

Phlegm has a special place at the heart of Chinese medicine. It turns up all over the place, in different forms. If you see a practitioner of Chinese medicine or acupuncture who, after you've explained your problem, looks sort of broody, he is probably diagnosing Phlegm: it gets blamed whenever he can't quite work it out.(Mind you, it could be Damp!)

  • Putting on weight - inappropriate flesh (and fat) - is regarded as being a form of phlegm.
  • It's also that stuff you feel embarrassed about spitting out.
  • If you get nodules or fatty cysts under you skin, that's a form of Phlegm too.
  • As regards Sleep Apnea, phlegm is said to collect in the breathing passages or around them, and this is pretty close to Western Medicine's diagnosis of fatty tissues surrounding the larynx and throat.
  • It is also represents what blocks your nose.

Qi Stagnation is a big subject (I've even written a book about it) and it can have many causes, not the least of which is emotional. If Qi stagnation has developed in you over a period of time, one of your Zangfu most affected will be the Spleen.

Spleen Qi stagnation leads to an increase in the problems mentioned above under Spleen, but with tension in the muscles too and, often a sense of a lump in the throat.

That lump may or may not be tangible phlegm-catarrh, but the genius of Chinese medicine is to realise that whether or not a lump of catarrh exists, one can treat it as such. So treatments for Sleep Apnea (in Chinese herbal medicine or acupuncture) often include action to clear Phlegm and soothe away Qi stagnation.

Blood Stagnation is another big subject. The idea behind it is foreign to Western medicine, although WM recognises its effects. If Blood fails to circulate properly, then your tissues cannot be repaired properly.

There are many (bad) consequences of having Blood Stagnation. The include poor circulation, and stopping Qi moving as it should. This then prevents the Qi of your Lungs flowing properly, causing sleep apnea.

Blood Stagnation seldom cures itself and may need extensive treatment to 'cure'.

2. The acupuncture channels that pass through the throat, pharynx, nose and mouth - ie airways - are all involved in maintaining their health. These include (but I have not included them all):

  • Lung primary and divergent
  • Large Intestine primary, divergent and sinew
  • Stomach primary and luo-connecting
  • Spleen divergent
  • Heart divergent
  • Kidney primary
  • Liver primary (ascends the posterior part of the throat)
  • Governor 
  • Conception

(Words like 'primary', 'divergent' and 'sinew' are names of the main acupuncture channels and their off-shoots which are not usually shown in books of acupuncture meridians.)

Re Sleep apnea, any of these may be involved. Consequently, for example, chronic Lung problems make more likely both snoring and difficulty breathing, including sleep apnea. Even if you only had a cold/virus, and it took longer for you to recover than expected, even without antibiotics, your Lung Qi function may have decreased making you more likely to snore etc.

Long term, as you age, your Kidney energy weakens. Because in Chinese medicine your Kidney energy (please do not confuse this with your kidneys or your bladder) is the support for all your other Zangfu, as it weakens, ie as you age, problems start to happen along the channels ruled by those Zangfu.

From this point of view, the tissues round the throat and in the nose and at the back of the mouth all tend to weaken with age, increasing susceptibility to snoring, poor tone, and Liver Qi stagnation.

What Helps Sleep Apnea and Why?

What can you do to prevent or reduce Sleep Apnea?

  • Sorting out what you eat and how you digest it may make a huge difference. For healthy Spleen function, you should avoid very cold or iced food and drink, and raw food. Warm foods are generally better. But you should also chew well, and take time to eat. You should not eat large meals and then go to bed immediately: you should allow some hours after eating and before retiring. If circumstances prevent this, at least take a gentle walk before going to bed: get some fresh air for 20 minutes or so. This helps your Lungs, your Stomach, your Large and Small intestines and your Heart. If it's a gentle walk it won't prevent your Spleen Qi from functioning, and enjoying the movement and rhythm of walking may nudge your mind away from its tendency to worry, which adversely affects Spleen function. However, even foods and meals eaten earlier in the day and even the day before, such as coffee, may affect you for several days so this paragraph is only a very small reminder of a huge topic.
  • Nose straps help to keep the nasal airways open at night: this is a mechanical way to stop your nostrils narrowing during sleep. Of course, you should consider why they might be narrowing when a million years of evolution have given you genes that, at least as a baby and child, kept them open effortlessly. Probably your Lung and Large Intestine zangfu and your 'Governor Vessel' (the name of one of the Extra-Ordinary channels) are becoming less effective. Acupuncture to help them might lead to better tissue health in the area.
  • Stopping smoking also helps because your Lungs become dependent on the tobacco to function properly. Consider acupuncture to assist your Lung energy back to health.
  • Reduce or stop taking medication, including alcohol. Drugs are known to weaken your system in many ways, often suppressing or masking symptoms (which is why you take them of course). Unfortunately there is nearly always a deeper consequence - see Suppression. Take professional advice before altering any medication regime, however.
  • Keep your weight down. Weight gain is often a function of Spleen Qi deficiency, although Kidney Yang is also involved. This means the right diet and appropriate exercise together can influence your tendency to sleep apnea. If your Spleen Qi weakens, you put on weight, and Phlegm accumulates. That phlegm is not just the stuff that accumulates in your nose but the fatty tissue pressing on your throat. The latter takes longer to form and is harder to clear.
  • Get into a regular sleep habit, going to bed at the same time. This is a small thing, but can help you relax better. Read Difficulty Falling Asleep for more tips.

© ysbrandcosijn -

  • Singing and voice exercises. As mentioned above, your Lung channel passes through the throat and of course, is intimately involved with breathing. You can improve your Lung Qi by learning to sing. Voice exercises also help you to modulate and control how your breathe.
  • Another approach is to learn to play a wind instrument - by which I mean one you blow into, not a church organ.
  • Your sleeping position may matter. If you know that you only snore when on your back, consider putting a tennis ball, sewn into the back of your pyjamas, to prevent you from lying so.
  • Massage round your neck and throat and under your chin helps to ease out tensions in the area, especially those caused by Liver Qi Stagnation. This causes lax tissues to tense up - which you may be unaware of. Massage for 10 minutes before bed may ease them out. Use a gentle pinching and rolling action and proceed round the area carefully. Don't expect huge improvements from doing it just once. You have to keep going. But also look up Qi stagnation. (Hint: I've written an entire book about this - see at the bottom of this page.)
  • For some people, using a tooth mouth guard helps how their jaw behaves. A tight jaw (bruxism) and tooth-grinding all show tensions. The acupuncture channels passing through the jaw muscles include the Gallbladder, the partner of the Liver. When Liver Qi stagnates, you often get problems along the Gallbladder channel in the head, causing headaches and jaw tensions. Read more about this under Gallbladder.
  • Get a better pillow. You'd be surprised how this helps some people. Just getting your head and neck in the right position can inhibit snoring and apnea. However, it doesn't work for everyone but is still worth trying.
  • Throat and mouth exercises. These are really secondary to singing because singing helps the Lung and other Zangfu and when these are fit you won't need to do throat exercises. However, not everyone is a singer, so there are exercises to help improve the tone of the body region.
  • What about surgery for this condition? Someone, somewhere, must have benefited from this, because there are always exceptions, but in general, I do not recommend it. Please read my page on Suppression before embarking on this. If it goes wrong, how you use the muscles of your neck and jaw may be affected, much to your embarrassment.
  • The normal method advised by Western medicine, if no other solution is available, is a Continuous Positive Airway Pressure (CPAP) device. As far as I am aware, this is only available on prescription. You wear it over your face and because of the pipes etc there is limitation on movement.
  • Of course, I hope you will consider having treatment from someone versed in Chinese medicine, either a herbalist or an acupuncturist, long before resorting to CPAP. How you respond to it will depend on your health. Many years of chronic ill-health or bad health habits will be harder to improve than if you are fit and healthy. However, if your condition can be diagnosed into one or more Chinese medicine syndromes, and if those syndromes can be helped, then your sleep apnea will also benefit.

Please Remember ...

Sleep apnea is not a joke. It can lead to serious health problems. Please do try some of the suggestions above.

Insomnia Conditions other than
Sleep Apnea

Click the following links to find out more:

Click to return from Sleep Apnea to Insomnia.

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