By Qineng Tan, L.Ac., Ph.D. & Xiaomei Cai, L.Ac., Ph.D.
Have you been told you’re snoring loudly? Do you feel tired even after 8 hours of sleep? Waking up with a dry mouth, feeling tired all the time, and having trouble staying asleep at night are all signs that you might have sleep apnea. Sleep apnea is a sleeping disorder in which normal breathing is interrupted repeatedly. Acupuncture and TCM offer a natural way to treat obstructive sleep apnea, insomnia, fatigue, and other sleep-related problems.
Sleep Apnea (also known as sleep apnoea) is when a person does not breathe normally during sleep. When there is a pause in normal breathing during the night, the body is not getting enough oxygen, and the brain sends an urgent message to start breathing again. The person wakes, so briefly that they usually do not remember it, gasps for air and starts breathing again. Often people do not realize that they are snoring or making snorting or choking sounds while they sleep unless another person tells them it’s happening. Because of this, many cases of sleep apnea go undiagnosed, and people go on feeling fatigued all the time.
While people of any age or gender can experience sleep apnea, it is most common among older men. There are a few different kinds of sleep apnea; the most prevalent type is obstructive sleep apnea (OSA), in which the throat and/or airway is physically obstructed by the positioning of the neck, jaw, and soft tissues of the throat, like the tongue and uvula. OSA is associated with being overweight or obese, because extra weight can affect the musculature of the upper respiratory system. Women who have already gone through menopause are more likely to develop sleep apnea because postmenopausal weight gain is more likely to occur in the upper body than it does prior to menopause. Sleep problems and obesity are related in many ways; getting less sleep or poor quality sleep can cause people to gain weight or have trouble losing weight. People with diabetes and/or metabolic syndrome are also at higher risk for obstructive sleep apnea.
Besides disturbing sleep and causing fatigue, apnea can lead to other serious health conditions, especially cardiovascular problems like high blood pressure, irregular heartbeat, and stroke. Sleep apnea can increase the heart rate and the production of stress hormones. Men with OSA are more likely to experience erectile dysfunction (ED). Lack of quality sleep can also have a negative impact on mental health, contributing to depression, anxiety, and cognitive decline.
The typical treatment for snoring involves the use of a sleep apnea machine, called a CPAP machine (continuous positive air pressure machine), which pushes air into the nose while you sleep, ensuring that the airway stays open and continuously active. This treatment can help people breathe easier throughout the night, but some people may find the machine noisy and uncomfortable.
TCM methods like acupuncture treatment for snoring and sleep apnea offer a way to address these problems at their source holistically, helping people to sleep well and breathe more freely.
Top 3 Types of Sleep Apnea
Sleep apnea causes loss of oxygen due to shallow breathing (hypopnea) and/or interrupted breathing while sleeping. Different types of sleep apnea are classified by their physiological causes:
- Obstructive sleep apnea (OSA) – this is caused by the improper relaxation of the throat muscles while sleeping.
- Central sleep apnea (CSA) – is caused by disordered signalling from the brain to the organs that control breathing.
- Complex sleep apnea – (or treatment emergent sleep apnea) is a combination of both of the above.
Restless legs syndrome (RLS), also known as Willis-Ekbom disease, is a condition wherein a person has an uncontrollable urge to move the legs, or sometimes arms or other parts of the body, accompanied by a sensation of itching, burning, crawling or throbbing. This usually happens when the person is lying in bed, trying to fall asleep. Restless leg syndrome can coexist with OSA, compounding the problem by making it difficult to get to sleep or stay asleep during the night.
Narcolepsy is a sleeping disorder in which overwhelming sleepiness during the daytime causes people to suddenly and uncontrollably fall asleep. Many people who suffer from narcolepsy also have sleep apnea. In this case, the sleep problem is not related to breathing so much as how the brain and body are moving through sleep cycles, like REM sleep. For people who have narcolepsy, treatment with a CPAP machine is often not very helpful.
Sleep apnea or snoring does not seem to be related to other abnormal sleeping behaviors (parasomnia), such as sleepwalking, night terrors, or sleep-related eating.
Top 10 Symptoms of Sleep Apnea
Many people snore and do not realize it. It is important to pay attention to the subtler sleep apnea symptoms. Signs of sleep apnea include:
- Loud snoring
- Interrupted breathing – moments during the night when the person’s breathing actually stops and then starts again
- Gasping for air while sleeping
- Waking up with a dry mouth or sore throat
- Headaches in the morning
- Insomnia, difficulty getting to sleep or staying asleep during the night
- Feeling very sleepy during the daytime (hypersomnia)
- Difficulty paying attention
- Feeling irritable
- Getting up often during the night to urinate (nocturia)
What Causes Snoring?
Sleep apnea is caused either by a physical obstruction of the throat and airways or by problems with brain signals to the breathing apparatus. Not everyone who has sleep apnea snores loudly. On the other hand, not everyone who snores necessarily has sleep apnea. Other reasons people snore may include:
- Congestion of the nose due to a cold or allergies
- In late pregnancy, the growing belly puts upward pressure on the respiratory system
- Sleeping pills, medications that work as relaxants, like Ativan or Valium
- Alcohol consumption
- Anatomy – large tongue or uvula, or swollen tonsils
People with sleep apnea are often advised to sleep on their side rather than on their back, as this helps prevent the obstruction, but it can be difficult for people to control their behavior while sleeping.
Treatment for Sleep Apnea
To firmly establish whether a person has sleep apnea, and what type, doctors will often evaluate the situation in a sleep study session. People will spend the night in a sleep center, where their heart and breathing functions are monitored (polysomnography).
CPAP machines are generally considered to be the best care available for sleep apnea. These devices can help stop snoring, allow a person to get more restful sleep, and cut the risks of serious issues like heart disease that are associated with sleep apnea. However, the machine does not actually do anything to improve the weak musculature that causes OSA or the disordered signalling that causes CSA. It is possible to swallow air while breathing with the CPAP machine, which can lead to gas and a bloated stomach. Some people may find the face mask, which must be strapped to the face, uncomfortable. The noise of the machine may be disturbing to the person using it, as well as to the person’s bed partner. It may be difficult for some patients to get used to using the machine, and if they are not using it regularly, they are not getting the health benefits.
There are also some oral appliances available, such as mandibular advancement devices (MAD), which are worn in the mouth to alter the placement of the jaw and tongue in order to keep the airway open during sleep. These can also be effective in terms of helping people breathe better while they sleep. Compared to CPAP, they are quiet, discreet, and cost-effective. Again, the main question is whether a person will be able to tolerate the device; some people may experience dental pain, TMJ jaw pain, dry mouth, or too much saliva.
Surgery for snoring and sleep apnea is usually only recommended if other methods of treatment have failed. Different procedures involve removing soft tissues (uvula, tonsils, adenoids), or changing the shape of the jaw bones. Small rods may be inserted into the upper palate to help keep the airway open. A device that monitors breathing and stimulates movement of the tongue may be implanted in the chest.
Sometimes people may use melatonin as a natural sleep aid. Melatonin may have a positive impact in terms of helping people fall asleep more easily. It also has strong antioxidant properties, which means it may help with the control of the breathing apparatus and the amount of oxidation a person is getting while sleeping. While it is generally considered safe as a health supplement, melatonin side effects can include problems with dizziness, headaches, and nausea, and it can also be contraindicated with other medications. Melatonin can affect blood coagulation, so it may be unsafe to take if a person is also taking blood thinners, for example.
Can Acupuncture Help Stop Snoring?
According to TCM theory, the spleen and stomach are responsible for transforming nutrients from food and fluids into Qi (life energy), which is then delivered to the heart and lungs. In the TCM view, sleep apnea is often a problem related to phlegm and Qi stagnation, as are many conditions related to fatigue or insomnia. If phlegm builds up and becomes stagnant in the spleen, the lungs cannot get the Qi they need. So, one possible differentiation for sleep apnea is Spleen Deficiency with Qi Stagnation. This condition of dampness and phlegm will often cause people to feel heavy and bloated.
In some cases, too much internal heat contributes to the problem. Snoring, combined with sweating, and waking up with a sore throat, is a sign that we need to clear heat and toxicity from the body.
Sleep disturbed by nightmares is associated with the gallbladder, while difficulty falling asleep is associated with the liver. An acupuncture practitioner will listen carefully to what specific symptoms of sleep apnea each individual patient is experiencing, and tailor the treatment accordingly.
A meta-analysis of over 200 randomized trials involving the use of acupuncture to treat sleep apnea concluded that acupuncture was more effective overall than CPAP treatment, in terms of improving breathing and oxygen levels.
Can Chinese herbs help snoring and sleep apnea? Specific herbs have been shown to help reduce inflammation and improve oxygen levels in patients with sleep apnea. Chinese herbal formulations can help stop snoring and reduce daytime fatigue.
Natural Remedies for Snoring
Acupressure can help snoring and sleep apnea. Since we are trying to clear heat and phlegm from the stomach, spleen, and large intestine, use acupressure points along the Stomach Meridian, which runs down the leg. On the front of the shin, apply pressure, kneading with your thumb, starting to the side of the shin bone a few inches below the knee, then moving down about 3 inches and doing the same thing. Knead each of the four points about 30 times as your move down the leg. If you are aware that one side of the nose is more blocked than the other while you are breathing during the night, practice the acupressure on the opposite leg. For example, if your left nostril is the one that is more stuffed up, do acupressure on the right leg.
Acupuncture Near Me for Snoring
As the population ages, and unfortunately, more people suffer from obesity and metabolic syndrome, sleep apnea is a growing health concern all over the world. Snoring can have a seriously negative impact on quality of life, health, and longevity. Conventional methods of treatment for sleep apnea can be effective, but many people find CPAP uncomfortable and inconvenient for long-term use. If you suspect you may have sleep apnea, or are worried because your partner snores loudly at night and seems to be gasping for air, do not wait to get help. Acupuncture and TCM herbs can help relieve fatigue due to snoring and reduce the risk of more serious problems related to sleep apnea.
*This article is for education from the perspective of Traditional Chinese Medicine only. The education provided by this article is not approved by FDA to diagnose, prevent, treat and cure human diseases. It should not stop you from consulting with your physician for your medical conditions. Traditional Chinese Medicine is based on Qi, which is an invisible force that usually cannot be observed by modern science. Because science focuses on testing ideas about the natural world with evidence obtained through observation, these aspects of acupuncture can’t be studied by science. Therefore acupuncture and Chinese herbs are often not supported by double-blind, randomized trials, and they are considered alternative medicine therapies in the United States.