01 February 2011 ~ 28 Comments

Ask Rash: Misconceptions About Sleep Apnea and The Neurological Effects of Vitamin D Deficiency

Question: I am curious what the biggest misconception is about sleep apnea. And have you found that low Vitamin D is a source of neurological problems?

This seems to be something that many thyroid patients suffer from and are sometimes unaware of. To read more on this topic, check out the comments following Heide’s question in this previous post, as well as Rash’s answer to her in this post. Feel free to post about your own experiences too – it is by sharing that we can learn from each other.

Let’s share our experiences. I’d also be very interested in hearing from those who have been diagnosed with sleep apnea and how they have dealt with/are dealing with it.

First of all, to help you determine if you might suffer from this, Rash would like to ask you the following three questions:

1.    Do you snore at night?

2.    Are you tired during the day?

3.    Do you get up to go to the toilet at night more than once?

Sleep apnea is hugely undiagnosed and many providers do not even screen for it, partly because they are very uneducated with regard to this condition. I see an average of 16 patients a day and of the three I screen I can guarantee that at least two of them will have sleep apnea.

Sleep apnea, if left untreated, can lead to pulmonary hypertension (high blood pressure in the lungs), increased fatigue during the day, cardiovascular disease and leg and ankle swelling due to fluid accumulation caused by cardiac valvular malfunction.

The misconception in sleep apnea is that you either have to have a large neck or be obese. [Editor: Lori also mentioned in her comment on the previous post that she didn’t have the classic symptoms of snoring and breathing pauses while sleeping when she was diagnosed with sleep apnea, so that is perhaps another misconception – that it is always associated with snoring]. However, although this is the reason in the majority of cases, it is not always the case. In some instances the individual is slim, but the problem lies within the brain. This is called central sleep apnea. The brain can fail to signal the breathing centre to breathe adequately, leading to a build-up of waste products that should be expelled with breathing. That is why the three questions posted above are always asked of all our clients as you never know.

The anatomy made simple is as follows. If you have a pipe (blood vessel) 5 cm in diameter (these measurements are not actual size), which is a normal width, blood will pass through the lungs and waste gases your body has discarded will be expelled while oxygen replaces the waste and nourishes our whole body and tissues. You need to allow enough time for this to take place.

Now make the pipe 2 cm in diameter. Blood will pass through it so much faster – like when you put your finger over a hosepipe and the jet gets stronger. Due to the faster blood transport, the exchange of both the waste and oxygen becomes inadequate. This eventually leads to increased pressure in the heart as the heart has a hard time pumping against the increased pressure, which will ultimately lead to heart incompetency. This in turns leads to further problems.

So how does this occur you ask? Well, when you sleep, depending on your anatomy, the tongue and oral pharynx (the part of the throat situated immediately behind the mouth and nasal cavity) relaxes, which causes a partial blockage over your entrance to the lungs. When this occurs, you get a lack of oxygen to nourish your body and hence the excessive tiredness during the day. Furthermore, as the pressure increases in your heart, the body thinks your heart is pumping inadequately and releases a natural diuretic which makes you go to the bathroom a couple of times during the night.

This is so easily treated that if you have sleep apnea and use the CPAP ventilation apparatus you will notice a major increase in energy levels, as well as a reduction in heart and lung problems, especially hypertension (high blood pressure). It also allows you to sleep with your significant other without waking them up.

Regarding the Vitamin D and neurological problems: they are still investigating the relationship, but no peer-reviewed research articles have been conducted. However, there are some preliminary studies showing a link between low Vitamin D and an increase in multiple sclerosis, as well as depression and bipolar disorder. To add to that, there is a very strong correlation between low Vitamin D and cardiovascular disease. In fact, a low Vitamin D level has been shown to increase the risk of a heart attack by 1 in 7. Also, remember Vitamin D and calcium are very important while going through menopause. That is another topic however and I am more than happy to address it if anybody is interested.

I hope I have answered your question and am always open to other questions.

NP Rash

As ever, Rash looks forward to your questions and suggestions on topics you would like him to talk more about – please mail me at: sarah@sarahjdowning.com.

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