Sleep Apnea caused by improper sleeping level in bed?!%$#

While searching the net looking for info on "sleep apnea," I came acrross a book in amazon.com, of which the author claims that sleep apneas, etc. are a result of too much blood pooling in the head from the way we lie on the bed while sleeping, and that would be flat! He claims that our heads need to be elevated a certain amount. Anyone ever heard of this before. Here is the link in amazon to the book.

http://www.amazon.com/Revealing-Surpris ... 592&sr=1-1

Your thoughts

He's full of crap, probably caused by blood pooling in his head. Sleeping with your head elevated, can help gerd and gerd can make apnea worse.

Just because people write books or tell you things, doesn't mean they know anything. Jim

Dr. Seuss makes more sense.

Tucking the chin in as we do when we bend our head down WORSENS sleep apnea!! If one is going to raise the head then one must raise the head of the bed not the head on a thicker pillow or pillows. The head, neck, shoulders and back to waist/hip level should be in as straight a line as is comfortable to alleviate and reduce apnea propensities. And even that will NOT stop them entirely. Bending the neck RESTRICTS the throat opening.

Slinky wrote:Tucking the chin in as we do when we bend our head down WORSENS sleep apnea!! If one is going to raise the head then one must raise the head of the bed not the head on a thicker pillow or pillows. The head, neck, shoulders and back to waist/hip level should be in as straight a line as is comfortable to alleviate and reduce apnea propensities. And even that will NOT stop them entirely. Bending the neck RESTRICTS the throat opening.

What I gathered from the bit I read of his book is that one needs to get a 'pillow wedge' so that you are bent at the waist, your head then being elevated.

Dgrendahl wrote:

Slinky wrote:Tucking the chin in as we do when we bend our head down WORSENS sleep apnea!! If one is going to raise the head then one must raise the head of the bed not the head on a thicker pillow or pillows. The head, neck, shoulders and back to waist/hip level should be in as straight a line as is comfortable to alleviate and reduce apnea propensities. And even that will NOT stop them entirely. Bending the neck RESTRICTS the throat opening.

What I gathered from the bit I read of his book is that one needs to get a 'pillow wedge' so that you are bent at the waist, your head then being elevated.

Elevating the head of your bed is a good idea, but doing it with a wedge is not such a great idea if you want to sleep on your side or stomach. Our anatomy simply wasn't made to bend in those directions. Probably better off just sticking some 2x4's or bricks under the legs at the head of the bed. It will help with controlling GERD.

As for pillows; the ideal position would be to hold the head in the CPR position for maximum open airway, but that is a bit uncomfortable to sleep with. A pillow shouldn't jack up your head pushing the chin into the chest and be expected to keep your airway open.

I rolled a blanket and layed it across the head of the bed between the mattress and box springs. Wasn't a sharp incline, but it helps. The wedge gave me a backache, and I couldn't stay on it. I have seen some novelty catalogs like Harriett Carter advertising the big rubber lifts for under the legs of the bed.

As far as the benefits of elevating, seems it would be particularly so if one is carrying excess upper body weight or tends toward fluid retention. Lying flat makes me feel like a sandbag is on my upper chest and neck. Surely that doesn't help my throat resist the pressure to collapse. Just the slight incline allows the pressure to move away from the neck.

Glad it was mentioned about neck position. My son-in-law wakes up with a headache regularly and he sleeps with his chin tucked real tight and his head up under the cover. Bet his air intake is compromised even if he doesn't have apnea.

Just to play devil's advocate.... People in the 18th and 19th centuries slept in a slightly sitting up position. It was considered more healthful, and allowed the "bad humors" to drain from the lungs. Very few people slept prone - and mostly they were people sleeping out on the ground.

Anyone with upper respiratory congestion will understand that.

I don't sleep that way, but I would recommend it to anyone with lung problems. I think the only reason I sleep flat is that I haven't learned how to sleep elevated. If I could learn, I would do it. Any doctor will tell you it's better for lung function.

Do not be fooled by museums that claim the beds of the time were shorter because people were shorter. They were not. Beds were shorter to FORCE people to sleep in an elevated posture on a stack of pillows.

Cheers,
B.

As stated before, tilting the head forwards using an "extra" pillow is likely to make your OSA more severe.

Influences of head positions and bite opening on collapsibility of the passive pharynx.Isono S, Tanaka A, Tagaito Y, Ishikawa T, Nishino T.
Department of Anesthesiology (B1 Graduate School of Medicine, Chiba University, Chuo-ku, Chiba, 260-8670, Japan. isonos-chiba@umin.ac.jp

A collapsible tube surrounded by soft material within a rigid box was proposed as a two-dimensional mechanical model for the pharyngeal airway. This model predicts that changes in the box size (pharyngeal bony enclosure size anatomically defined as cross-sectional area bounded by the inside edge of bony structures such as the mandible, maxilla, and spine, and being perpendicular to the airway) influence patency of the tube. We examined whether changes in the bony enclosure size either with head positioning or bite opening influence collapsibility of the pharyngeal airway. Static mechanical properties of the passive pharynx were evaluated in anesthetized, paralyzed patients with sleep-disordered breathing before and during neck extension with bite closure (n = 11), neck flexion with bite closure (n = 9), and neutral neck position with bite opening (n = 11). Neck extension significantly increased maximum oropharyngeal airway size and decreased closing pressures of the velopharynx and oropharynx. Notably, neck extension significantly decreased compliance of the oropharyngeal airway wall. Neck flexion and bite opening decreased maximum oropharyngeal airway size and increased closing pressure of the velopharynx and oropharynx. Our results indicate the importance of neck and mandibular position for determining patency and collapsibility of the passive pharynx.

Elevating the entire back has been shown to reduce airway closing pressure

Effects of sleep posture on upper airway stability in patients with obstructive sleep apnea.Neill AM, Angus SM, Sajkov D, McEvoy RD.
Sleep Disorders Unit, Repatriation General Hospital, Adelaide, Australia.

Changes in sleep posture have been shown to improve obstructive sleep apnea (OSA). To investigate the mechanisms by which this occurs we assessed upper airway stability in eight patients with severe OSA in three postures (supine, elevated to 30 degrees, and lateral). We used a specially adapted nasal continuous positive airway pressure (nCPAP) mask to measure upper airway closing pressure (UACP) and upper airway opening pressure (UAOP) during non-REM sleep. Statistical comparisons were made between postures using ANOVA for repeated measures. Elevation resulted in a less collapsible airway compared with both the supine and lateral positions (mean UACP: 30 degrees elevation -4.0 +/- 3.2 compared with supine 0.3 +/- 2.4 cm H2O, p < 0.05 and; lateral -1.1 +/- 2.2 cm H2O, p < 0.05). Supine UACP and lateral UACP were not significantly different. Elevation or lateral positioning produced a 50% reduction in mean UAOP (supine 10.4 +/- 3.5 cm H2O compared with 30 degrees elevation 5.3 +/- 2.1, p < 0.05; and lateral 5.5 +/- 2.1 cm H2O, p < 0.05). We conclude that in severely affected OSA patients upper body elevation, and to a lesser extent lateral positioning, significantly improve upper airway stability during sleep, and may allow therapeutic levels of nCPAP to be substantially reduced.

Anonymous wrote:Just to play devil's advocate.... People in the 18th and 19th centuries slept in a slightly sitting up position. It was considered more healthful, and allowed the "bad humors" to drain from the lungs. Very few people slept prone - and mostly they were people sleeping out on the ground.

Anyone with upper respiratory congestion will understand that.

I don't sleep that way, but I would recommend it to anyone with lung problems. I think the only reason I sleep flat is that I haven't learned how to sleep elevated. If I could learn, I would do it. Any doctor will tell you it's better for lung function.

Do not be fooled by museums that claim the beds of the time were shorter because people were shorter. They were not. Beds were shorter to FORCE people to sleep in an elevated posture on a stack of pillows.

Cheers,
B.

My only problem with the old days was the "Pea" they used to put under my bedding hurt my back and kept me awake. Jim