Sleep Apnoea and Snoring
Sleep apnoea is a condition in which people stop breathing in
their sleep. Quite often the person with sleep apnoea is unaware
of it, and it is likely their partner or someone else in their household
who will advise them of the problem. Sleep apnoea is generally classified
into two types: obstructive sleep apnoea (OSA) and the less common
central sleep apnoea (CSA). Diagnosis is confirmed by having an
overnight sleep study, referred to as a polysomnograph.
Most people are familiar with snoring and the negative effects
it can have on relationships with partners and other members of
the household. Snoring often leads to the onset of sleep apnoea.
From the Buteyko perspective both sleep apnoea and snoring occur
due to incorrect breathing, specifically overbreathing or hyperventilation.
People exert most control of their breathing and breathe smaller
volumes of air when upright. The closer a person becomes to the
horizontal position the deeper the breathing volume becomes and
the more loss of carbon dioxide (CO2) there is from the lungs. The
worst way to sleep is on the back with the mouth open without the
use of a pillow. This is the situation in which the breathing volume
People with sleep apnoea and snoring will typically display one
or more of the following:
- Apnoeas of duration 10 seconds or more (they can be up to and
even over 2 minutes)
- Snoring (though not always with CSA)
- Excessive movement and restlessness
- Restless legs syndrome
- Breathing through the mouth
- Dry mouth and throat during the night and in the morning
- Thirst overnight and/or on waking
- Waking unrefreshed, often feeling as tired or even more tired
than when going to bed
- Daytime fatigue
- Poor daytime concentration
- Tendency to fall asleep in meetings, in front of the TV, and
even in the car while driving
- Breathlessness on exercise
Normal sleep occurs in several stages. The middle and latter stages
before REM (Rapid Eye Movement) sleep involve the most restful and
deep sleep. When a person is over breathing, or hyperventilating,
they are prevented from easily reaching these stages and remain
in the light sleep stages during which they are easily disturbed.
A person with sleep apnoea has the added difficulty of ‘arousal’
occurring each time an apnoea finishes with a gasping breath. This
will either wake the person or take them close to waking. The fact
that some people do not actually fully awaken after an apnoea explains
why they often do not initially accept that they have a problem
needing investigation. The observer of course knows otherwise.
The Buteyko Institute Method corrects the breathing pattern by
reducing the hyperventilation, with a resulting decrease in both
the duration and frequency of apnoeas, a decrease in snoring and
the return to normal sleep patterns. Hyperventilation decreases
the arterial and alveolar levels of carbon dioxide (CO2) to the
point where the breathing reflex is depressed. This is interpreted
as an apnoea or hypopnoea to an observer. A hypopnea is defined
as when breathing is reduced by 50% or more. During cessation of
breathing (apnoea) the CO2 slowly accumulates until it triggers
the body to take the next breath. By correcting the breathing pattern
the body no longer needs to suppress the breathing reflex as the
CO2 level is maintained within normal limits.
When apnoeas no longer occur CPAP (Continuous Positive Air Pressure)
machines are no longer required and surgery can be avoided.
Other Sleep Disturbances
Sleeping disturbances can of course take other forms: insomnia,
waking throughout the night, vivid chaotic dreams, night terrors,
nightmares, sleep talking, sleep walking, excessive waking for urination,
bed wetting and many more. The way that a person breathes pays a
part in all of these conditions and correcting breathing patterns
with Buteyko greatly reduces their occurrence. .
The different stages of sleep are very important to the body as
the production of certain hormones and other chemicals occurs during
certain stages. One of these hormones is ADH (Anti-Diuretic Hormone),
which enables the body to concentrate the urine. People who hyperventilate
during sleep will often need to void urine more frequently than
others and will experience broken sleep due to nocturnal visits
to the bathroom. Children will often be bed-wetters.
The Buteyko Institute Method of breathing retraining normalises
both daytime and night-time breathing. A return to normal sleep
patterns is observed in the vast majority of people who undertake
the Buteyko course.
Articles on Sleep Apnoea and the Buteyko Institute Breathing Method written by BIBH member Mary Birch have been published in the ANJ (Australian Nursing Journal) in August 2004 and October 2012. Please email firstname.lastname@example.org for further information.
BIBH Sleep Apnoea Survey
Mary Birch of the BIBH developed a survey questionnaire on Obstructive Sleep Apnoea which was sent to all BIBH Practitioners in 2010. The results were compiled and a 20 page report was produced incorporating the survey findings together with the history, theory and science of the Buteyko Institute Method and published on the BIBH website in May 2012.
Please see anj_clinic_update