Snoring, sleep apnea, and how functional breathing can help

It’s estimated that 25-45% of adults snore occasionally, with up to 25% snoring regularly. Snoring generally occurs when air passes through the soft tissues in our upper airway (soft palate, tongue, uvula) causing them to vibrate. This is the type of snoring typically associated with mouth breathing. However, it is possible to suffer from nasal snoring which can be caused by narrow nasal passages, congestion, or a deviated septum. Rather than the deeper snore associated with mouth breathing, nasal snoring tends to be softer with a higher pitch—often sounding like humming or whistling.

Sleep apnea is when a person repeatedly stops breathing during their sleep.  This can vary from a few pauses to, in severe cases, more than thirty times an hour. Sleep apnea is often linked to snoring but is a distinct condition. Some people who suffer from sleep apnea may not snore at all. Sleep apnea is a serious and potentially life-threatening illness due to oxygen deprivation. It is also associated with an increased risk of other illnesses such as heart disease and stroke. 

Symptoms of sleep apnea include:

• Excessive daytime fatigue

• Poor cognition/memory

• Headaches (especially upon waking)

• Waking with a dry mouth

• Restless sleep

• Being woken by gasping or choking

• Needing to pee frequently during the night

The only way to confirm a diagnosis is to participate in a sleep study, so if you have concerns talk to a medical professional about your symptoms and treatment. Breathwork training is complementary to, but not a substitute for, a proper assessment and treatment. It is worth noting that many of these symptoms are similar to those experienced by women going through menopause.

Snoring is often associated with men but we don’t have a monopoly. In fact, women going through perimenopause are more likely than men of the same age to start snoring and hormonal changes during this time are also linked to an increased risk of developing asthma (although the cause and effect is not fully understood). Fluctuations and reductions in the hormones oestrogen and progesterone affect a woman's breathing, and the tone of the smooth muscles that provide functional support for the airways. When we lose tone in the smooth muscles, we lose the ability to control the diameter of these airways. This leads to narrowing of the windpipe, making it harder to breathe.

So how can functional breathing help?

Breathing through the nose is a simple and effective place to start. Nasal breathing has many benefits. It increases the production and distribution of nitric oxide. When drawn into the lungs, that gas dilates the airways and blood vessels. It balances your carbon dioxide levels which improves the oxygenation of your cells. And it supports the health of the smooth muscles that enable our airway (trachea and bronchial tubes) to stay open. 

How nasal breathing helps is a complicated process, but the release of nitric oxide, diaphragmatic breathing, preserving healthy levels of carbon dioxide, and keeping our nervous system in a well-balanced state, all support the proper function of the airways. It’s not so much a workout for the smooth muscles, as it is creating an environment that supports optimal functioning.

On the flip side, mouth breathing is likely to increase the risk of snoring and sleep apnea. When we breathe through the nose, the correct position for the tongue is against the hard palate (roof of the mouth). This creates an open airway. When we mouth breathe, the tongue releases back and down to allow air to pass through the oral cavity. This narrows the airway.

If we breathe through the mouth when we sleep, the back of the tongue can end up pressing against the throat causing a partial or full obstruction of the airway. This is exacerbated when we sleep on our backs because gravity presses the tongue towards the back of the throat. The smooth muscles that support the windpipe can also lose tone allowing the windpipe to narrow. These these things can contribute to dysfunctional breathing that can lead to snoring and possibly sleep apnea. Other risk factors for sleep apnea include obesity, a large neck circumference, a naturally narrow airway, nasal congestion, smoking, and drinking alcohol.

By making nasal breathing your default during the day you create the conditions for healthier airways, steadier breathing, and better overall oxygenation. In time, that can also move to become your default when you sleep, reducing the risk of snoring, improving sleep quality, and lowering the likelihood of developing sleep apnea (noting the wide range of factors that can contribute to that condition). Functional breathing isn’t a quick fix, but with consistent practice it can transform how you breathe at night and how you feel during the day.wellbeing.