Are you tired all the time? Do you have trouble staying awake in the afternoon and often fall asleep watching TV? Has your sex life dried up?
If so, you may be suffering from an often undiagnosed condition called sleep apnea. It is estimated that at least ten million people in the UK have sleep apnea, but fewer than 15 per cent of those affected know they have it, let alone receive treatment. And the people least likely to receive treatment are women.
People with sleep apnea repeatedly stop breathing (this could be for a few seconds or more than a minute) during the night.
That not only disrupts sleep, but over time leads to weight gain and an increased risk of heart disease and stroke. It also reduces the production of sex hormones such as estrogen and testosterone, although it is not clear why, and reduces sex drive.
I’ve always associated sleep apnea with overweight men who snore, and they’re definitely at risk, especially since excess fat around the neck puts pressure on the upper airway during sleep.
It is estimated that at least ten million people in the UK have sleep apnea. File image
But as I discovered while doing a new series on sleep, sleep apnea affects all ages — and is common among women (according to a Swedish study, 20 percent of women have moderate to severe sleep apnea, and 90 percent of those don’t know that they have).
The main form of sleep apnea, obstructive sleep apnea (OSA), usually occurs when your tongue falls back and partially blocks your airway.
When it gets more severe, that blockage means you stop breathing, which wakes you up so you can shift, perhaps from lying on your back to lying on your side, to clear the blockage.
Regularly cutting off your oxygen supply and being constantly awake can be harmful to your brain and body. It is a major cause of severely elevated blood pressure, leading to strokes, fatigue and irritability.
It can even kill you. The actress Carrie Fisher, known as Princess Leia in Star Wars, died at the age of 60 of a heart attack while on a plane. The coroner said the main contributing factors were untreated sleep apnea and a buildup of fatty tissue on the walls of her arteries. Men are often diagnosed because their partner notices snoring, regular breathing stops, and gasping or snorting sounds.
Unfortunately, men don’t seem to realize when the same thing happens to women, so women don’t get rushed to the doctor as often.
Women also often have slightly different symptoms – so when they go to the doctor they often report fatigue, headaches or restless legs, for example, which their GP may not immediately recognize as being linked to sleep apnea. Why women are more prone to these symptoms is unclear, but one theory is that they tend to have different sleep cycles and this leads to fewer but more severe apneas (awakening).
Sleep apnea gets worse after menopause, partly because women are more prone to weight gain, but also because of the drop in the hormones estrogen and progesterone, which strengthen the upper airways and prevent them from collapsing.
A Norwegian study published last year in PLOS One found that women with lower levels of these hormones are much more likely to snore and have sleep apnea.
But if you’re referred for testing and it turns out you have OSA, you have a few options. Losing weight is a good place to start. Although slim people can develop OSA, it is more common in overweight people.
For a study in Finland, a group of overweight or obese people with OSA were put on a rapid weight-loss diet (800 calories per day for up to 12 weeks; similar to my Fast 800 program). They lost an average of 10.7 kg, and more than half of them cured OSA. Even if they lost only 3 kg and kept it off, their chance of curing their OSA was still 38 percent.
Another option is to buy a device that lets you sleep on your side instead of your back. I’ve seen one that you wear around your neck while you sleep, that vibrates you a little when it detects you’re lying on your back and urges you to move. Sewing a tennis ball into the back of your pajamas would have a similar effect. I know people who swear by this.
There is also something called a mandibular musculoskeletal system (MAD), which you normally get from a dentist, which is a bit like an advanced mouthguard. When you put it in at night, it advances your lower jaw (and tongue), keeping your airway clear.
If you have severe sleep apnea, you may be prescribed a continuous positive airway pressure (CPAP) device. It sits next to your bed and pumps air into a mask that covers your nose and mouth while you sleep. The pressure of the air keeps your throat open so you don’t stop breathing.
It can be a lifesaver, but it also has drawbacks. You have to wear a mask to bed every night, and looking like Darth Vader can be a bit of a passion killer too.
Women usually have slightly different symptoms – fatigue, headaches or restless legs. File image
If nothing else works, there’s uvulopalatopharyngoplasty — surgery to burn or cut away tissue in your throat to try to remove the obstruction. This has risks, recovery is painful and not always effective.
However, there is another hope on the horizon. In a study published last December in the journal Chest, researchers tested a nasal spray containing a drug designed to prevent the collapse of the upper airways during sleep.
They found that it was much more effective at keeping patients’ airways open compared to a placebo.
The next step is bigger trials, but it’s an exciting possibility for the millions who suffer from sleep apnea — albeit not silently.
Tennis players right to moan
Lately I have started moaning and grunting when I get up from a chair. It’s not that it takes a lot of effort, it’s just something I started doing subconsciously.
So I’ve started looking at the research to try to determine why this might be.
One theory I came across is that grunting helps prepare you for the effort of getting up. A small study in the Journal of Strength and Conditioning Research found that tennis players’ serve power and speed increased when they were allowed to grunt. Alternatively, growling may simply be an unconscious expression of frustration that you can no longer effortlessly do something (such as getting up from a chair) that you once took for granted.
If you’re a fellow grunter and embarrassed about it, I’ve been told that one way to reduce the noise is to take a few slow, deep breaths before standing up.
Or you can just ignore it, because everyone you know is probably grunting or moaning too.
Having a pet can prevent egg allergy
I love cats and dogs and, as anyone who has one knows, petting and having company can improve your mood and reduce stress.
In fact, a recent Ohio State University study found that neighborhoods with more dogs have fewer robberies and assaults. Research now shows that living with cats and dogs reduces the risk of children developing food allergies.
Allergic diseases – asthma, eczema, hay fever – and food allergies are caused by your immune system overreacting and treating harmless substances such as pollen, nuts or eggs as dangerous threats.
Research shows that living with cats and dogs reduces the risk of children developing food allergies. File image
Previous research has shown that children growing up on a farm are less likely to develop allergic diseases, probably because life on a farm exposes them to many microbes, which helps their immune systems learn how to behave. Now a study published in PLOS One shows that children get similar benefits from growing up with cats and dogs.
Researchers in Japan looked at more than 65,000 children and found that those who had cats or dogs at home when they were younger were less likely to have food allergies by age three.
Owning a dog reduces the risk of developing egg, milk, and nut allergies; while having cats led to significantly fewer allergies to eggs, wheat, and soybeans, though it’s not clear why there is this difference.
Another reason to love our canine and feline friends.