Obstructive Sleep Apnea: Why Sucking Air Sucks

Forgive the pun in the title. I am a dad and prone to the occasional dad joke humor. Poor sleep is often caused by poor breathing, which, in turn, is often caused by poor jaw development. In 2016, the American Heart Association released a "scientific statement" on the connection between poor sleep and heart disease; you can find it here. The American Academy of Sleep Medicine states that severe sleep apnea doubles one's chance of dying from heart disease. I have spoken at length about the connection between facial development and obstructive sleep apnea before. If you are curious, click here to learn more or use the search feature on this site by typing in “apnea”. In my post today, I am going to focus on the pressure changes to the body that sleep apnea causes and their consequences.

When we are struggling to breathe during sleep, negative pressure occurs. If you have ever used a straw to drink a thick milkshake, you may have noticed that the opening at the bottom can get clogged while you are sucking, and the straw collapses. The same thing happens with your airway. However, since the body is a closed system, the negative pressure translates to it. The negative pressure affects several systems. First, the eustachian tubes regulating the pressure in the ears collapse, just like the straw, which affects the ears. If the Eustachian tube cannot open, a person may suffer hearing impairment, ear pain, a sensation of fullness in one or both ears, tinnitus, and other symptoms. 1

Second, the pressure in the esophagus, which connects the stomach to the mouth, acts similarly. The valve between the stomach and the esophagus, called a sphincter, may be challenged and open, spilling stomach acid into the esophagus. The esophagus does not normally experience stomach acid, so it has no protective mechanisms against it. The damage and discomfort from the acid insult are known as acid reflux, heartburn, or gastroesophageal reflux disease (GERD). 2

Third, the negative pressure is sensed by numerous blood pressure sensors in our body called baroreceptors. Some are in the heart, and others in blood vessels. 3 When the correct oxygen level is achieved, other chemicals like CO2 are balanced. When the negative pressures associated with obstructive sleep apnea happen, the chemical sensors in the body try to fix the problem by promoting deeper breathing and increased heart rate. The chemical sensors and baroreceptors work in tandem normally. With Sleep apnea, the baroreceptors and chemical receptors are uncoupled. The mechanism is complicated, so I will not cover it in this post. 4  The combination of lower oxygen in the blood forces the heart to pump more, and the increased demand can damage the heart. The heart muscles can grow, causing the heart to enlarge. One would think this is good, but it is not. The condition is called cardiomegaly, and it can be fatal. Yale researchers using PET scans identified the blood flow changes associated with apnea just this June. 5

The body's main mechanism to increase the heart's effort is the sympathetic nervous system. The result is a fight-or-flight reaction that we are all familiar with. The hormone involved is adrenalin, so people with apnea have increased sympathetic nervous systems and commonly feel anxious. 6

This post aimed to explain the physical mechanisms that damage the body due to pressure changes associated with obstructive sleep apnea. Hopefully, I have succeeded. I did not cover the other associated problems, such as a weakened immune system, type 2 diabetes, weight gain, adult asthma, depression, memory loss, confusion, and drowsiness. 7 Please understand that humans are supposed to be free of these conditions. Please don't buy into the hype that we are designed to break down and suffer as we age. This is a lie. We do degenerate, but it should not debilitate us. If you suffer from "normal" problems like weight gain or anxiety, it may be related to lifestyle issues like diet and sleep. Please pay attention to how you live your life because it may be the cause. For a quick guide to the key lifestyle basics, read this post.