Sleep apnea is a medical condition mostly prevalent in Western countries. Its effects spread across the population, affecting 10-17% of adult men in the US and 3-9% of adult women in the US. Obstructive sleep apnea is also rising as the number of people with obesity increases.
Sleep apnea has health implications as it increases the risk of people getting other chronic health conditions like cognitive dysfunction, daytime sleepiness, high blood pressure, anxiety, and overall risk of death. In fact, cardiovascular disease risk is twice as high in people suffering from moderate to severe sleep apnea.
Before we look at the sleep apnea diet, let’s try to understand everything about the condition.
What Is Sleep Apnea?
Obstructive Sleep Apnea (OSA), also commonly known as sleep apnea, is having persistent episodes of upper airway collapse when sleeping. This leads to a condition where a person’s airway is blocked, making it difficult to breathe. The tongue and the soft palate collapse on the back of the throat, blocking the regular flow of air in the lungs.
An average person with sleep apnea has about 15 episodes of not being able to breathe each hour during sleep. Individuals with sleep apnea cannot sleep well and will have several episodes of “waking up” to allow breathing. Since they don’t have enough sleep, people with apnea may develop daytime sleepiness, fatigue, and other medical conditions.
Clues You Might Have Sleep Apnea
Feeling tired when you wake up in the morning? Or do you wake up with frequent headaches? Has your bed partner moved to the next room? If so, you may have obstructive sleep apnea (OSA).
The surest way to find out if you have this condition is through a sleep study; a test used to record what happens to you during sleep. However, there are a few common signs of sleep apnea, including:
Loud and consistent snoring
Excessive sleepiness when you wake up
Breathing pauses when sleeping
But should everyone who snores see a specialist?
Most people use the words snoring and sleep apnea interchangeably. However, most people who snore don’t necessarily have sleep apnea, but people with sleep apnea snore. People with sleep apnea wake up frequently mid-sleep to gasp for air. If you’re sleeping alone and don’t have someone to monitor your sleep, you may have to record yourself and contact a doctor for a diagnosis.
Another less common sign of sleep apnea is waking up with a dry mouth and gummy front teeth. It is visible in people with sleep apnea as they sleep with their mouths open. Other studies also show that people with sleep apnea wake up frequently with a desperate urge to urinate.
Some people with sleep apnea have also reported symptoms like mood changes, lower back pain, depression, or issues concentrating.
What Are The Risk Factors Of Obstructive Sleep Apnea?
Though anyone can get sleep apnea, a few factors can increase the risk of contracting this condition.
Large Tonsils of Adenoids
Some people have small airways or large tonsils, which can bring up difficulties breathing during sleep. Studies show that large adenoids and tonsils are the major causes of obstructive sleep apnea.
Jaw Misalignment and Size
Some genetic factors or conditions may cause an imbalance in facial structure that can place your tongue back further down the mouth, and it can consequently block the airway and lead to sleep apnea.
The most popular risk factor of sleep apnea has excessive weight, and some studies suggest that sleep apnea in obese people is as high as 40 percent. The fat accumulating in the neck area around the tongue may block the palates and cause sleep apnea. It becomes much more difficult to breathe when lying down.
High Blood Pressure
People who suffer from hypertension are more likely to have sleep apnea, as hypertension has been associated with untreated sleep apnea.
When you have breathing difficulties during sleep, the oxygen levels fall. Your brain sends signals to the body to narrow the blood vessels and increase blood and oxygen flow to the brain.
The rise in adrenaline signal may be present during the day, even when you’re breathing normally. Continuous tightening of blood vessels may later set the stage for hypertension.
In 2019, a study published in the Journal Diabetes Care found that those with type 2 diabetes were almost twice as likely to have sleep apnea than those without diabetes. Although being obese may be the link, insulin resistance in diabetes can also cause symptoms of obstructive sleep apnea.
There’s scanty evidence of sleep apnea causing type 2 diabetes, though some evidence shows a huge number of diabetes type 2 patients with undiagnosed sleep apnea. So, it’s crucial to check out for sleep apnea symptoms if you have type 2 diabetes.
Chronic Nasal Congestion
Those with persistent nasal congestion at night have a higher chance of developing obstructive sleep apnea, probably due to the constricted airways.
Research shows that people with asthma are more likely to develop sleep apnea. Also, the two are linked so that symptoms of either of the two can increase the other one to become severe.
Gender and Age
While sleep apnea can occur at any age, male adults are more likely to develop this condition due to fats and hormone distribution.
Other sleep apnea risk factors include heart failure, smoking, alcohol, asthma, brain tumor, stroke, etc. Veterans can also have sleep apnea issues. See our article on VA ratings and sleep apnea treatment.
Obstructive Sleep Apnea And Diet
The above risk factors show that sleep apnea strongly links diet and lifestyle. Food is at the foundation of healthy living and needs careful consideration for those with sleep apnea symptoms.
First off, food will not cure sleep apnea! However, it will reduce the risk factors and help you sleep better. Also, some foods do the opposite and alleviate sleep apnea symptoms. There is not much evidence to prove that foods can directly help sleep apnea, but there are foods that can promote better sleep, which is a step closer to sleep apnea treatment.
Taking foods with sleep-promoting compounds such as Melatonin and tryptophan can help improve sleep patterns.
The Mediterranean Diet is a favorite among nutritionists and weight watchers. It is backed by a ton of evidence showing benefits to chronic diseases and increasing the quality of life. Also, there is evidence that shows the Mediterranean Diet could help in treating sleep apnea symptoms.
So, what is the Mediterranean Diet?
It is based on the historic food habits of the habitats of the Mediterranean region. The diet is mainly composed of plants and moderate amounts of poultry, fish, eggs, and dairy. Sweets and meats are rarely a priority.
One study observed participants after 6 months on a Mediterranean Diet and found that those with obstructive sleep apnea had lower apnea episodes during REM sleep. The diet has good anti-inflammatory properties and is known to reduce oxidative stress, improving the upper muscle airways.
Scientists believe that the Mediterranean diet improves sleep quality due to the low-fat foods found in the diet. It is also a weight-reducing diet, so the lower body weight most likely has some benefits to improving sleep.
No matter the mechanism, the Mediterranean Diet is still an excellent, healthy choice that shows great potential in improving sleep quality. It is certainly good to stick to this diet for sleep apnea treatment.
When changing to this diet, you don’t have to go all the way to the Mediterranean. The basics are cross-cultural and can be applied to familiar foods. Some common Mediterranean basics include:
Meatless Monday. Choose at least one day without taking meat and replace it with legumes like beans, chickpeas, and lentils. These plant-based proteins can contribute to better sleep quality.
Aromatics are a must. Treat onions and garlic like base ingredients for your foods as they have good anti-inflammatory properties.
Fish. Choose one day of the week to eat fish and other seafood. The omega3 fatty acids are anti-inflammatory and ideal for brain health.
Nuts and olive oil. Use olive oil in cooking and eat nuts at intervals during the day.
Fruits and vegetables. These should be included in all your meals!
Veganism has been around for thousands of years, and it is definitely not a new idea. However, it has recently picked up steam with more Americans shifting to the plant-based diet.
So, what is a vegan diet?
It is 100% plant-based, meaning you only consume foods filled with legumes, grains, seeds, fruits, and vegetables. It is completely void of animal products such as dairy, meat, eggs, and honey. Unlike vegan, vegetarian diets may allow animal products such as milk and eggs.
There is little to no evidence of research conducted to study the link between vegan diets and sleep apnea. However, we can look at different ways in which vegan diets may assumably lead to an improved sleep apnea pattern.
Vegan diets are rich in Vitamin C and E, which can help prevent oxidative effects on the body. Also, vegan diets have foods high in Vitamin B6, which helps the body to produce sleep-including brain chemicals(serotonin and Melatonin).
There have been numerous reports of losing weight after switching to a vegan diet, and this is likely possible due to eating more fiber, fruits, and veggies with less ultra-processed foods. So, if a vegan diet has to do with weight loss, then the chances of treating sleep apnea increase significantly.
Taking the amino acid tryptophan can help you get better sleep. It is found in poultry, oily fish, and eggs (non-vegan). You can find tryptophan in seeds, soy, nuts, and beans for plant-based eaters.
Intermittent fasting diet
Intermittent fasting is adopting a lifestyle of not eating at specific times of the day. The most popular way people do this is through fasting while they sleep. Intermittent fasting is nothing like starving yourself, as you’ll be skipping a meal or two during the day.
Intermittent fasting is associated with many benefits, including weight loss and better sleep. Some common intermittent fasting routines include eating from 12 pm to 8 pm and then fasting for the rest of the night (also known as 16:8). Other forms of fasting include eating meals in a short period during the day. You can allocate time slots like 4 or 6 hours between every meal.
Studies show the many perks of intermittent fasting as it can boost the immune system and the secretion of hormones. It can also help fight symptoms of heart disease, Alzheimer’s, obesity,.and type 2 diabetes.
Another benefit of intermittent fasting can be linked to treating sleep apnea. The fasting process allows the heart to get a circadian rhythm which is key to several biological functions like metabolism, appetite, and the sleep-wake cycle.
Your circadian rhythm mainly relies on sunlight, although food is also a strong “time cue.” Sticking to set meal times (like fasting) reinforces the natural circadian rhythm.
Studies also show that intermittent fasting can help boost the human growth hormone. This hormone is produced during sleep and helps the body repair itself, burn fat, and restore muscles. So, people who fast while sleeping may wake up more revitalized and refreshed after sleeping.
Fasting increases the production of orexin-A, a neurotransmitter known to help you stay alert. People who fast may have more focus and energy during the day and better sleep at night due to low orexin-A when asleep.
Even as you practice intermittent fasting, it is crucial to do it correctly and avoid more complications. Here are a few tips for intermittent fasting:
Stay hydrated. Going to bed dehydrated can lower the quality of sleep. So, ensure you drink enough water to satisfy your hunger cravings and make it easier to sleep at night.
Don’t sleep hungry. Setting up for sleep might be too difficult if you have a grumbling stomach. Aim to eat at least three hours before sleep to avoid distracting the digestion process.
Eat healthy foods. Avoid eating foods high in sugar or fat as they have empty calories. It may be easier to digest and stick to the diet if you eat healthy foods.
Choose what works for you. Not everyone will be comfortable with a 5:2 fasting or the common 16:8 fasting. Fasting is gradual, and your body may take a few days to adjust. Give yourself some flexibility as you look for the best fasting routines to help you fall asleep.
Foods That Can Make Sleep Apnea Worse
Some foods are not recommended for sleep apnea patients, especially when taken at night. Changing your eating habits and avoiding these foods may play a huge role in treating sleep apnea. Let’s discuss some foods and beverages that you should trim or avoid entirely to facilitate effortless breathing at night.
There has been a popular myth that intake of high-fat dairy milk can increase mucus production. Though dairy products can offset a “thick” feeling in your mouth, they do not necessarily increase mucus production.
If you feel that you breathe easier when you cut back on dairy, feel free to do so. Research done in 2008 showed that people with sleep apnea who reduced high-fat dairy as part of their diet experienced fewer symptoms.
Bananas are excellent fruits bursting with nutrients and flavor. Unfortunately, they may not be a good choice for individuals with sleep apnea. That’s because they escalate mucus production in the throat and mouth, which can cause breathing problems. If you need to eat bananas, go for the greener ones- they have less effect on mucus production. Also, eating too many bananas can cause weight gain, a risk factor for OSA.
Even as alcohol makes you sleep faster at night, it can reduce your time in REM sleep and cause the muscles in your throat to relax at night. Even if you breathe normally, the effects of alcohol on sleep may trigger episodes of sleep apnea if consumed in large amounts. If you choose to drink, do so in moderation and have your last glass a few hours before sleep.
No doctor will refrain you from eating whole grain foods as they are packed with nutrients and immensely contribute to growth. However, that’s not the case for sleep apnea. Consuming a lot of sugar can trigger an inflammatory response in your body, worsening sleep apnea. Refined carbs also easily contribute to weight gains and possibly obesity.
Fatty meats contain lots of saturated fats and can increase the rate of inflammation in your body. It would be nice to replace it with other leaner alternatives such as chicken breast or fish.
Other Treatments of Sleep Apnea
As you focus on a proper diet for sleep apnea, doubling up with other treatments has a higher chance of relieving sleep apnea or completely curing it. So, it’s only fair to explore other ways to treat sleep apnea.
Continuous Positive Airway Pressure (CPAP)
The top recommendation for sleep apnea patients is usually continuous positive airway pressure (CPAP). It is the industry standard treatment for OSA as it has a higher elimination rate than most treatments.
The CPAP machine is plugged into an outlet and connects to the face through a tube that covers the nose or the nose and mouth. The CPAP machine then blows pressurized air into the sleeper’s airway, making it difficult to collapse. It is considered the most effective treatment, although it is ineffective at treating central sleep apnea.
Since every person has a unique breathing rate, the CPAP is calibrated to one rate which the doctor determines. Some people may find it hard to tolerate the continuous pressure levels, hence other sleep apnea treatment therapies.
Bilevel Positive Airway Pressure (BiPAP)
Whenever a person with sleep apnea struggles with the constant pressure of CPAP, doctors recommend a bilateral positive airway pressure (BPAP or BiPAP). The BiPAP has the same mechanism as a continuous positive airway pressure, connecting to a sleeper’s face via a mask and blowing pressurized air to keep the airway open.
However, the BiPAP machine is slightly different as it releases higher pressurized air when a sleeper inhales and a lower pressure when exhales. This is a great relief for those who have trouble exhaling at the high pressures of CPAP machines. BiPAP is used to treat people with sleep apnea and obesity, or other health conditions.
Automatic Positive Airway Pressure
Automatic positive airway machines are similar to CPAP as they are connected to an outlet and the sleeper’s face to push out air in the nostrils. APAP machines are great alternatives as they enable the sleeper to breathe normally without adjusting the rate. The machine automatically detects the breathing rate and adjusts depending on the sleep stage, sleeping level, and amount of congestion.
APAP machines have pressure sensors and a well-articulated algorithm to calculate the exact amount of air pressure a sleeper needs during sleep. This way, an APAP machine may be a good option for those uncomfortable with the consistent air pressure from a CPAP. Doctors can also set minimum and maximum pressure to ensure there is effectiveness.
Oral Appliance Therapy
There is a significant rise in the popularity of oral appliances as they have become the first choice for many people with sleep apnea. The FDA has approved over 100 oral appliances to treat sleep apnea and snoring. The appliances are worn in the mouth while you sleep.
Oral appliances hug the lower jaw and push it forward enough to keep the airways open and prevent the palate muscles from collapsing. The American Academy of Sleep Medicine (AASM) has approved oral therapy as the first line of treatment for obstructive sleep apnea and snoring. It also recommends oral therapy for patients who cannot tolerate the constant pressures of CPAP.
Sleep apnea can be treated through multiple lifestyle changes that may be triggering its symptoms. These include:
Throat exercises: These are repeated movements in the soft palate, tongue, and throat to improve sleep and reduce contracting airways. Several studies show that participants who engaged in these exercises regularly for three months have improved sleep apnea symptoms.
Weight loss: Research shows that many people who lose weight improve OSA symptoms. So, doctors and other medical practitioners might recommend a weight loss diet to obese patients.
Quitting smoking: Smoking cigarettes increases a person’s risk of having OSA, as in some cases, it helps reduce OSA symptoms. However, more studies need to prove that quitting smoking indeed helps weather OSA symptoms.
When diet and non-invasive devices fail to tend to sleep apnea symptoms, a sleep specialist may suggest surgery to help prevent sleep disorders. The exact surgery a person may go through depends on the patient's anatomy and what is causing the sleep apnea. It is worth noting that surgery is more effective for treating snoring than obstructive sleep apnea.
Tissue shrinkage or removal
Several tissue removal surgeries include uvulopalatopharyngoplasty, radiofrequency tissue reduction, and adenoidectomy. These surgeries will either remove the uvula, adenoid, and other glands that may cause blockage of the airway. The most invasive surgery is tracheotomy, where a hole is created in the patient’s neck to release airflow. This surgery is only recommended for treating adult obstructive sleep apnea or when a person’s life is at risk.
This treatment involves permanently moving the jaw forward to make way for the airway and allow breathing. Studies show that this surgery is 87% effective at reducing sleep apnea symptoms with an 85% success rate, although it may permanently change a person’s appearance.
Some causes of sleep apnea may have something to do with the nasal anatomy. Some patients have a crooked nose wall or nasal growths that block the airway. Doctors recommend nasal surgery techniques such as septoplasty, rhinoplasty, endoscopic sinus surgery, and turbinectomy.
Frequently Asked Questions
What foods should you avoid with sleep apnea?
Foods with high inflammation rates are not good for people with sleep apnea. If you have this condition, avoid eating pork, steak, burgers, sausage, and other zero-calorie foods, and they can also lead to other cardiovascular problems.
Can sleep apnea be fixed with a diet?
A diet can relieve some sleep apnea symptoms, especially when the foods have anti-inflammatory properties. Weight loss can also reduce the sleep apnea severity by as much as 40%.
Do certain foods trigger sleep apnea?
Most dairy products rich in fat, such as cream and certain cheeses, can increase mucus production and trigger sleep apnea. Bananas have the same effect and should not be taken before sleep. Also, eating too much of these foods will cause weight gain and increase the risk of sleep apnea and other chronic illnesses.
Is Melatonin safe for sleep apnea?
No. Melatonin is known to cause relaxation of muscles which is one of the symptoms of obstructive sleep apnea. Too much Melatonin will put you at greater risk of getting OSA.